Insomnia

Many people with insomnia think they simply have “bad sleep habits,” but chronic insomnia is a medical sleep disorder with real daytime consequences. You may notice:

Nighttime symptoms:

• Difficulty falling asleep
• Difficulty staying asleep
• Waking too early and unable to return to sleep
• Sleep that does not feel refreshing

Daytime effects:

• Fatigue and low energy
• Trouble focusing or remembering things
• Reduced performance at work or in school
• Irritability, anxiety, or depression
• Sleepiness that can make driving or operating machinery unsafe

Insomnia can also strain relationships, especially when a bed partner is kept awake as well, leaving both people exhausted. If these problems last a month or longer, professional insomnia treatment is recommended.

Insomnia is often a symptom of another problem rather than a stand‑alone diagnosis. At our Sterling Heights sleep clinic, we look for underlying causes so we can treat the source of your sleep difficulty, not just mask it with pills. Common causes of insomnia include:

• Sleep apnea: A dangerous condition that causes repeated choking or gasping at night; people with sleep apnea rarely feel rested.
• Restless Legs Syndrome (RLS): Uncomfortable leg sensations and an irresistible urge to move the legs, worse at rest or near bedtime, and eased briefly by movement.
• Periodic limb movements: Frequent, repetitive leg jerks during sleep that can repeatedly wake you or fragment sleep.
• Brain chemical imbalances: Wake‑promoting brain chemicals (serotonin, norepinephrine, histamine, dopamine, orexin) may not “turn off” at night, making it hard to sleep.
• Depression and anxiety: Mental health conditions commonly cause or worsen insomnia, and many psychiatric medicines can also interfere with sleep.
• Medications, drugs, and alcohol: Many medicines cause insomnia, and sleeping pills or alcohol can actually make insomnia worse over time.

We also carefully review your lifestyle and sleep habits, because behavior and environment can strongly affect sleep quality.

Before recommending testing or medication, we carefully explore your sleep routine and environment. Poor sleep habits often keep insomnia going even after the original trigger is gone. Sleep can be worsened by:

• Spending too much time in bed: Staying in bed more than 7-8 hours a night often makes insomnia worse rather than better.
• Distractions in the bedroom: TV, bright lights, noise, phones, computers, and tablets keep your brain stimulated and make it harder to fall asleep or stay asleep.
• Irregular schedule: Frequently changing bedtimes and wake times disrupts your body’s sleep–wake rhythm and can lead to chronic insomnia.

As part of your insomnia treatment, we help you reshape these habits using evidence‑based strategies so your bedroom once again becomes a place associated with sleep, not wakefulness.

Not every patient with insomnia needs a sleep study, but in certain situations, testing is very important. At the Sleep & Attention Disorders Institute in Sterling Heights, we start with a detailed conversation about your sleep, health, medications, and daily life. We may recommend:

• Overnight sleep study (polysomnography) if you snore, wake gasping, or if sleep apnea or periodic limb movement disorder is suspected.
• Blood work to check for low iron stores if restless legs symptoms are present.
• Sleep diary or sleep logs to track your bedtime, wake time, naps, and insomnia patterns over 1–2 weeks.

Many people are given sleeping pills as a quick fix for insomnia, but these drugs often lose effectiveness over time and can be habit‑forming. At the Sleep & Attention Disorders Institute, we focus on treatments that work long‑term and address the true cause of your insomnia.

Cognitive Behavioral Therapy for Insomnia (CBT‑I)

Cognitive behavioral therapy for insomnia (CBT‑I) is considered the first‑line treatment for chronic insomnia. CBT‑I is a structured program that changes the behaviors and thoughts that keep you awake and teaches you healthy sleep habits that last. CBT‑I often includes:

• Sleep restriction: Matching your time in bed to the amount you are actually sleeping to strengthen your sleep drive, then gradually increasing time in bed as your sleep improves.
• Stimulus control: Going to bed only when sleepy, getting out of bed if you cannot sleep, and using the bedroom only for sleep (and sex), not TV, reading, or screens.
• Consistent schedule: Waking up at the same time every day and avoiding daytime naps.
• Sleep hygiene: Creating a quiet, dark, cool sleeping environment; avoiding caffeine, nicotine, and alcohol near bedtime; and building a relaxing pre‑sleep routine.
• Cognitive techniques: Addressing racing thoughts, worry, and negative beliefs about sleep that heighten anxiety at bedtime.

These behavioral treatments can be highly effective and do not carry the risks associated with long‑term sedative use.

Medications Used Thoughtfully

Sometimes, medicines are also needed as part of an insomnia treatment plan. Many common “sleeping pills” work by boosting GABA, a brain chemical that slows brain activity, but they often become less effective with time and can be addictive.

Instead of relying on sedative sleeping pills, we may use other non‑addicting medications that influence wake‑promoting brain chemicals, reduce nighttime arousal, or treat contributing conditions such as depression, anxiety, restless legs syndrome, or chronic pain. Our goal is to use the lowest effective dose for the shortest necessary time while we strengthen long‑term behavioral and lifestyle strategies.

The Sleep & Attention Disorders Institute is the oldest fully accredited sleep center in Macomb and Oakland counties and has over 25 years of experience treating insomnia and other sleep disorders. Our insomnia care includes:

• Comprehensive evaluation of chronic insomnia and other sleep disorders
• Screening and treatment for sleep apnea, restless legs syndrome, and periodic limb movements
• Evidence‑based insomnia treatment, including CBT‑I and sleep‑focused habit change
• Thoughtful use of non‑addicting medications when appropriate
• A unique focus on both sleep and attention/ADHD‑related issues, which can overlap with insomnia symptoms

Our mission is simple: help you sleep better so you can feel better, think more clearly, and live more fully.