Clarity on Sleep Difficulty & Insomnia
What Is Insomnia?
Insomnia is a sleep disorder marked by difficulty falling asleep, staying asleep, or waking too early despite adequate opportunity for rest. It often leads to daytime fatigue, trouble concentrating, and increased worry about sleep.
Understanding what keeps sleep elusive, and how to rebuild rest
Sleep does not just happen. It is shaped by how your nervous system, thoughts, body rhythms, and daily stress interact. When sleep becomes difficult, it can feel confusing and deeply frustrating, especially when you are doing everything you are supposed to do.
At Clarity Therapy Associates, we help you understand what is interrupting your sleep and how certain patterns, often unintentionally, keep the problem going. With clarity and support, it becomes possible to move out of nightly struggle and toward more consistent, restorative rest.
Anissa Bell, LMFT, provides sleep therapy in California for insomnia and sleep anxiety (telehealth).
When Sleep Feels Out of Reach
Sleep difficulty can show up in many ways, including:
-
Trouble falling asleep for long stretches
-
Waking frequently during the night
-
Waking too early and being unable to fall back asleep
-
Feeling exhausted despite spending enough time in bed
-
A racing or alert mind when you are trying to rest
-
Growing anxiety about sleep itself and its impact on the next day
Many people with sleep difficulty also notice ongoing worry, tension, or hypervigilance during the day. If stress or anxiety is part of your experience, learning more about our work with anxiety and stress may feel especially relevant.
These patterns are not a sign that something is wrong with you. They are signals that your system has learned to stay on high alert.
Understanding the Pattern Not Just the Symptoms
Insomnia is rarely just about bedtime. It is shaped by how your nervous system responds to stress, how your mind relates to sleep, and how your body has learned to associate the bed with effort or frustration.
In therapy, we work together to understand:
-
How thoughts and expectations about sleep affect your body’s ability to relax
-
How daytime stress and overfunctioning spill into nighttime wakefulness
-
How pressure, avoidance, or monitoring sleep can unintentionally reinforce insomnia
-
How routines, habits, and environment influence your internal sleep signals
As these patterns become clearer, sleep often begins to feel less mysterious and less adversarial. Change comes from understanding, not forcing rest.
How Therapy Helps
Effective therapy for insomnia is not about trying harder to sleep. It is about learning how to support your nervous system so sleep can return more naturally and sustainably.
Our work together focuses on:
-
Reducing physiological arousal so your body can downshift at night
-
Changing how you relate to wakefulness rather than battling it
-
Addressing sleep related anxiety, which often keeps insomnia stuck
-
Developing realistic, personalized strategies that fit your life
This approach helps break the cycle of effort, frustration, and fear that keeps sleep problems going.
Our Approach
We use evidence based, sleep informed approaches grounded in how sleep actually works. This includes behavioral strategies, nervous system regulation, and cognitive techniques applied thoughtfully rather than rigidly.
Therapy is personalized to your sleep history, current stressors, and goals. We do not push generic sleep rules or rigid schedules. Instead, we help you understand why your system resists rest and how to work with it more effectively.
Sessions are offered through secure online therapy in California, allowing you to work on sleep patterns consistently from the comfort of home.
Who This Work Is For
This work is helpful for adults who:
-
Lie awake for long periods at night
-
Wake frequently or too early
-
Feel tired but unable to sleep
-
Experience racing thoughts or mental replay at bedtime
-
Worry about how poor sleep affects mood, focus, health, or performance
For some people, sleep difficulty is also closely connected to relationship stress, emotional strain, or difficulty winding down after conflict or ongoing tension.
You do not need to solve your sleep problem on your own. You just need support that helps you understand and shift what is keeping it in place.
Moving Forward
Sleep is a pattern, and patterns can change. With the right support, it is possible to rebuild trust in your body’s ability to rest without force or constant monitoring.
If you are ready to gain clarity on what is interfering with your sleep and begin changing how nights feel, we are here to help.
When Sleep Difficulty May Warrant A Medical Evaluation
-
Some sleep difficulties may benefit from medical evaluation, particularly when symptoms suggest an underlying sleep or medical condition. Examples can include:
-
Loud snoring, choking, or gasping during sleep
-
Uncomfortable leg sensations or urges to move the legs at night
-
Significant daytime sleepiness despite adequate time in bed
-
Insomnia that appears alongside new or worsening medical symptoms
-
This is not an exhaustive list. A medical professional can help determine whether additional evaluation is appropriate.
Therapy can be helpful alongside medical care, and many people benefit from a coordinated approach when sleep difficulties are complex.
Frequently Asked Questions
What causes insomnia or ongoing sleep difficulties?
Insomnia and persistent sleep difficulty often involve a mix of biological, psychological, and behavioral factors. Common contributors include stress and anxiety, conditioned arousal around bedtime, inconsistent sleep schedules, lifestyle factors (e.g., caffeine late in the day), medical conditions, and emotional concerns that keep the mind active at night. Insomnia is most accurately diagnosed when sleep problems occur regularly and interfere with daytime functioning.
What is Cognitive Behavioral Therapy for Insomnia (CBT-I)?
Cognitive Behavioral Therapy for Insomnia (CBT-I) is a structured, evidence-based approach that addresses thoughts, behaviors, and habits that disrupt sleep. It often incorporates sleep restriction, stimulus control (strengthening the bed–sleep association), cognitive restructuring to reduce sleep-related worry, and behavioral techniques to improve routines. CBT-I is recommended as the first-line treatment for adults with chronic insomnia because it improves sleep quality and has lasting effects.
How long does CBT-I usually take?
CBT-I programs are typically delivered over several weeks, often around 6–10 sessions, though the exact number can vary based on individual needs. The focus is on learning and applying practical skills to support healthier sleep patterns, while also understanding the factors that contribute to ongoing sleep difficulties.
When should I consider therapy for sleep problems?
You may want to talk to a therapist or sleep specialist when sleep difficulty:
-
Happens regularly (several nights per week)
-
Interferes with daily functioning (fatigue, mood changes, concentration difficulties)
-
Persists despite good sleep habits
-
Leads to worry about sleep that increases bedtime anxiety
Early support can prevent sleep problems from becoming more entrenched and make behavioral strategies like CBT-I more effective.
Can insomnia improve without medication?
Yes, many people experience significant improvement in sleep through behavioral and psychological approaches without medication. Cognitive Behavioral Therapy for Insomnia (CBT-I), in particular, has been shown to be as effective as sleep medications for many individuals and often produces more sustained benefits over time.
While medication may be part of a treatment plan in some cases, it is not considered the first-line approach for persistent insomnia on its own. Decisions about medication should always be made in consultation with a qualified medical professional.
Can self-guided or AI tools treat insomnia?
Self-guided approaches can be helpful for some people, particularly when sleep difficulties are mild or situational. However, AI tools are not a substitute for clinical care and should not be relied on to treat insomnia.
Persistent or anxiety-driven sleep problems often benefit from working with a trained clinician who can tailor treatment, monitor response, and adjust strategies over time.