You're lying in bed at 2 a.m., staring at the ceiling, doing the math on how few hours you have left before the alarm. The more you want sleep, the further away it feels. If that scene sounds familiar, you're in good company. Some of the most accomplished, capable people I see in my Los Angeles practice are quietly exhausted.
Here's the good news I tell them across the desk: most insomnia treatment doesn't start with a pill. It starts with a plan. A structured sleep hygiene protocol — the habits, timing, and environment around your sleep — is the foundation, and for many patients it's enough to turn things around.
What is a sleep hygiene protocol, really?
A sleep hygiene protocol is a set of consistent, evidence-based habits that signal to your body when it's time to wind down and when it's time to be alert. It's not a single trick. It's a system.
The pieces sound simple, but they work because of how they stack together:
- A fixed wake-up time, seven days a week — yes, even Saturday.
- Morning light exposure to anchor your internal clock.
- A consistent wind-down routine in the hour before bed.
- A bedroom that's cool, dark, and reserved for sleep.
- Cutting caffeine after early afternoon, and being honest about that 4 p.m. coffee.
I often tell patients to think less about chasing sleep and more about building the conditions that let it happen on its own.
Why can't I just take a sleeping pill?
You can, and sometimes short-term medication has a place — but it treats the symptom, not the pattern. Prescription sleep aids can lose effectiveness over time, carry side effects, and rarely fix the underlying habits keeping you awake. That's why I reach for them carefully and usually briefly, alongside behavioral work rather than instead of it.
For chronic insomnia, the gold-standard first-line treatment isn't a drug at all. It's a structured behavioral approach, often delivered through cognitive behavioral therapy for insomnia. I'll frequently pair a sleep protocol with a CBT referral when the racing-mind piece is the real obstacle.
How do I know if my insomnia needs a doctor?
If poor sleep has lasted more than three nights a week for three months or longer, it's worth a real evaluation. Occasional bad nights are human. A persistent pattern that's wearing down your mood, focus, and health deserves attention.
When someone comes in for sleep, I don't just hand over a checklist. I look for what's driving it. Sometimes it's an unexamined medical issue — thyroid trouble, reflux, sleep apnea. Often it's tangled up with the mind.
Is my insomnia connected to anxiety or depression?
Very often, yes — and the relationship runs both ways. Anxiety can keep your brain switched on long after the lights go out, and lost sleep then makes anxious thoughts louder the next day. Depression shows a similar loop, sometimes as early-morning waking or sleep that never feels restorative.
This is why I treat the whole person, not just the symptom. If I sense anxiety or low mood underneath the insomnia, we address those directly. Improving one almost always helps the other.
What does this look like in my practice?
Because I run a small membership-based practice, I have time to actually get into the details of your nights — not a rushed seven minutes. We map out your real schedule, screens, caffeine, stress, and the workarounds you've been quietly using to cope.
From there we build something realistic. A few changes you can actually keep, layered in over weeks, with check-ins to adjust. If you'd benefit from learning more about the broader picture of insomnia and sleep disorders, we cover that too, so you understand the "why" behind each step.
One thing I want you to hear clearly: needing help with sleep is not a personal failing. It's one of the most common and most fixable problems I see.
If you've been quietly losing sleep here in LA and you're tired of white-knuckling it, I'd genuinely like to help. Reach out to my practice and let's build a plan that gets you back to real rest — the kind you wake up grateful for.