Dr. Rigobert Kefferputz

Patient Library / Mental Health / Insomnia

Insomnia

Insomnia is driven by identifiable physiological and psychological mechanisms — matching the intervention to the cause is what makes treatment work.

Insomnia affects roughly 30% of adults and is one of the most undertreated conditions in clinical practice — sleeping pills are prescribed far more often than the underlying causes are investigated. Whether the driver is cortisol dysregulation, low progesterone, blood sugar instability, or hyperarousal, the right treatment depends entirely on which mechanism is active. Finding it changes everything.

Cortisol Rhythm Drives Sleep

Cortisol should be lowest at night and peak in the morning. When stress inverts this rhythm — high cortisol at night — sleep onset is disrupted regardless of any sleep hygiene practice. Testing the actual rhythm reveals this directly.

CBT-I Outperforms Sleep Medication

Cognitive Behavioural Therapy for Insomnia produces better long-term outcomes than sleeping pills in head-to-head trials — without dependency or rebound insomnia. I integrate its core principles into clinical practice.

Wake Time Is the Lever

A consistent wake time — more important than bedtime — is the most powerful circadian anchor available. Maintaining it regardless of the previous night's sleep consolidates the sleep drive faster than any other single intervention.

What You Need to Know

Frequently Asked Questions

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How I Treat This

These are the services I most commonly draw on when working with insomnia.

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