Sleep Problems
Structured, evidence-based treatment for sleep disorders — distinguishing insomnia, apnea, and restless legs, not just advice to "sleep better."
Why sleep problems need proper assessment
Sleep difficulties are almost never just about sleep. They're frequently either a symptom of an underlying condition or a driver of one — and often, both directions are true at once. Generic advice to "maintain good sleep hygiene" rarely resolves a real sleep disorder, because it addresses habits, not the underlying mechanism.
Assessment distinguishes between disorders that can look similar on the surface but need entirely different treatment — chronic insomnia, obstructive sleep apnea, and restless legs syndrome. The evidence-based treatment for chronic insomnia, CBT-I, is structured and specific — a genuinely different thing from generic tips about screens before bed.
What sleep disorders are commonly assessed?
Occasional poor sleep vs. chronic insomnia disorder
| Occasional Poor Sleep | Chronic Insomnia Disorder | |
|---|---|---|
| Duration | A few nights, tied to a stressor | 3+ nights a week, for 3 months or more |
| Daytime impact | Mild, resolves once stressor passes | Significant fatigue and irritability that persists |
| Response to sleep hygiene | Usually resolves with better habits | Rarely resolves alone — needs CBT-I |
Insomnia vs. sleep apnea — why the distinction matters
| Insomnia | Sleep Apnea | |
|---|---|---|
| Key sign | Lying awake, mind racing | Loud snoring, witnessed gasping |
| Diagnosis | Clinical assessment, sleep diary | Requires a sleep study (polysomnography) |
| Primary treatment | CBT-I, addressing underlying anxiety/depression | CPAP therapy, ENT evaluation — referred appropriately |
Chronic Insomnia
Chronic insomnia often gets worse the harder someone tries to fix it through willpower — watching the clock, dreading bedtime, mentally reviewing sleep hygiene checklists at 2 a.m. CBT-I addresses the thoughts, behaviours, and conditioned associations that sustain insomnia over time, rather than simply offering tips about caffeine and screen time.
Sleep Apnea — Recognised, Then Referred
Sleep apnea often brings people in through the psychiatric door because its most noticeable effect is exhaustion and low mood, not because anyone suspects a breathing problem during sleep. Recognising the pattern matters because this isn't a condition CBT-I or psychiatric medication treats — it needs a sleep study and typically CPAP therapy or ENT evaluation.
An uncomfortable, hard-to-describe urge to move the legs, typically worse in the evening. It affects an estimated 10.6% of the Indian population, yet is commonly dismissed as restlessness or anxiety. It's also strongly associated with iron deficiency, so assessment includes checking iron levels.
83.4% of psychiatric outpatients in an Indian study had some form of sleep disorder. Poor sleep is a core symptom of many mood and anxiety conditions, and independently worsens them — creating a cycle that's hard to break from either side alone. Sleep is assessed as part of every psychiatric consultation here, not treated as a secondary complaint.
What happens at a sleep consultation?
Frequently asked questions about sleep problems
Grouped by topic
Assistant Professor, Department of Psychiatry, NIIMS, Greater Noida, and consultant psychiatrist at Sowaka Care. MD Psychiatry, People's University, with residency training at AIIMS Raipur.
Sowaka Care, Sector Pi-1
Greater Noida, UP
Online follow-ups available
Sleep that actually restores you
Structured, evidence-based treatment — not more advice to try harder to relax.