Reviewed byAigul Serikova, MDPsychiatrist · updated 11.11.2026
Key facts
- ICD-10 code
- F51.0
- Who provides care
- a psychiatrist (a medical doctor) looks for the cause, rules out depression and anxiety, and selects treatment; a psychotherapist delivers CBT for insomnia
- Format
- in-person appointments in Almaty, online follow-up based on a sleep diary, and referral to a sleep specialist or neurologist if needed
- Duration
- CBT for insomnia usually takes 4–8 sessions; sleep often improves noticeably within 4–6 weeks
- Confidentiality
- medical confidentiality, anonymous care, no registration with the state psychoneurological dispensary (PND) registry
- When it is urgent
- several days without sleep combined with agitation, delusions, or suicidal thoughts: call 103 or 112
- Outcome
- falling asleep and staying asleep more reliably without constant sleeping pills, and more energy during the day
What to know
In Almaty, insomnia often has a distinctly urban face. Software developers who work for American and European companies join calls at midnight and fall asleep near dawn. Students sit up with their laptops until three in the morning and then rush to an 8 a.m. class. Taxi drivers and couriers work rotating shifts. In winter, when smog hangs over the city and windows stay shut, apartments get stuffy, mornings outside are gray, and the body loses its bearings. Many people come to a doctor only after months of self-treatment: melatonin, over-the-counter sleeping pills, a glass of wine before bed.
Chronic insomnia under ICD-10 (F51.0, nonorganic insomnia) means sleep problems at least three times a week for more than a month that interfere with daytime functioning. It is not just "I sleep badly" but a self-perpetuating condition: anxiety about sleep makes the insomnia worse. According to guidelines from NICE and the American Academy of Sleep Medicine, the first-line treatment is cognitive behavioral therapy for insomnia, while sleeping pills are used only as a short course and only when prescribed by a doctor. This page is about medical treatment with a psychiatrist.
When Insomnia Is a Reason to See a Doctor
- it takes you more than 30–40 minutes to fall asleep several times a week
- you wake up at night and lie awake for a long time thinking about work and chores
- you wake up early, at 4 or 5 a.m., and can no longer fall back asleep
- during the day you feel drained and irritable and make mistakes at work or behind the wheel
- you can no longer fall asleep without sleeping pills or alcohol
- you dread the night and worry in advance that you won't fall asleep again
- insomnia comes together with anxiety, low mood, or snoring with pauses in breathing
If life is at risk — loss of consciousness, seizures, hallucinations, overdose, suicidal thoughts — call 103 or 112. Helpline for children and young people: 150.
Why Sleep Breaks Down and Why Pills Don't Solve the Problem
Insomnia almost always has a cause or a combination of causes. Acute stress triggers a few bad nights, and then habits kick in that lock the problem in place: lying in bed for a long time trying to fall asleep, catching up on sleep during the day, drinking coffee to keep going, scrolling on the phone in bed. Insomnia is often driven by depression and anxiety disorders: early-morning waking is typical of depression, while trouble falling asleep is typical of anxiety. Shift work and calls in someone else's time zone belong on the same list.
Sleeping pills bought at a pharmacy or taken on an old prescription help for a short while but do not remove the cause. Many of them quickly lead to tolerance and dependence, worsen the structure of sleep, and cause even more severe rebound insomnia when stopped. Alcohol helps you fall asleep but wrecks the second half of the night. It is also important to rule out physical causes: sleep apnea, restless legs syndrome, thyroid disease, chronic pain, and side effects of medications.
How a Psychiatrist Treats Insomnia
For one or two weeks before your appointment, it helps to keep a sleep diary: when you go to bed, fall asleep, wake up during the night, and get up, plus coffee, alcohol, and physical activity. You can send it online. During the consultation, the psychiatrist goes through the diary and checks for depression, anxiety, alcohol use, and breathing problems during sleep. The doctor then puts together a plan: CBT for insomnia, a sleep schedule, and, when indicated, a short-term medication phase. Follow-up sessions are convenient to hold by video, based on the ongoing diary.
Do not take sleeping pills or tranquilizers on your own for long periods, especially if you drive or operate complex machinery. If insomnia lasts several days in a row and comes with agitation, strange thoughts, or a surge of energy despite getting no sleep at all, it may be a sign of mania or psychosis. This requires an urgent consultation, and if there is any danger, call 103 or 112. Snoring with pauses in breathing calls for a consultation with a sleep specialist.
How we help
CBT for Insomnia (CBT-I)
A structured method recommended by NICE and the American Academy of Sleep Medicine as the first-line treatment. It includes limiting time in bed, the "bed is only for sleep" rule, working with thoughts about sleep, and relaxation techniques. The first weeks can be harder, but then sleep becomes deeper and more stable. Unlike the effect of pills, the results last a long time.
Treating the Underlying Cause
If insomnia is a symptom of depression, an anxiety disorder, or bipolar disorder, the underlying condition is treated first. The psychiatrist will select medications that help with both mood and sleep. If the cause is alcohol, an addiction physician joins the treatment. If sleep apnea or a neurological problem is suspected, the doctor will refer you to the appropriate specialist.
Safe Medication Support
Sometimes medications that make it easier to fall asleep are needed for a short period. The psychiatrist chooses the drug class with the risk of dependence, your age, your work, and driving in mind, prescribes it for a limited time, and discusses a plan for stopping it right away. No self-made regimens and no long-term use without supervision: only as prescribed by a doctor.
Sleep Hygiene in a Big City
Practical steps adapted to real life: a fixed wake-up time even on weekends, morning light (especially in winter smog), blackout curtains against streetlights, quiet away from traffic noise, no caffeine after lunch, and no phone in bed. For those who work across time zones, a Akalam doctor will help build a realistic schedule.
How treatment works
- 01Call or WhatsAppThe administrator and the doctor on duty clarify the situation and tell you what to do right now.
- 02Examination or consultationThe doctor visits your home, sees you at the clinic or joins by video.
- 03Treatment planWe choose the format — at home, inpatient, psychotherapy or rehab — with a clear price.
- 04Ongoing supportYour doctor and psychotherapist stay in touch: follow-ups, family support and relapse prevention.
Myths and facts
MythGo to bed earlier and just lie there; sleep will come
FactLying awake for a long time only reinforces insomnia: the brain learns that the bed is a place for being awake and anxious. In CBT for insomnia, time in bed is actually limited for a while.
MythSleeping pills are the fastest and most reliable solution
FactSleeping pills work quickly, but they do not remove the cause, and with long-term use they lead to dependence. They are prescribed as a short course and only as part of a plan built around CBT.
MythA glass of wine at night helps you sleep
FactAlcohol makes it easier to fall asleep but wrecks the second half of the night: frequent awakenings, shallow sleep, and feeling drained in the morning. Drinking regularly at bedtime entrenches insomnia and raises the risk of alcohol dependence.
Prices: Insomnia treatment
| Insomnia treatment | 20 000 ₸ |
| Psychiatrist consultation at the clinic | 15 990 ₸ |
| Psychiatrist home visit | 35 000 ₸ |
| Follow-up visit, treatment adjustment | 12 000 ₸ |
| Phone consultation | free |
Prices are approximate: the doctor confirms the exact cost after the examination, before treatment starts.
Confidential
We do not register patients with state dispensaries or share information with employers. You do not have to give your surname; doctors arrive in unmarked cars. Medical confidentiality is protected by the Code of Kazakhstan “On Public Health and the Healthcare System”.
Clinic addresses
FAQ
When does insomnia become a medical condition?
If sleep problems occur at least three times a week for more than a month and interfere with your day, it is a reason to see a doctor. A few bad nights before a deadline or exams are a normal reaction. Chronic insomnia sustains itself and rarely goes away without treatment.
Who should I see: a psychiatrist, a neurologist, or a sleep specialist?
For insomnia with anxiety, low mood, or irritability, or insomnia triggered by stress, see a psychiatrist: they will work out the cause and provide treatment. For snoring with pauses in breathing or restless legs, see a sleep specialist or a neurologist. A Akalam psychiatrist will refer you to the right specialist if needed.
Does melatonin help?
Melatonin can help when your body clock is out of sync, for example when you work across time zones or after long flights. For chronic insomnia, its effect is modest. It is best to talk to a doctor before taking it, especially if you are already taking other medications.
How long does insomnia treatment take?
CBT for insomnia usually takes 4–8 sessions, and noticeable improvement often comes within 4–6 weeks. If insomnia is a symptom of depression or anxiety, treating the underlying condition will take several months. The timeline is discussed at the first consultation.
Can insomnia be treated online?
Yes, it is one of the best examples of online treatment: CBT for insomnia is built around a sleep diary, which can be reviewed over video. The initial assessment can also be done online. If tests are needed, the doctor will refer you for them. This is especially convenient if you work during night hours.
What should I do if I have been taking sleeping pills for a long time?
Do not stop abruptly: this can cause severe insomnia and other withdrawal symptoms. See a psychiatrist and tell them what you take and how much. The doctor will draw up a plan for gradual tapering and start CBT for insomnia at the same time so that your sleep does not collapse as the medication is stopped.
Sources and review
Prepared by the Akalam medical editorial team based on:
- ICD-10 and ICD-11: mental and behavioural disorders
- Clinical protocols of the Ministry of Health of Kazakhstan
- Code of Kazakhstan “On Public Health and the Healthcare System”
- WHO: mental health and substance use
- NICE and APA clinical guidelines
This information is for reference and does not replace a doctor's consultation. Editorial policy