Insomnia Treatment in NYC That Lasts
Chronic insomnia is treatable, and the first-line treatment isn't a sleep aid. CBT-I works best paired with treatment of the anxiety, ADHD, or depression driving the sleeplessness. At Integrative Psych in Manhattan, one clinician handles both parts of your insomnia treatment in a single plan.
- In-person · Manhattan
- Telehealth · New York
Start with an assessment
Short, private check-ins that help you put words to what you're noticing before your first conversation.
Child ADHD
A check on a child's focus, follow-through, and emotional reactions.
Adult ADHD
A check on focus, organization, and follow-through in adults.
Anxiety
A check on worry, tension, and how much they shape your days.
Depression
A check on mood, energy, and interest in everyday life.
Our clinicians are affiliated with
What is Chronic Insomnia
Insomnia disorder is persistent difficulty falling asleep, staying asleep, or getting restorative sleep, occurring at least three nights a week for three months or longer and causing real daytime impairment. Short-term insomnia after stress or travel usually resolves. Chronic insomnia is a different clinical problem, and it rarely travels alone.
The strongest research links chronic insomnia to conditions a psychiatric practice treats: anxiety that keeps the nervous system hot, ADHD that makes winding down hard, and depression, where early-morning waking is a hallmark. Trauma, thyroid conditions, pain, and perimenopause can drive it too.
- CBT-I is the first-line treatment for chronic insomnia, recommended ahead of medication by the American College of Physicians and the American Academy of Sleep Medicine.
- Chronic insomnia is usually downstream of something else: anxiety that doesn't turn off, ADHD, or depression that has altered sleep itself.
- Sleep medication has a role early or during acute stretches, but on its own it rarely resolves chronic insomnia, because it doesn't reach the driver.
- At Integrative Psych, the clinician treating your sleep is the same clinician treating the condition underneath it, on one plan.
- Your clinician reviews the Sigmund Assessment before your first appointment, so they understand your case from day one.
It tends to show up like this
- Physically exhausted by 10pm, then wide awake the moment your head hits the pillow.
- Racing thoughts at lights-out: tomorrow's meetings, an old conversation, a dread you can't trace.
- Falling asleep fine, then waking at 3am with the volume turned all the way up.
- Clock math every 45 minutes: "if I fall asleep now I'll still get five hours."
- Leaning on melatonin, a drink, or a prescription that worked for a while and stopped.
- Daytime fog coffee doesn't clear, a short fuse, running at 70% of yourself.
Common, treatable, and worth addressing
has chronic insomnia disorder (StatPearls, NCBI Bookshelf)
reports at least one symptom of insomnia (StatPearls, NCBI Bookshelf)
for chronic insomnia, recommended ahead of medication (American College of Physicians clinical practice guideline)
How Insomnia Is Diagnosed
Insomnia is a clinical diagnosis built from your symptoms, sleep patterns, and daytime functioning, not a lab test or overnight study. Those are reserved for ruling out sleep apnea, restless legs, or other primary sleep disorders that need different treatment. A thorough psychiatric evaluation covers your sleep history and routine, screens for anxiety, depression, ADHD, and trauma, reviews medical and medication factors, and looks at what you've already tried.
The Sigmund Assessment captures this before your first appointment, so your clinician already understands the shape of your insomnia and what's likely driving it. That head start matters for sleep in particular, because the driver is often a co-occurring condition a short sleep-only intake would miss.
Treatment Options for Chronic Insomnia
Effective insomnia treatment follows a clear, evidence-based order, and CBT-I leads it.
Cognitive Behavioral Therapy for Insomnia (CBT-I)
CBT-I is the first-line treatment for chronic insomnia, recommended over medication by the American College of Physicians and the American Academy of Sleep Medicine. It's a structured, time-limited protocol, typically 6 to 8 sessions, targeting the thoughts and behaviors that keep insomnia going long after the original trigger is gone: sleep restriction to rebuild sleep pressure, stimulus control to rebuild the bed-sleep association, cognitive work on sleep worry, and relaxation training. Its improvement tends to outlast medication, and it's the backbone of CBT here when sleep is the presenting complaint.
Treating the underlying driver
For most patients, there's an anxiety, ADHD, or depression engine underneath, and treating it alongside CBT-I is what produces lasting change. One clinician handles both threads, so the sleep plan and the underlying-condition plan never work against each other.
Medication
Sleep medication has a role early in treatment, during acute stressors, or when insomnia is too severe to engage CBT-I. Commonly used options include low-dose trazodone, mirtazapine (useful when depression co-occurs), doxepin, ramelteon, and gabapentin when pain contributes. Z-drugs like zolpidem work short-term but carry tolerance and dependence concerns, so they're reserved for short courses. Good medication management matches the drug to the underlying pattern, not the first option on a formulary.
Lifestyle foundations
Consistent sleep and wake times, morning light, an early-afternoon caffeine cutoff, and a realistic wind-down are the floor. Sleep hygiene alone doesn't cure chronic insomnia, but without it nothing else holds, so it's woven in alongside CBT-I rather than handed over as a checklist.
How We Treat Insomnia at Integrative Psych
Insomnia care here is delivered by one clinician in a single plan: CBT-I, treatment of the condition driving the sleep loss, and medication when the picture warrants it, coordinated from the start. No notes shuttled between a prescriber and a separate sleep therapist, no repeating your history to a new face. Our clinicians are board-certified psychiatrists and psychiatric nurse practitioners, and the practice houses clinicians affiliated with the National Institutes of Health, Columbia University, and New York-Presbyterian Hospital. What we offer isn't a sleep-medicine specialty; it's deep expertise in the conditions that drive most chronic insomnia.
Your clinician reviews the Sigmund Assessment before your first appointment, so that appointment moves straight to a plan. The way we treat the conditions behind insomnia is informed by academic research: Dr. Ryan Sultan, Professor of Clinical Psychiatry at Columbia University, has published peer-reviewed work on ADHD, a frequent driver of adult sleep problems, and you can explore the research if you want to look deeper. Care is available in person at our Manhattan office, and by telehealth anywhere in New York State.
Assess
The Sigmund Assessment captures your symptoms, history, and goals before your first appointment, so your clinician already understands your case.
Match
We match you to the clinician best suited to your goals, not the next open slot.
Treat
Therapy, medication, and lifestyle structure delivered from the same chair, so your first appointment moves straight to a plan.
Track
Validated tools track response at regular intervals, so changes are guided by data, not guesswork.
Clinicians who treat insomnia
Board-certified psychiatrists and psychiatric nurse practitioners. The practice houses clinicians affiliated with NIH, Columbia, and New York-Presbyterian.
What Patients Say
Insurance and Billing
Integrative Psych is an out-of-network practice. You pay at the time of service and receive a monthly superbill to submit to your insurer for potential out-of-network reimbursement. Many PPO plans reimburse a portion, and your insurer is the best source for what your specific plan covers. To check yours, call the number on your card and ask about out-of-network reimbursement for outpatient psychiatric evaluations, follow-up visits, and therapy.
Billing, simply
- Out-of-network; you pay at the time of service.
- Monthly superbill provided for reimbursement.
- Many PPO plans reimburse a portion of out-of-network care.
- Call the number on your card to confirm your benefits.
Frequently Asked Questions About Insomnia
What is the best treatment for chronic insomnia?
CBT-I, recommended over medication by the American College of Physicians and the American Academy of Sleep Medicine. It works in 6 to 8 structured sessions and produces results that tend to outlast medication. When anxiety, ADHD, or depression is also present, treating that condition alongside CBT-I produces the most durable improvement. Medication can help early or during acute stretches, but it works best as part of the plan, not the whole plan.
Why am I so tired but can't sleep?
Feeling physically drained yet mentally wired at night is a classic sign of a nervous system running hot all day. Anxiety, ADHD, and chronic stress all keep arousal elevated past bedtime, so you're exhausted and unable to switch off at once. The fix isn't more sleep aids; it's identifying and treating what's keeping the engine running, which is what a full psychiatric evaluation is built to do.
Does ADHD cause insomnia?
ADHD is strongly associated with insomnia, delayed sleep phase, and non-restorative sleep. Many adults with untreated ADHD describe the same pattern: the day finally quiets down, and the brain starts generating ideas and cycling through tomorrow's tasks. Treating ADHD well often improves sleep, though stimulant timing and dose matter, which is one reason a single coordinating clinician helps.
How do I know if my insomnia is right for treatment here?
If poor sleep has lasted three months or more and is affecting your days, an evaluation is worthwhile, and it's an especially good fit when a mental health condition may be involved. Our clinicians' core expertise is in the anxiety, ADHD, depression, and trauma that drive most chronic insomnia, so the practice is well-suited when sleep is tangled up with how you feel during the day.
Is sleep medication safe long-term?
It depends on the medication. Low-dose trazodone, mirtazapine, doxepin, and ramelteon are generally considered safer for longer-term use than Z-drugs like zolpidem and eszopiclone, or benzodiazepines, which carry tolerance and dependence risk. For most chronic insomnia, the more durable answer is CBT-I plus treatment of the underlying condition, with medication used strategically rather than indefinitely.
Where can I find insomnia treatment near me in NYC?
Our office is at 80 8th Ave in Manhattan, where insomnia evaluation, CBT-I, and ongoing care are available in person. We also offer telehealth anywhere in New York State, and CBT-I in particular translates well to virtual care.
Ready to Sleep Again?
You don't need to keep stacking sleep aids and hoping one works. A comprehensive evaluation isn't a commitment to any particular treatment; it's a clear picture of why sleep broke and what's most likely to fix it. Appointments are in person at our Manhattan office or by telehealth anywhere in New York State.
This information is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. If you believe you may have insomnia, consult a qualified healthcare provider for personalized guidance.