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Home / Conditions / Insomnia and sleep problems in Houston & across Texas
Insomnia and sleep problems in Houston & across Texas
Sleep is both a symptom and a cause. Left untreated, it quietly undermines every other psychiatric treatment you are on.
Why sleep gets its own page
Sleep problems are treated as a side issue in most psychiatric care — a symptom that will resolve once the depression or anxiety is treated. Frequently it works the other way round. Untreated insomnia worsens depression, amplifies anxiety, degrades attention in ways indistinguishable from ADHD, and destabilises mood in bipolar illness.
Treating the sleep is often what makes the rest of the treatment work.
What gets assessed
- The pattern. Trouble falling asleep, staying asleep, or waking too early — these point in different directions. Early morning waking, for example, is closely associated with depression.
- Sleep apnea. Snoring, witnessed pauses in breathing, morning headaches, daytime sleepiness. It is common, under-diagnosed, and a frequent hidden cause of treatment-resistant depression and of attention problems mistaken for ADHD.
- Circadian rhythm. Shift work, an inverted schedule, or a delayed sleep phase that has been misread as insomnia for years.
- Substances. Alcohol (which fragments sleep architecture even when it speeds onset), caffeine timing, cannabis, nicotine and stimulant medication.
- Medications. Including psychiatric ones. Some antidepressants and stimulants disrupt sleep, and timing adjustments alone sometimes resolve the problem.
- Restless legs, chronic pain, nocturia and other physical causes of fragmented sleep.
Treatment options
Cognitive behavioural therapy for insomnia (CBT-I) is the first-line treatment for chronic insomnia and outperforms medication over the long term. It is specific, structured and available by telehealth, and where it is the right lead you will be told so and pointed toward it.
Medication has a role, particularly in the short term or where insomnia sits alongside another psychiatric condition. Several options carry substantially less dependence risk than the sedative-hypnotics most people have heard of, and choosing between them is part of the appointment rather than a default.
Where sleep apnea or another primary sleep disorder is suspected, you will be referred for a sleep study. That referral is one of the higher-yield things this practice does.
What treatment looks like at Tentie
Sleep is assessed in detail as part of every psychiatric evaluation here, not as an afterthought. Where it is the primary problem it is treated as the primary problem, and where it is a symptom it is treated alongside the condition driving it rather than after it.
Start with an evaluation
| Patients | Adults 18+ |
| Evaluation | Up to 90 min |
| Fee | [$XXX] |
| Format | In person or video |
| Languages | English, Spanish |
Reviewed by José M. Torrijos, MDBoard-certified adult psychiatrist, licensed in Texas. Last reviewed August 2026.
Related
Frequently asked
Can you prescribe a sleeping pill?
Where it is clinically appropriate, yes. But medication is rarely the right long-term answer for chronic insomnia, and the first task is identifying what is actually disrupting your sleep. Some sedative-hypnotics carry dependence and rebound risk that make the problem harder over time.
How do I know if I have sleep apnea?
Common signs are snoring, witnessed breathing pauses, morning headaches, waking unrefreshed and daytime sleepiness. It is diagnosed with a sleep study, which can often be done at home. If your history suggests it, you will be referred.
What is CBT-I?
A structured, short-term therapy specifically for insomnia, usually six to eight sessions. It outperforms medication over the long term and is available by telehealth.
Does alcohol help me sleep?
It shortens the time to fall asleep and fragments the second half of the night, reducing restorative sleep. Many people who use alcohol to sleep are trading sleep onset for sleep quality without realising it.
My ADHD medication keeps me awake. What can be done?
Often a timing or formulation change resolves it. This is exactly the kind of adjustment that gets missed in short appointments and addressed in longer ones.