Help for sleep problems tied to anxiety, depression, trauma or stress — built around the cause, with non-habit-forming medication only when it helps.
Tyler Patten, APRN, PMHNP-BC — board-certified psychiatric nurse practitioner
Book Now →Chronic insomnia means trouble falling asleep, staying asleep, or waking too early at least three nights a week for three months or more, with days that suffer for it. It rarely travels alone. Anxiety keeps the mind running at bedtime, depression disrupts sleep timing, trauma brings nightmares, and poor sleep in turn makes all of those worse.
That’s why insomnia often doesn’t respond to a sleeping pill alone. Effective care treats the sleep problem and whatever is feeding it. In Utah, Idaho and Nevada, where psychiatric care is scarce and rural areas have the least of it, many people never get past a short-term prescription.
With video visits, you can get a full evaluation without leaving home — including on the nights and mornings when you’re running on very little sleep.
A mind that races at bedtime or wakes you at 3 a.m. with worry.
Early waking, unrefreshing sleep, or sleeping too much and still feeling exhausted.
Recurrent nightmares that make sleep feel unsafe.
Sleep that won’t settle around nights, rotating shifts or early starts.
Help reviewing or tapering a sleep medication you’ve relied on for years.
Insomnia or grogginess caused by another psychiatric medication.
I start by finding out what’s driving the insomnia: anxiety, mood, trauma, pain, alcohol or caffeine, screen and light habits, irregular schedules, or medical causes. Signs of sleep apnea or restless legs get flagged for the right testing, and cash-pay lab work can check things like iron and thyroid that affect sleep. Nutrition, gut health and stress are part of the picture too.
Cognitive behavioral therapy for insomnia (CBT-I) is the most effective long-term treatment for chronic insomnia, and I’ll point you to CBT-I programs, including app-based and telehealth options. When medication helps, I use non-habit-forming options matched to the cause — for example low-dose doxepin, trazodone, mirtazapine or hydroxyzine — and treat any underlying anxiety or depression directly.
I don’t prescribe controlled sleep medications such as zolpidem (Ambien), eszopiclone or benzodiazepines. If you’re already taking one, we can talk about whether and how to taper safely.
You need to be physically located in one of these states during each video visit.
From the Wasatch Front to small-town Utah, a video visit fits around the hours you’re actually awake and functional.
In Idaho, where psychiatric care is scarcest, sleep problems are usually handled with a quick prescription in primary care. We take a fuller look for adults anywhere in the state.
Shift work, casino hours and long commutes make sleep a constant problem for many Nevadans. Sleep timing is built into the treatment plan from the first visit.
Further reading:
Book a 60-minute evaluation with Tyler Patten, PMHNP-BC. Most new patients are seen within two weeks.
Book Now →Questions first? Call or text (435) 625-3098 or email office@affordablepsych.org.