As a registered psychologist based in Sydney CBD, I work with people experiencing chronic insomnia and sleep difficulties using CBT for Insomnia (CBT-I), the most effective long-term treatment for sleep problems. Sessions are available in-person at my Elizabeth Street practice or via telehealth anywhere in Australia, with Medicare rebates available through a Mental Health Treatment Plan.

Causes of Insomnia

Insomnia usually isn’t caused by a single bad night. It develops when sleep disruption becomes conditioned, and the mind and body start to associate bed with wakefulness, effort, or stress.

Common features include:

• difficulty falling asleep

• waking frequently during the night

• waking too early and unable to return to sleep

• feeling unrefreshed despite enough time in bed

• anxiety or frustration about sleep itself

The Role of the Nervous System

Sleep requires the nervous system to feel safe enough to let go.

When stress, worry, or hypervigilance are present, the body remains in a state of alertness — even when you’re physically exhausted. This can result from:

• chronic stress or burnout

• anxiety or overthinking

• pressure to “perform” sleep

• previous bad nights creating anticipatory anxiety

• irregular schedules or disrupted routines

As the pattern continues, the mind starts scanning for signs of wakefulness, making sleep even harder to achieve.

What Keeps Insomnia Going

Many people respond to insomnia by:

• trying harder to fall asleep

• checking the time repeatedly

• going to bed earlier to “catch up”

• forcing relaxation

• worrying about the consequences of poor sleep

• monitoring how tired they feel during the day

While understandable, these strategies can increase performance pressure around sleep — teaching the brain that bedtime is something to be managed rather than eased into.

In this way, insomnia becomes self-perpetuating.

When It’s Worth Getting Support

It may be helpful to consider therapy if:

• sleep difficulties last weeks or months

• anxiety about sleep is growing

• fatigue is affecting mood or functioning

• you dread going to bed

• you rely heavily on substances or routines just to sleep

How I Help With Insomnia

My approach to work with insomnia on evidence-based principles and draws from various psychological interventions that I tailor to your specific needs and goals.

This generally involves:

• understanding what’s keeping your nervous system activated

• reducing sleep-related anxiety and monitoring

• changing unhelpful beliefs about sleep

• rewiring the brain’s stimulus association with the physical bed and sleep

• improving sleep hygiene and sleep routines

• working with thoughts, emotions, and bodily arousal

This may involve cognitive and behavioural strategies, mindfulness-based and somatic approaches, and addressing broader stress patterns that feed into sleep difficulty.

Frequently Asked Questions

• What is CBT-I and how is it different from regular CBT? CBT for Insomnia (CBT-I) is a specialised form of CBT developed specifically for chronic sleep problems. While standard CBT addresses thinking and behaviour patterns generally, CBT-I targets the specific cognitive and behavioural mechanisms that maintain insomnia — including sleep-related anxiety, conditioned wakefulness, and unhelpful beliefs about sleep. It typically involves sleep restriction, stimulus control, and cognitive restructuring techniques tailored to sleep.

• Is CBT-I more effective than sleep medication? Research consistently shows CBT-I produces better long-term outcomes than sleep medication. Medication can be effective short-term but does not address the underlying patterns maintaining insomnia and often leads to dependence or rebound insomnia when stopped. CBT-I teaches skills that continue to work after treatment ends. Australian clinical guidelines recommend CBT-I as the first-line treatment for chronic insomnia.

• How many sessions does insomnia treatment take? CBT-I is typically delivered across 6-8 sessions, making it one of the more time-efficient psychological treatments available. Some people with more complex presentations or significant anxiety around sleep benefit from additional sessions. Progress is usually visible within the first few weeks of treatment.

• Does Medicare cover psychology sessions for insomnia? Yes. With a Mental Health Treatment Plan from your GP, you're eligible for Medicare rebates on individual psychology sessions. Insomnia is a recognised clinical presentation that qualifies for a Mental Health Treatment Plan.

• Will I need to stop taking sleeping tablets before starting CBT-I? Not necessarily. CBT-I can be delivered alongside sleep medication. In many cases, people find they naturally reduce their reliance on medication as their sleep improves through treatment. Any changes to medication should be discussed with your GP or prescribing doctor.

• Is telehealth available for insomnia treatment? Yes. CBT-I has strong evidence for telehealth delivery. Many people find the flexibility of telehealth particularly useful for insomnia treatment, as it removes the burden of travel at times when fatigue is already affecting daily functioning.

Related Services

If insomnia is part of a broader pattern, you may also find these pages relevant:

• Anxiety — anxiety is one of the most common drivers of sleep difficulty and the two frequently need to be treated together

• Depression — disrupted sleep is both a symptom and a maintaining factor in depression

• Burnout & Stress — chronic stress keeps the nervous system activated and is a major contributor to insomnia

• Trauma & PTSD — hypervigilance and trauma-related arousal commonly disrupt sleep

If you'd like to discuss your situation and whether therapy might help, please get in touch here, or by using the form below.