Insomnia & Sleep Disorder Treatment at Rittenhouse Psychiatric Associates

Sleep Disorders: Symptoms, Causes & Care Options

At Rittenhouse Psychiatric Associates, our providers evaluate, diagnose, and treat a full range of sleep disorders, including insomnia. Care begins with a comprehensive psychiatric and medical assessment to identify contributing factors such as sleep habits, stress, medications, and underlying conditions. When appropriate, we coordinate sleep studies and collaborate with outside specialists to ensure accurate diagnosis and effective, personalized treatment.

What are Sleep Disorders?

Sleep disorders are conditions that affect the quality, timing, and duration of sleep, often leading to daytime fatigue, mood changes, difficulty concentrating, and impaired performance. These conditions can also increase risk for accidents and worsen underlying mental health concerns. Common sleep disorders include insomnia, sleep apnea, narcolepsy, circadian rhythm disorders, parasomnias such as sleepwalking, and restless leg syndrome (RLS).

Individuals suffering with sleep disorders (or who have distress related to insomnia or other sleep symptoms), often benefit from a full psychiatric and medical evaluation, as many conditions and behaviors can affect sleep, and experts can often help to make a more clear diagnosis and direct proper treatment.

Common Types of Sleep Disorders

• Insomnia: Characterized by difficulty falling asleep, staying asleep, or waking too early. While it is classified as a sleep-wake disorder, it is often closely linked to anxiety, depression, and stress.
• Sleep Apnea: A breathing-related sleep disorder where airflow is repeatedly interrupted during sleep, often leading to daytime fatigue and increased cardiovascular risk.
• Restless Leg Syndrome (RLS): Causes uncomfortable sensations and an urge to move the legs, typically worsening at night and interfering with sleep.
• Narcolepsy and Hypersomnia: Neurological sleep disorders marked by excessive daytime sleepiness and, in some cases, sudden sleep episodes.
• Circadian Rhythm Sleep Disorders: Disruptions in the body’s internal clock that affect sleep timing, commonly seen in shift workers or those with delayed sleep phase.
• Parasomnias: Abnormal behaviors during sleep, including sleepwalking, night terrors, and REM sleep behavior disorder.

How Common are Sleep Disorders?

Sleep disorders are highly prevalent, with insomnia among the most common reasons adults seek care. Approximately 10-15% of adults meet criteria for insomnia disorder, and many ask whether insomnia is a mental illness due to its strong connection with anxiety and depression. In fact, up to 50% of individuals with insomnia have a co-occurring psychiatric condition. Other sleep disorders, including sleep apnea, parasomnias, and restless leg syndrome, also affect a significant portion of the population.

• Insomnia disorder: affects approximately 10-15% of adults
• Parasomnias (sleepwalking, night terrors): affect approximately 1-5% of adults
• Restless Leg Syndrome (RLS): 2% of adults
• Shift Work Sleep Disorder: affects 10-50% of adults in non-traditional work schedules
• Circadian Rhythm Sleep Disorders: affect approximately 3% of adults

Treatment Options for Sleep Disorders and Insomnia

Treatment for sleep disorders is individualized and begins with a thorough evaluation. If you are asking whether insomnia is a mental illness or a symptom of another condition, your provider will develop a plan that addresses both sleep and underlying factors. Treatment may include:

• Psychotherapy, such as Cognitive Behavioral Therapy for Insomnia (CBT-I), a first-line, evidence-based therapy shown to improve sleep in up to 75% of patients with insomnia
• Medication management of underlying psychiatric conditions (such as anxiety or depression, affecting insomnia and sleep disorders).
• Targeted treatment for contributing medical issues, such as iron deficiency in restless leg syndrome. Our providers may coordinate with your primary care provider.
• Medication options for sleep disorders and insomnia may be considered when clinically appropriate, based on symptoms, medical history, and any co-occurring mental health conditions. These may include:
  • Melatonin receptor agonists: Melatonin, Rozerem (Ramelteon)
  • Orexin receptor antagonists: Belsomra (Suvorexant), Quviviq (Daridorexant)
  • Antidepressants sometimes used for sleep: Trazodone, Amitriptyline, Doxepin, Remeron (Mirtazapine)
  • Benzodiazepine receptor agonists: Ambien (zolpidem), Lunesta (Eszopiclone), Sonata (Zaleplon), Restoril (Temazepam)
  • Other medications in select cases: Gabapentin, Seroquel (Quetiapine), especially when a co-occurring psychiatric condition is also being treated

Medications for Shift Work Disorders include:

Provigil (Modafinil)

Nuvigil (Armodafinil)

* Medication decisions are individualized and we consider safety, risk of dependence, and your overall health. Your provider will work with you to determine the most appropriate treatment plan for your sleep disorder.

A Note on Sleep Apnea and Breathing-Related Sleep Disorders

• While Rittenhouse Psychiatric Associates does not perform sleep studies directly, our providers can coordinate care with local sleep labs and specialists to ensure comprehensive evaluation and treatment of conditions such as sleep apnea.

Why Choose Rittenhouse Psychiatric Associates for Sleep Disorder Treatment

• A multidisciplinary team of psychiatrists, nurse practitioners, and psychologists with training from leading institutions such as Johns Hopkins, University of Pennsylvania, and Children’s Hospital of Philadelphia (CHOP)
• In-office and Virtual Telehealth Appointments within 1-2 weeks.
• Evidenced-based and holistic care, which may or may not include medication management. We work with our patients to create an individualized plan that meets your specific needs and preferences for the treatment of Insomnia or your Sleep Disorder.
• Providers licensed in PA, NJ, DE, NY, FL, CA and others. Office locations in Philadelphia, on The Main Line, Pittsburgh, Manhattan, Wilmington, DE and others.