Insomnia & Sleep Difficulties

Difficulty sleeping can affect nearly every part of daily life. Trouble falling asleep, waking repeatedly during the night, waking too early, or lying awake with a mind that will not settle can leave people exhausted, frustrated, and increasingly worried about whether they will sleep the next night.

Sleep difficulties can have medical, behavioral, psychological, or environmental causes—and sometimes several factors are involved at the same time. Counseling can help address the thoughts, emotions, stress, and behaviors that may contribute to ongoing sleep problems while recognizing when medical evaluation may also be appropriate.

Clinically Reviewed by Dr. Angel Corbin, DBH, LPC, LAC
Last reviewed: September 2026

Insomnia involves persistent difficulty falling asleep, staying asleep, or obtaining good-quality sleep despite having adequate opportunity to sleep.

Short periods of poor sleep are common, particularly during times of stress, illness, travel, grief, major life changes, or disruptions in routine. For some people, however, sleep difficulties continue even after the original trigger has passed.

Over time, worrying about sleep itself can become part of the problem. A person may begin watching the clock, calculating how many hours remain before morning, becoming anxious as bedtime approaches, or trying increasingly hard to force themselves to sleep.

Sleep and emotional health are closely connected.

Anxiety can make it difficult to quiet racing thoughts. Depression may affect sleep timing, sleep quality, or the ability to maintain a regular routine. Trauma and PTSD can contribute to hyperarousal, nightmares, or fear surrounding sleep. Stress, grief, relationship difficulties, and major life transitions can also disrupt previously normal sleep.

Poor sleep can then make emotional difficulties harder to manage. Fatigue may affect patience, concentration, motivation, mood, relationships, and the ability to cope with everyday stress.

This can create a cycle in which emotional distress interferes with sleep and inadequate sleep makes emotional distress more difficult to manage.

People struggling with sleep may experience:

• Difficulty falling asleep
• Frequent waking during the night
• Waking earlier than intended
• Racing thoughts at bedtime
• Worry about not getting enough sleep
• Feeling tired but unable to sleep
• Difficulty relaxing at night
• Irregular sleep schedules
• Daytime fatigue or irritability
• Problems with concentration or memory
• Anxiety as bedtime approaches
• Sleeping differently during periods of stress or depression
• Feeling dependent on particular routines or behaviors in order to sleep

Not every sleep problem is insomnia, and persistent sleep difficulties can sometimes have medical causes.

One frustrating feature of insomnia is that trying harder to sleep can sometimes make sleep more difficult.

After several bad nights, people may begin changing their behavior in an attempt to compensate. They may spend excessive time in bed, nap during the day, repeatedly check the clock, alter their schedule, cancel activities because of fatigue, or become increasingly focused on how much sleep they are getting.

These responses are understandable, but some can unintentionally reinforce the association between bedtime and wakefulness, frustration, or anxiety.

Counseling can help identify patterns that may be maintaining sleep difficulties and develop more effective ways of responding to them.

Cognitive Behavioral Therapy for Insomnia (CBT-I) is an evidence-based approach specifically developed for insomnia. It addresses thoughts and behaviors that can contribute to persistent sleep difficulties.

Depending on the client's needs and the therapist's training and clinical approach, counseling for sleep-related concerns may include:

• Understanding patterns that interfere with sleep
• Addressing anxiety and worry surrounding bedtime
• Challenging catastrophic thoughts about the consequences of poor sleep
• Developing more consistent sleep and wake patterns
• Learning relaxation or stress-management strategies
• Addressing behaviors that may unintentionally reinforce insomnia
• Managing anxiety, depression, grief, trauma, or other concerns affecting sleep
• Developing healthier responses to occasional poor nights of sleep

Treatment should be individualized. Sleep hygiene—such as maintaining a consistent schedule and creating an appropriate sleep environment—can be useful, but persistent insomnia may require more than simply being told to avoid caffeine or put away a phone before bed.

Counseling is not a substitute for evaluation of a medical sleep disorder.

Sleep difficulties can sometimes be associated with conditions such as obstructive sleep apnea, restless legs syndrome, circadian rhythm disorders, chronic pain, hormonal changes, medication effects, neurological conditions, or other medical problems.

Medical evaluation may be particularly important when sleep concerns involve symptoms such as loud snoring, witnessed pauses in breathing, waking while choking or gasping, significant unexplained daytime sleepiness, unusual movements or behaviors during sleep, or other concerning physical symptoms.

Etheria Counseling does not perform sleep studies, diagnose medical sleep disorders, or prescribe sleep medications. When appropriate, counseling can complement care provided by primary care clinicians, sleep specialists, or other healthcare professionals.

There is no requirement that sleep difficulties reach a particular level before someone talks with a counselor.

Counseling may be worth considering when difficulty sleeping is persistent, causing distress, creating anxiety around bedtime, affecting mood or concentration, or interfering with work, school, relationships, or everyday activities.

Counseling may also be useful when sleep problems seem connected to stress, anxiety, depression, grief, trauma, major life changes, or patterns of thinking and behavior that have developed around sleep.

Etheria Counseling provides counseling for sleep difficulties associated with stress, anxiety, depression, trauma, life transitions, and other emotional or behavioral concerns for adolescents and adults.

Counseling is available in person in Myrtle Beach, South Carolina, and through telehealth throughout South Carolina. Treatment is individualized according to each client's concerns, goals, circumstances, and the clinical judgment of their therapist.

Accepting New Clients

In-Person: Myrtle Beach, SC
Telehealth: Available throughout South Carolina
Ages: 6+
Insurance: Medicaid & major insurance plans
Self-Pay: Available

If difficulty falling asleep, staying asleep, worrying about sleep, or feeling exhausted from ongoing sleep problems is affecting your life, you can contact Etheria Counseling to discuss available therapists and appointment options.

Call 843-868-6200

National Heart, Lung, and Blood Institute (NHLBI) — Insomnia

National Heart, Lung, and Blood Institute (NHLBI) — Insomnia Treatment

American Psychological Association (APA) — Getting a Good Night's Sleep

American Academy of Sleep Medicine (AASM) — Behavioral and Psychological Treatments for Insomnia

Furukawa et al. — Initial Treatment Choices for Long-Term Remission of Chronic Insomnia: Systematic Review and Network Meta-Analysis