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Patient Education

Insomnia / Sleep Disorders

Thoughtful, root-cause care to help you fall asleep, stay asleep, and wake up restored.

Insomnia is more than the occasional restless night — it's persistent difficulty falling asleep, staying asleep, or waking unrefreshed, often leaving you depleted by day. As your Los Angeles primary care physician, Dr. Golian looks beyond the symptom to identify what's disrupting your sleep, whether it's stress, a medical condition, or habits that quietly work against you. Because poor sleep so often travels with anxiety and depression, she evaluates the whole picture rather than treating sleeplessness in isolation.

Symptoms & Warning Signs

  • Difficulty falling asleep despite feeling tired
  • Waking frequently during the night or far too early
  • Daytime fatigue, low energy, or trouble concentrating
  • Irritability, low mood, or heightened anxiety
  • Relying on alcohol or over-the-counter aids to sleep
  • Dreading bedtime or watching the clock with worry

Causes & Risk Factors

  • Chronic stress, anxiety, or depression
  • Irregular schedules, shift work, or excess screen time before bed
  • Caffeine, alcohol, or certain medications
  • Underlying conditions such as untreated thyroid imbalance or chronic pain
  • Sleep apnea or other primary sleep disorders
  • Hormonal changes and the natural shifts of aging

How Dr. Golian Manages Insomnia / Sleep Disorders

Dr. Golian begins by listening — mapping your sleep patterns, daily habits, and stressors — and screening for contributors like anxiety, depression, or thyroid imbalance with targeted thyroid function testing when appropriate. Her first-line approach emphasizes a structured sleep hygiene protocol, which builds the consistent routines and environment that make natural, lasting sleep possible.

When evidence-based behavioral strategies need reinforcement, she offers careful prescription sleep aid management — used judiciously, at the lowest effective level, and reviewed regularly. If a primary sleep disorder such as sleep apnea is suspected, she coordinates specialist evaluation, including referral to a trusted specialist, such as at Cedars-Sinai, so the right diagnosis guides your care.

Living Well with Better Sleep

Small, steady changes often make the biggest difference: a consistent wake time, a wind-down routine, limiting late caffeine, and reserving the bed for sleep. Because sleep, mood, and stress are deeply connected, addressing anxiety or coordinating cognitive behavioral therapy frequently improves the nights as well. Dr. Golian partners with you over time, adjusting the plan as your sleep and your life evolve.

Frequently Asked Questions

1When does trouble sleeping become insomnia I should see a doctor about?
If sleep difficulty happens at least three nights a week for a month or more, or it's affecting your mood, focus, or daily function, it's worth an evaluation. Persistent insomnia often has an underlying cause that's very treatable once identified.
2Do I have to take medication to fix my insomnia?
No. Dr. Golian's first-line approach is behavioral — a structured sleep hygiene protocol and, when helpful, cognitive behavioral therapy. Medication is considered only when needed, used at the lowest effective level, and reviewed regularly.
3Could my insomnia be caused by another health condition?
Often, yes. Anxiety, depression, thyroid imbalance, chronic pain, and sleep apnea can all disrupt sleep. Dr. Golian screens for these contributors so treatment addresses the real source rather than just the symptom.
4Will I need a sleep study?
Not always. A sleep study is recommended when a primary sleep disorder such as sleep apnea is suspected. When it's appropriate, Dr. Golian coordinates the evaluation, including referral to a trusted specialist, such as at Cedars-Sinai.
5Are sleeping pills safe to use long term?
Most prescription sleep aids are best used short-term and selectively, as some carry risks of dependence or next-day grogginess. Dr. Golian manages them carefully and prioritizes durable, non-medication strategies for lasting results.

Ready for Restful Sleep Again?

Let Dr. Golian help you uncover what's keeping you awake and build a personalized plan for insomnia and sleep disorders.

Schedule a Consultation

Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

Some listed indications involve investigational/off-label use. Learn more.