NYC Psychiatry & Primary Medical:Insomnia & Sleep Disorder evaluation and treatment in Manhattan NYC.
Updated by NatanSchleider, M.D. on January 11th, 2021
DOCTOR IN THE FAMILY: NYC Psychiatry & Primary Medical Care Doctorsspecialize in Insomnia & Sleep Disorder evaluation and treatment in Manhattan NYC from our Manhattan Office or via Telepsychiatry.
Our NYC Psychiatrists follow DSM V(Diagnostic Statistical Manual) criteria in confirming a diagnosis of insomnia.
Symptoms MUST be present at least 3 nights weekly for 3 months DESPITE adequate opportunity to sleep.
Insomnia is an ‘umbrella term’ as there are many subtypes of insomnia but requires ONE of the following form Part 1 AND one from Part 2:
- NIGHTIME: Dissatisfaction with sleep quantity or quality, with one or more of the following symptoms: Difficulty initiating sleep; Difficulty maintaining sleep, characterized by frequent awakenings or trouble returning to sleep after awakenings
- Daytime: The sleep disturbance causes clinically significant distress or impairment in daytime functioning, as evidenced by at least ONE or more of the following:
- Fatigue or low energy
- Daytime sleepiness
- Impaired attention, concentration, or memory
- Mood disturbance
- Behavioral difficulties
- Impaired occupational or academic function
- Impaired interpersonal or social function
- Negative effect on caregiver or family functioning
Insomnia can be divided for the sake of medical treatment into two groups:
- Primary insomnia—These patients present to our office saying ‘Doc, life is great, work is good, I am happy and healthy, I just can’t sleep and I don’t know why. I have ben to a sleep specialist for an overnight sleep study which was negative or inconclusive. Medical treatment for primary insomnia can be started with over the counter medicines like melatonin or diphenhydramine or Zequel; however, most patients have already tried and failed these. We are therefore left with medicines FDA approved for primary insomnia like zolpidem (Ambien), zolpidem CR (Ambien CR—which is approved for chronic insomnia), zalepolon (Sonata), and Lunesta.
- Secondary insomnia—These patients present to our NYC psychiatrists or primary care doctors saying ‘Doc, life is bad, I am stressed, my health good be better, I am unhappy at home or at work, my mind races as I try to sleep.’ These patients have insomnia SECONDARY to underlying problems. These underlying problems must be treated for sleep to improve. Many medicines are available for secondary insomnia. While the benzodiazapenes like alprazolam (Xanax), triazolam (Halcion), diazepam (Valium), etc are good choices for SHORT TERM treatment of secondary insomnia, they can be habit forming if used for months on end. We therefore may prescribe a benzodiazapene to ensure our new patient gets some sleep (as they are often too tired to focus on the consult). After, other medicines can be tried.
Please contact DOCTOR IN THE FAMILY psychiatrists and primary care doctors in NYC if you are seeking diagnosis, second opinion, and/or treatment options for insomnia by calling or texting 646-957-5444.