Services / Psychiatry / Sleep Disorders
Sleep Disorders
Sleep problems aren't just an inconvenience. When sleep breaks down night after night, it drags on your mood, focus, and health, and it often travels with anxiety, depression, or stress. shrinkMD evaluates sleep the way we evaluate any other medical concern, then builds a plan that helps you sleep without leaning on controlled sedatives.
Medically reviewed by Shariq Refai, MD, MBA, FAPA, board certified psychiatrist · Published June 7, 2026 · Last reviewed June 8, 2026 · Editorial policy
Understanding sleep
Why sleep is a mental health issue
Sleep and mood run on the same wiring. Poor sleep makes anxiety louder and depression heavier, and anxiety and depression make sleep harder to come by. That loop is real, and it's part of why treating sleep on its own, without looking at the whole picture, so often falls short.
Because sleep trouble has so many roots, the first job is figuring out what's driving it. Is it racing thoughts at bedtime, a body clock that's drifted out of sync, an underlying mood condition, or a habit pattern that's quietly making things worse? Naming the cause is what points us to the fix that actually lasts.
What we treat
Sleep concerns we help with
Some of these have their own detailed page. Others we address as part of treating the condition underneath them.
Insomnia
Trouble falling asleep, staying asleep, or waking too early, even when you have the time and the chance to rest.
Learn more →Circadian rhythm disruption
A body clock that's drifted, from shift work, jet lag, or a delayed sleep pattern, so your sleep window doesn't match your life.
Learn more →Sleep tied to anxiety or depression
Sleep that breaks down because of a mood or anxiety condition, where treating the root cause is what restores rest.
Learn more →
Better sleep starts with understanding what's actually keeping you up.
Treatment
How we treat sleep disorders
Thorough evaluation
We review your sleep pattern, daytime function, stress, mood, and habits, and we look for medical contributors and conditions like sleep apnea that need a different path.
CBT-I as the foundation
For chronic insomnia, cognitive behavioral therapy for insomnia, or CBT-I, is the first line treatment, and we coordinate it as the core of your plan.
Non controlled medication when needed
When medication helps, we use non controlled options and never controlled sedative hypnotics, chosen to fit your situation and any conditions underneath the sleep problem.
Consistent follow up
We track how you're sleeping, adjust the plan, and treat any mood or anxiety condition that's keeping you up, so the improvement holds.
Sleep and the mind
The psychiatric vital sign
Sleep and mental health run in both directions. Insomnia raises the risk of developing depression and anxiety, worsens both when present, and is frequently the first symptom to return before a relapse. Treating sleep is often the fastest single lever for improving mood, focus, and irritability.
That is why every shrinkMD evaluation takes a real sleep history: schedule, awakenings, snoring, restless legs, caffeine, alcohol, and screens, because each points to a different problem with a different fix.
Treatment order
Why CBT-I comes before sleeping pills
Cognitive behavioral therapy for insomnia is the first line treatment in every major guideline, and it outperforms medication over the long run. Its core tools are stimulus control, which retrains your brain to associate bed with sleep, and time in bed restriction, which rebuilds deep, consolidated sleep. Generic sleep hygiene advice alone rarely fixes chronic insomnia.
Medication still has a place, especially short term or alongside CBT-I, and we use non controlled options chosen around your other conditions and medications.
Keep exploring
Related care and next steps
Related conditions
Frequently asked questions
Good questions, clear answers
Do you prescribe sleeping pills?
Not controlled ones. shrinkMD doesn't prescribe controlled sedative hypnotics. For chronic insomnia we lead with CBT-I, the proven first line treatment, and we add non controlled medication when it genuinely helps.
Why does my sleep get worse when I'm stressed or down?
Sleep and mood share the same circuitry, so stress, anxiety, and depression all push sleep off track, and poor sleep then makes those feelings heavier. We treat the whole loop, not just one piece of it.
Is CBT-I really better than a pill?
For long term insomnia, yes. CBT-I works as well as sleep medication in the short run and keeps working after treatment ends, which pills don't. That's why it's the recommended first line.
Can you treat my sleep apnea?
We screen for sleep apnea because it's common and important, but it needs a sleep study and equipment like CPAP, which sits outside what we provide. We'll point you toward the right care and treat any mood or anxiety piece alongside it.
How fast can I be seen?
Many people book a full evaluation as soon as availability allows. Sleep problems tend to snowball, so starting sooner usually means an easier path back to rest.
Will treating my anxiety fix my sleep?
Often a large part of it. When anxiety or depression is driving the sleeplessness, treating that condition is frequently what finally lets sleep return, sometimes alongside CBT-I.
Is online care effective for sleep problems?
Yes. Sleep evaluation, CBT-I coordination, and medication management all work well by secure video, and being seen from home fits naturally with a problem that's about your nights at home.
What should I bring to my first appointment?
A rough sense of your sleep pattern helps, like when you go to bed, how long it takes to fall asleep, how often you wake, and how you feel during the day. A simple sleep log for a week or two is even better. And list anything you have tried for sleep, prescription or over the counter, with the dose, how long you used it, and how it worked, that history shapes what we recommend next.
Get started with sleep care
Restful nights are within reach, and you don't need a controlled medication to get there. Choose your state, complete the intake, and book your evaluation online, often as soon as availability allows.
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