Conditions we treat

Insomnia treatment

Evaluation and medication management for insomnia. Treatment starts with understanding what you're experiencing, how it's affecting daily life, and what else may be contributing before deciding what treatment makes sense.

First visit: 60 minutes, $400. Telehealth from anywhere in Oregon. No referral needed.

Book a first visit

Meredith personally reviews every appointment request and confirms within one business day.

If this sounds familiar

Difficulty falling asleep, staying asleep, or waking too early may be affecting mood, focus, school, work, relationships, or daily life. Maybe insomnia has been a problem for years, maybe it began during a stressful period or a life change, or maybe sleep aids and sleep-hygiene changes haven't helped the way you hoped.

Meredith starts with a careful look at the sleep pattern, its history, and what else may be contributing: mood, anxiety, hormones, medications, stress, and medical history.

Common ways insomnia shows up

A few of the patterns we see most, not a complete list and not a checklist you need to match.

Anxiety-driven insomnia

Racing thoughts at bedtime, worry that returns as soon as the lights go out, physical tension that makes it hard to wind down. Anxiety and insomnia often occur together, each making the other worse.

Depression-related sleep disruption

Early morning waking, wide awake at 3 or 4am and unable to get back to sleep. Or sleeping much more than usual and still feeling exhausted.

Perimenopause and hormonal sleep disruption

Night sweats, hot flashes, and anxiety that interrupts sleep. Hormonal changes and the demands of this stage of life may both play a role.

Chronic insomnia

Difficulty falling or staying asleep at least three nights a week, for three months or longer. Over time, worry about sleep itself can become part of the pattern.

Medication-related sleep problems

Some psychiatric medications cause insomnia as a side effect. If your current medication is keeping you awake, that's a medication management problem.

How we approach insomnia treatment

Your first visit is 60 minutes. Meredith will ask about the insomnia (when it started, what pattern it follows, what you've tried) and about what's driving it: anxiety, depression, hormonal changes, stress, medical history, current medications. The sleep problem is real, and so is whatever's underneath it.

Treatment might include medication for the insomnia directly, or it might mean treating an underlying condition that's disrupting sleep. Sometimes it's both. The aim is to understand why sleep is disrupted before deciding what to treat.

Follow-up visits are 30 minutes, typically every 4 to 6 weeks, and the plan is adjusted at each visit based on how you're actually sleeping.

Pricing and logistics

First visit: 60 minutes, $400

Follow-up: 30 minutes, $250

Extended follow-up: 60 minutes, $375 (when you want more time)

Insurance: We are out-of-network with all insurance plans. Superbills are provided (upon request) for possible out-of-network reimbursement on commercial plans. We are not able to see Medicare or Medicaid (Oregon Health Plan, or OHP) members, and we screen for this at intake so eligibility is clear before care begins.

Format: Visits are by video, from anywhere in Oregon. In certain circumstances a face-to-face visit may be necessary.

No referral needed. Book directly.

See full pricing details →

Questions about insomnia treatment

Will I need to take a sleeping pill every night?

Not necessarily. If the insomnia is driven by anxiety or depression, treatment may focus on the underlying condition rather than a nightly sleep medication. When a sleep-specific medication is part of the plan, it includes regular reassessment and an ongoing conversation about how long to use it.

I'm worried about becoming dependent on sleep medication.

That's a reasonable concern, and it's part of the treatment conversation. Not all sleep medications carry the same dependency risk. Meredith will explain the options, their risk profiles, and why she's recommending one over another. The goal is better sleep, not medication dependence.

My insomnia started during perimenopause. Is that something you treat?

Yes. Perimenopause-related sleep disruption is a common concern we see. Hormonal changes, anxiety, and sleep problems can be interconnected, and Meredith considers them together when building a treatment plan.

I've tried melatonin and over-the-counter sleep aids. What's different about prescription treatment?

Part of the evaluation is understanding what you've already tried and how it worked. Prescription treatment starts with a diagnosis: whether the insomnia stands alone or is driven by anxiety, depression, hormonal changes, or something else. The treatment plan follows from that.

Will medication make me groggy the next day?

Daytime grogginess is a known side effect of some sleep medications, and medication choice, dose, and timing all factor in. If a medication causes morning grogginess, tell Meredith so the plan can be adjusted.

Your provider

Meredith Galvin is a board-certified psychiatric nurse practitioner (PMHNP-BC). She came to prescribing after thirteen years in social work and ten years in psychiatric nursing, including work as a charge nurse, conducting emergency psychiatric assessments at Duke Regional Hospital, and providing home health care. That background is why she looks beyond the symptoms themselves and considers the stress, life circumstances, relationships, and other factors that may be affecting sleep.

Read Meredith's full story →

Sleep is worth a careful look.

If you want a thorough evaluation of what may be disrupting your sleep, we'd like to meet you.

Book a first visit Get in touch

Meredith personally reviews every appointment request and confirms within one business day.

See what to expect at your first visit →