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Insomnia and sleep problems, measured over months

Silvia A. Bernardi, M.D. · Psychiatrist & Neuroscientist · New York & Milan · Updated October 2026

Almost every psychiatric condition shows up in sleep, and poor sleep makes almost every psychiatric condition worse. Yet sleep is usually assessed with one question at a visit: “How are you sleeping?” We measure it instead.

Measurement, not recollection

With your consent, MindFirst Sleep analyzes data from your own wearable, such as an Oura Ring, over weeks to months: when you fall asleep and wake, how continuous your sleep is, its architecture, nighttime heart rate and heart-rate variability, and how all of these change when a medication is started, changed or stopped.

Treatment

Cognitive behavioral therapy for insomnia is the first-line treatment for chronic insomnia, and we use its principles directly. Medication choices are made with their effects on sleep architecture in mind — some common prescriptions fragment sleep or suppress REM, and some insomnia is caused by the medications meant to treat something else. When the pattern suggests sleep apnea, restless legs or another primary sleep disorder, we refer to sleep medicine for formal testing.

See also Sleep and psychiatric medications.

Questions

Can a psychiatrist treat insomnia?
Yes. Insomnia is closely linked to depression, anxiety, bipolar disorder and ADHD, and psychiatrists treat it with behavioral approaches such as CBT-I and, where appropriate, medication. Suspected sleep apnea or other primary sleep disorders are referred for sleep testing.

Is Oura Ring data useful for psychiatric treatment?
Wearable data is not a diagnostic sleep study, but followed over weeks to months it shows trends in sleep timing, continuity and heart rate that can reveal how a condition or medication is affecting sleep.

Can psychiatric medications cause insomnia?
Yes. Several antidepressants, stimulants and other medications can disrupt sleep, while others can impair sleep quality despite making people drowsy.

Related reading

• Sleep and psychiatric medications
• Bipolar disorder: treatment that watches the rhythm
• Attention problems and brain fog: measure first

MIND FIRST sees patients in Midtown Manhattan (Grand Central) and the Financial District, and by telehealth for patients located in New York, Florida or Milan. Dr. Bernardi is licensed to practice medicine in New York, Florida and Italy.