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J. Connor Barnhart, MD

Insomnia Treatment in San Francisco

Also known as: Sleep Disorder, Sleeplessness, Chronic Insomnia, Sleep Disturbance, Difficulty Sleeping

3 min readLast updated: 2026-02-20
Reviewed by J. Connor Barnhart, MD

Insomnia is a common sleep disorder that involves difficulty falling asleep, staying asleep, or waking too early and not being able to get back to sleep. It may result in daytime fatigue and impaired functioning. Insomnia can occur alongside many other mental health conditions or by itself.

At a Glance

  • Insomnia can be acute (short-term) or chronic (lasting three months or more)[1]
  • Cognitive behavioral therapy for insomnia (CBT-I) is considered an effective first-line treatment[2]
  • Insomnia affects sleep quality and can result in significant daytime impairment[3]
  • Many people improve with behavioral changes and appropriate treatment

Affected Anatomy

  • Brain and central nervous system
  • Circadian rhythm regulation systems
  • Hypothalamic-pituitary-adrenal axis
  • Cardiovascular system

What are the symptoms of Insomnia?

  • Difficulty falling asleep at night
  • Waking up during the night
  • Waking up too early in the morning
  • Not feeling well-rested after sleep
  • Daytime tiredness or sleepiness
  • Difficulty paying attention or focusing
  • Increased errors or accidents
  • Irritability, low mood, or ongoing worries about sleep

When to See a Psychiatrist for Insomnia

  • Difficulty falling or staying asleep most nights for three weeks or more
  • Daytime fatigue, irritability, or difficulty concentrating due to poor sleep
  • Reliance on alcohol, supplements, or over-the-counter sleep aids
  • Insomnia that is occurring alongside anxiety, depression, or other mood changes
  • Sleep problems that persist despite good sleep hygiene practices
  • Racing thoughts or worry that keep you awake at night

If any of these apply, consider reaching out to schedule a visit.

What causes Insomnia?

Causes

  • Mental health disorders such as major depression, bipolar, or anxiety
  • Poor sleep habits and irregular sleep schedule
  • Eating too late in the evening
  • Medical conditions, particularly those that cause pain or discomfort
  • Use of substances like caffeine, nicotine, and alcohol
  • Certain medications

Risk Factors

  • Age over 60
  • Mental health conditions
  • Physical health conditions
  • High levels of stress
  • Irregular schedule or shift work
  • Travel across time zones

How It's Diagnosed

  • 1Comprehensive history
  • 2Physical examination and lab testing
  • 3Sleep diary tracking in some cases
  • 4Sleep study (polysomnography) in some cases

How is Insomnia treated?

I offer several approaches for insomnia:

Psychodynamic Therapy

Psychodynamic therapy is an evidence-supported form of talk therapy rooted in longstanding psychoanalytic theory about how unconscious thoughts, past ...

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Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a structured, evidence-based form of psychotherapy that focuses on identifying and modifying unhelpful patterns ...

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Psychotherapy

Psychotherapy, also called talk therapy, refers to a variety of treatment approaches that aim to help a person identify and change troubling emotions,...

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Medication Management

Medication management refers to the ongoing, physician-supervised process of prescribing, monitoring, and adjusting psychiatric medications to treat m...

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Lifestyle Optimization

Lifestyle optimization is an evidence-based approach to mental health that uses individually tailored behavioral interventions – including sleep hygie...

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Prognosis and Recovery

  • Many people improve with behavioral changes and treatment
  • Addressing underlying causes often improves sleep quality

Frequently Asked Questions

Insomnia is a common sleep disorder that involves difficulty falling asleep, staying asleep, or waking too early and not being able to get back to sleep. It can be acute (short-term) or chronic (lasting three months or more), and often results in daytime fatigue and impaired functioning.
Common symptoms include difficulty falling asleep at night, waking up during the night or too early in the morning, and not feeling well-rested after sleep. Many people also experience daytime tiredness, difficulty concentrating, irritability, and ongoing worries about sleep.
Insomnia can result from other mental health conditions like depression and anxiety, poor sleep habits and irregular sleep schedules, and certain medical conditions. Taking substances like caffeine, nicotine, alcohol, and certain medications can also contribute.
See a psychiatrist if trouble sleeping persists for more than three weeks, occurs alongside mood or anxiety symptoms, or impairs your daytime functioning. Psychiatric evaluation can help identify underlying causes.
Treatment options include cognitive behavioral therapy for insomnia (CBT-I), which addresses sleep-related thoughts and behaviors, sleep hygiene improvements, relaxation techniques, and lifestyle modifications. Medications or supplements help some people, particularly those with co-occurring mental health problems.
Many people improve with behavioral changes and treatment. Chronic insomnia may require ongoing management, but addressing underlying causes often improves sleep quality significantly. Learning proper sleep habits and stress management strategies can provide long-term benefits.
Helpful home strategies include maintaining consistent sleep and wake times, limiting caffeine, nicotine, and alcohol close to bedtime, creating a quiet, dark, and cool sleep environment, and practicing relaxation techniques before bed. Avoiding bright artificial light before bedtime and establishing a calming pre-sleep routine can also support better sleep.
Dr. Barnhart addresses insomnia through a combination of sleep hygiene optimization, behavioral strategies, and targeted medication or supplements when needed. He also evaluates whether anxiety, depression, or other conditions contribute to sleep difficulties.

Your Practitioner

J. Connor Barnhart

J. Connor Barnhart, MD

Dr. J. Connor Barnhart is a board-certified psychiatrist and psychotherapist practicing in San Francisco. He completed his psychiatry residency at UCSF, where he trained in the Bipolar, LGBT, and Women's Mental Health specialty clinics and developed focused expertise in integrative psychiatry through a year-long rotation at the UCSF Osher Center. He attended medical school at the University of Pennsylvania's Perelman School of Medicine and graduated from Brown University with honors in Human Biology. His practice combines insight-oriented therapy, medication management, supplements, and lifestyle optimization to holistically address the root causes of mental health challenges including depression, anxiety, and difficulties with focus.

Sources & References

This article draws from 4 sources, including NIH, leading medical institutions.

Government & Research

Medical Institutions

Medically reviewed by J. Connor Barnhart, MD · Last reviewed: 2026-06-12