Sleep is where mental health starts
Poor sleep and mental health problems feed each other. A few bad weeks of sleep can make anyone anxious, irritable and low, and anxiety, depression, ADHD and stress all disrupt sleep in return. Treating sleep directly is one of the most effective things we can do for mood, focus and resilience, and it often makes every other part of treatment work better.
Common sleep problems we help with
- Trouble falling asleep because the mind will not switch off
- Waking at 2 or 3 a.m. and lying awake
- Waking too early and not getting back to sleep
- Unrefreshing sleep and daytime exhaustion
- Night owl patterns that clash with work or school
- Sleep disrupted by shift work, travel, a new baby or perimenopause
- Long-term reliance on sleep aids that no longer work well
Looking for the cause
Insomnia usually has more than one driver. We look at:
- Stress and an overactive mind. Racing thoughts and a high stress response keep the brain alert at night. See cortisol, stress and anxiety.
- Circadian rhythm. Irregular wake times, little morning light and bright screens late at night shift the body clock.
- Caffeine, alcohol and timing of meals. Afternoon caffeine and evening alcohol are common hidden culprits.
- Medical factors. Sleep apnea, restless legs (often linked with low iron), reflux, pain, thyroid problems and hormonal changes all disrupt sleep. Loud snoring or gasping at night should be evaluated for sleep apnea.
- Medications. Some medicines interfere with sleep or cause vivid dreams.
- Mental health conditions. Anxiety, depression, ADHD and trauma all have sleep effects that need treating alongside the sleep itself. See anxiety and panic and depression.
How we treat insomnia
Behavioral sleep treatment
Cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment for chronic insomnia in clinical guidelines. It includes a consistent wake time, using the bed only for sleep, time-limited sleep windows to rebuild sleep drive, and practical techniques for a racing mind. We adapt these methods to your life and support you through the first few weeks, which are the hardest.
Resetting the body clock
Morning outdoor light, regular meal times, movement during the day and dimmer evenings help realign circadian rhythm, especially through dark Pacific Northwest winters.
Calming the nervous system
Breathwork, relaxation training and biofeedback reduce the physical arousal that keeps people awake.
Targeted support
Where history suggests it, we check iron, vitamin D, thyroid and other markers, and consider supplements such as magnesium when appropriate, checked for interactions. See magnesium for anxiety and sleep.
Medication review
If you already take sleep medication, we review it carefully. Any change is planned and gradual; please do not stop a sleep medication abruptly. See medication management and tapering and deprescribing.
Our providers are licensed naturopathic physicians and mental health counselors led by Dr. Koichi Tanji, ND, LMHC. In Washington, controlled substances such as ADHD stimulants and benzodiazepines are outside naturopathic prescribing scope, so when one is part of the right plan we coordinate with your prescribing physician or nurse practitioner.
Simple steps to start tonight
- Pick a fixed wake-up time and keep it seven days a week.
- Get outside light within an hour of waking.
- Stop caffeine by noon and keep alcohol low.
- If you cannot sleep after about 20 minutes, get up, do something calm in dim light, and return when sleepy.
- Keep the bedroom cool, dark and screen-free.
Read more: how to rebuild restorative sleep.
Getting started
We see patients in person at 2135 112th Ave NE, Suite 201, Bellevue, and by secure telehealth anywhere in Washington. We are in-network with Premera, Regence, BlueCross BlueShield, Aetna, Cigna and Kaiser PPO. Most people begin with our Biopsych Assessment. Book online or call (425) 278-6166.
If you are in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911.
