If you have a serious or ongoing sleep disorder like insomnia, sleep medication may be part of your treatment plan.
Primary care providers (PCPs), psychiatric providers, and sleep specialists can all prescribe sleep medication when appropriate.
Your provider may also suggest lifestyle changes or therapy to improve your sleep.
An estimated 50 to 70 million U.S. adults have chronic sleep problems. Sleep problems are more common in women and older adults.
When sleep problems go untreated, it becomes harder to manage stress, focus, and make good decisions. A lack of rest can also drain your patience and energy, which may strain relationships and hurt your performance at work or school. Getting the right help for sleep problems can boost both your mental and emotional well-being.
If you lie awake every night tossing and turning, it might be time to talk to a healthcare provider who can identify the cause of your sleep challenges and help you find the right solutions.
If medication could be part of your treatment plan, it’s usually prescribed only for a short time while you work on long-term solutions. The type of provider you see depends on what’s keeping you awake and how long you’ve been having trouble sleeping.
Primary care providers
A good first step in seeking sleep medication is to discuss your concerns with your family physician, nurse practitioner, or primary care provider (PCP). They can check for common causes of sleep difficulties. It’s important to rule out underlying physical causes of sleep problems before considering medication.
They’ll ask questions about whether you have problems falling or staying asleep. They may assess and treat any chronic pain that’s impacting your sleep. They may also order blood work to check for thyroid issues or vitamin deficiencies. They will also screen for sleep apnea by checking your airway and nasal passages. Sleep apnea can come with serious long-term health problems, so it’s important for this to be identified and treated effectively.
Your doctor may also suggest lifestyle changes. Regular exercise, reducing stress, and limiting screen time before bed can improve sleep quality.
Depending on your symptoms, your doctor can determine whether you might benefit from adding sleep medication to your treatment plan. If your PCP thinks more testing is needed to get to the root cause of your sleep challenges, they’ll refer you to a sleep specialist.
How a sleep specialist can help
If you and your PCP think you have a sleep disorder like insomnia, sleep apnea, or restless leg syndrome, a sleep specialist can run a sleep study to find the cause. Some studies are done in person, but many studies can be done at home with a monitoring kit you return the next day.
After reviewing your sleep study and providing a diagnosis, they may prescribe a C-PAP machine or other device, or short-term medication to help break the cycle of poor sleep.
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Psychiatric providers
Psychiatrists and psychiatric mental health nurse practitioners (PMHNPs) are medical providers who specialize in treating mental health conditions with medication. About 50% of insomnia cases are related to depression, anxiety, or stress. Psychiatric providers can help identify the root of your sleep challenges and work with you to find ways to address them.
For example, if you live with post-traumatic stress disorder (PTSD) and are having sleep challenges, a psychiatric provider can help. They may prescribe a medication that specifically helps to reduce PTSD-related nightmares, as well as medication to treat your other PTSD symptoms that may be impacting your sleep. They’ll also recommend specialized trauma therapy. For PTSD nightmares, imagery rehearsal therapy (IRT) can be especially helpful. Some psychiatrists may offer therapy. If they don’t, they can refer you to a therapist who specializes in this area.
For many sleep problems, cognitive behavioral therapy for insomnia (CBT-I) is a good evidence-based treatment for lasting improvement in sleep. Since many sleep medications can cause side effects, including dependence, your psychiatrist might refer you to a CBT-I therapist or work with you on healthy sleep habits before considering medication. For example, they can show you how to keep a regular sleep schedule and create a calming bedtime routine that works for you.
Psychiatric providers can prescribe sleep medication if it’s recommended for your situation. They also choose medications that help with both mood or anxiety symptoms and sleep problems. If your goal is to build lasting habits for better sleep, a psychiatrist can help you get there.
The power of collaborative sleep care
Collaborative care means your healthcare providers work together to help you sleep better.
For example, if you have chronic pain that keeps you up at night and also live with an anxiety disorder, your PCP or pain specialist can treat the pain while your psychiatrist addresses the anxiety. Together, they can create a treatment plan that addresses both issues.
You might consider collaborative care if:
Your sleep problems have more than one cause
One type of treatment hasn’t worked on its own
You need input from different specialists
If this sounds right for you, let your doctor know you’d like them to share updates with your psychiatrist or sleep specialist.
It’s important to rule out and treat any physical causes for your sleep challenges. But if you and your primary care provider have done this, it would be good to consider seeing a specialist. Mental health concerns often come with sleep challenges so a psychiatric provider can help you figure out what’s causing your insomnia and provide additional support.
Stephanie J Reed, MSW, MSN, PMHNP-BC
Clinical reviewer
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Effectively managing sleep disorders and mental health conditions is possible with the right support. If you’re considering sleep medication, it’s important to see a provider who can help. Primary care physicians, psychiatrists, and nurse practitioners can prescribe sleep medication. By treating both your mental health and sleep challenges, a psychiatric provider can help you build habits that ensure you get the sleep you need.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
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Linda Childers
Linda is an award-winning medical writer with experience writing for major media outlets, health companies, hospitals, and both consumer and trade print and digital outlets.
Her articles have appeared in the Washington Post, USA Today, WebMD, AARP, Brain+Life, HealthyWomen.org, The Rheumatologist, California Health Report, Everyday Health, HealthCentral, and many other media outlets.
While juggling the responsibilities of being part of the “sandwich generation” and caring for both her toddler son and terminally ill mother, a nurse friend encouraged her to seek therapy, which helped her to learn coping strategies and manage her depression. Linda hopes her work will help to destigmatize mental health conditions and encourage others to get the help they need.
Stephanie J Reed, MSW, MSN, PMHNP-BC
Stephanie started her career in mental health as a clinical social worker in 1997. She’s been practicing as a psychiatric nurse practitioner since 2020. She’s worked in many settings, including in labor and delivery as an RN, in child protection, in community mental health, and in an urban clinic affiliated with the Indian Health Service.
Her passion for mental health comes from a desire to provide the kind of care and education for people that she wishes had been available to her family. Good mental healthcare can be transformative for people and families, and it’s work that she’s very proud to be part of.
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