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Carolina Wellness Psychiatry, PLLC

Psychiatrists serving Raleigh, Durham, and Chapel Hill, North Carolina

Being unable to sleep for a night or two is bad enough, but if insomnia continues for longer periods, it may be a symptom of another medical or psychiatric condition and has the potential to cause serious physical and mental health problems. If you’re having trouble sleeping, turn to Elizabeth Bullard, MD, and Allison Foroobar, MD, at Carolina Wellness Psychiatry, PLLC. Using lifestyle management approaches, sleep behavior modification and medications when required, they provide treatments to relieve your insomnia. Call the office in Chapel Hill, North Carolina, today to schedule a consultation or book an appointment online.

Insomnia Q & A

What is insomnia?

Everyone needs a different amount of sleep for optimal health, but on average, most people do best with seven or eight hours of sleep every night. Insomnia is a common sleep disorder, and can include difficulty falling asleep, difficulty staying asleep, or early morning awakening. 

Insomnia can be short-term or chronic.  Short-term insomnia is common and often results from stress or traumatic events.  Chronic insomnia, lasting for a month or longer, is generally a symptom of another problem – medical and psychiatric conditions, certain medications, substance use, or long-term stress.  

What causes insomnia?

Insomnia can develop as a result of another condition, or as a problem in its own right. Common causes of insomnia include:

  • Stress and anxiety
  • Poor sleep habits
  • Shift work
  • Eating late
  • Depression
  • Caffeine
  • Other stimulants
  • Certain medications
  • Chronic pain
  • Sleep apnea
  • Restless legs syndrome


There are several medications that can affect sleep, including antidepressants, asthma medications, and blood pressure medicines. Even over-the-counter treatments can contain stimulants that make it hard to sleep.

Certain medical conditions like cancer, diabetes, hypothyroidism, cardiovascular disease, asthma, gastroesophageal reflux disease (GERD), thyroid disease, Parkinson's disease, or Alzheimer's disease can also cause insomnia.

How is insomnia treated?

Insomnia, primary or secondary to other medical or psychiatric disorders, can be effectively treated.  Treatment for insomnia may involve lifestyle modification, improving sleep hygiene, effectively treating underlying health conditions, effectively treating underlying psychiatric diagnoses, taking medication, psychotherapy, or both.  

Adopting healthier sleep habits, also known as sleep hygiene, can improve symptoms of insomnia.  These interventions include:

  • Regular bedtime
  • No napping
  • No screen time before bed
  • Comfortable bed
  • No eating before bed
  • No TV in bed


Cognitive-behavioral therapy for insomnia (CBT-I) can be a highly effective psychotherapeutic intervention for insomnia.  It consists of a variety of approaches designed to break the cycle of sleeplessness and could include:

  • Healthy sleep strategies
  • Progressive muscle relaxation
  • Biofeedback
  • Breathing exercises
  • Sleep restriction
  • Reducing anxiety
  • Passive wakefulness
  • Light therapy


Your physician will complete a comprehensive assessment of your symptoms, your comorbid medical and psychiatric diagnoses, your medications, and any dysfunctional lifestyle factors and discuss if medication treatment, psychotherapy, or both are appropriate to reduce symptoms.  

Sleep is essential to everyone’s mental and physical health, so if insomnia is affecting your quality of sleep, call Carolina Wellness Psychiatry, PLLC, today or book an appointment online.