What this can feel like.
- You wake at the same time every night, and the brain is already running before you've opened your eyes.
- You can argue down the worry intellectually and still not sleep.
- You start dreading bedtime by the afternoon.
- You're "tired but wired" — the body wants sleep and the mind has refused it for so long it's forgotten how.
- You're working harder during the day to make up for nights you keep losing.
- Your morning self is short, snappish, and a stranger to your evening self.
Stress-related insomnia is not a discipline problem. The more you try to force sleep, the further it moves. The intervention is structural, not heroic.
How therapy can help.
Cognitive-behavioral therapy for insomnia (CBT-I) is the first-line treatment, with stronger evidence than most medications for long-term outcomes. It works by gently restoring the brain's natural sleep-wake patterning — sleep restriction, stimulus control, and the cognitive work of teasing apart the worry-about-sleep from the actual sleep problem.
For insomnia that's part of a larger picture (anxiety, burnout, grief), we pair CBT-I with the broader work — because if you don't address why the alarm system is running, you can fix the sleep window for a month and still lose it again.
Group is particularly useful here, because a major part of insomnia is the loneliness of being awake at 3 a.m. while the world sleeps. The first week of being in a room with five other people who know that exact feeling is, for a lot of people, the first quiet improvement.
What we work on.
- Reclaiming the bed as a place for sleep, not for thinking.
- Building a wind-down architecture that the brain actually trusts.
- Working with the rumination at 3 a.m. instead of against it.
- Making peace with imperfect nights — the way out is rarely through perfection.
