Insomnia treatment in Fort Lauderdale

What happens in CBT-I?

CBT-I stands for cognitive behavioral therapy for insomnia. It is not talk therapy about your childhood. It is a short, practical program focused on sleep. The National Heart, Lung, and Blood Institute describes it as a 6- to 8-week treatment plan.

CBT-I usually includes several parts. Stimulus control means going to bed only when sleepy and getting up if you can't sleep, so your bed becomes a cue for sleep again. Sleep restriction briefly limits your time in bed to match the sleep you are actually getting, then adds time back as your sleep gets steadier. Relaxation training helps your body unwind. The thinking part helps you notice and change worries about sleep that keep you alert at night. The first weeks can feel harder before they feel better, which is one reason it helps to have a doctor guiding the steps.

Why see a sleep doctor who is also an internist?

Insomnia rarely happens in a vacuum. Pain, heartburn, a frequent need to urinate at night, breathing problems, anxiety, depression and hot flashes can all break up sleep. So can common medicines, caffeine and alcohol.

Some sleep disorders also look like insomnia. People with sleep apnea often say they wake up many times a night but don't know why. Restless legs can make it hard to settle down in the evening. A body clock that runs late can feel like you just can't fall asleep.

Because Dr. Ruiz is board-certified in both sleep medicine and internal medicine, he can look at your sleep and your overall health in the same visit. That helps him decide whether insomnia is the main problem, part of something else, or both, and treat what he finds.

Where do sleeping pills fit?

Sleep medicines are not off the table. The American College of Physicians recommends that doctors and patients decide together whether to add a medicine when CBT-I alone has not worked, after weighing the benefits, harms and costs of short-term use.

Every sleep medicine has trade-offs. Depending on the drug, side effects can include next-day drowsiness, dizziness, confusion, and rarely, doing things while not fully awake, such as walking, eating or driving. Some medicines can be habit-forming. Others can interact with medicines you already take. Older adults may be more sensitive to these effects.

If you already take a sleeping pill, do not stop it suddenly on your own. Some need to be lowered slowly. Dr. Ruiz can review what you take and help you make a safe plan.