Reviewed byAigul Serikova, MDPsychiatrist · updated 11.11.2026
Key facts
- ICD-10 code
- F51.0
- Who provides it
- A psychiatrist assesses the causes and prescribes treatment; a psychotherapist provides CBT for insomnia
- Format
- In-person appointments in Almaty and Astana; online consultations and sleep-diary-based support for all cities
- Duration
- A CBT-I course of 6–8 sessions; first changes after 2–3 weeks
- Confidentiality
- Anonymous, medical confidentiality, no entry in the state dispensary registry
- When it is urgent
- Insomnia with suicidal thoughts, a sudden loss of need for sleep with a surge in activity, confusion — call 103 or 112
- Outcome
- Falling asleep without lying awake for long, fewer night awakenings, daytime alertness, no more reliance on regular sleeping pills
What to know
When someone comes to me with insomnia, they have usually already tried a lot: herbal teas, melatonin, over-the-counter sleeping pills, alcohol “to relax,” watching TV series late into the night to tire themselves out. They get into bed thinking “if only I can fall asleep tonight,” and it is this very tension that gets in the way of sleep the most. Chronic insomnia is not just a nuisance. It impairs memory and attention, raises the risk of depression, anxiety and relapse in people with addiction, and makes it harder to work and drive.
The good news is that insomnia is treatable, and according to international guidelines the main treatment is not pills but cognitive behavioral therapy for insomnia. Below I explain how a doctor looks for the cause of sleep problems, why sleeping pills should not be taken for months, how a course of therapy is structured, and when you need to see a sleep specialist or neurologist — for example, if you snore with pauses in breathing. Importantly, insomnia is often a symptom of another disorder, and in that case we treat the cause.
Signs of Chronic Insomnia
- falling asleep takes more than 30 minutes almost every night
- frequent night awakenings followed by a long struggle to fall back asleep
- waking up 1–2 hours earlier than you need to and being unable to fall asleep again
- daytime fatigue, irritability, difficulty concentrating
- dreading the night and constantly thinking about whether you will manage to sleep
- sleep problems occur three or more nights a week for longer than three months
- you can no longer fall asleep at all without a sleeping pill or alcohol
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 Insomnia Develops
Insomnia usually starts with an obvious trigger: stress at work, illness, the birth of a child, a move, or jet lag. The trigger passes, but the sleep problems remain. The reason is that the person starts compensating: going to bed earlier, lying in bed awake for a long time, napping during the day, drinking more coffee. Gradually the bed becomes associated not with sleep but with anxiety and wakefulness. This is how acute insomnia turns into chronic insomnia.
Insomnia can be a symptom of other conditions: depression, anxiety disorder and bipolar disorder, the effects of alcohol misuse, chronic pain, hyperthyroidism, restless legs syndrome, and sleep apnea. Some medications, energy drinks, late workouts and shift work also disrupt sleep. That is why a Akalam psychiatrist first determines whether the insomnia is primary or secondary and, if necessary, refers the patient to a neurologist or sleep specialist.
How Insomnia Is Treated
Before the first appointment, the doctor asks you to keep a sleep diary for 1–2 weeks: the time you go to bed, fall asleep, wake up and get up, daytime naps, and coffee and alcohol intake. At the consultation, the psychiatrist asks about sleep, mood, anxiety, illnesses and medications, and rules out depression and sleep apnea. Next, a course of CBT for insomnia is offered: 6–8 sessions that work well online. The doctor and psychotherapist review the diary and change your routine step by step.
Insomnia cannot be handled with a scheduled appointment if it comes with suicidal thoughts, a sudden surge in activity and a reduced need for sleep, confusion, or hallucinations. In that case, call 103 or 112. Sleep restriction as part of CBT requires caution in people with bipolar disorder or epilepsy, in the first weeks of pregnancy, and for drivers — the doctor adapts the method to the situation.
How we help
CBT for insomnia
This is the first-line treatment recommended by NICE, the American Academy of Sleep Medicine and the European Sleep Research Society. It includes restricting time in bed to the time you actually sleep, the rule “bed is only for sleep,” getting up at the same time every day, and working on anxious thoughts about sleep. The first weeks can be hard, but then sleep becomes deeper and more stable, and the effect lasts longer than after sleeping pills.
Treating the underlying cause
If insomnia is caused by depression, an anxiety disorder or alcohol misuse, the psychiatrist treats that condition first. Sometimes an antidepressant is chosen that also improves sleep. If sleep apnea, restless legs syndrome or chronic pain is suspected, the patient is referred to the appropriate specialist, because without that no technique will help.
Medication support
Sleeping pills and sedatives are prescribed only by a doctor, as a short course, and usually together with CBT. With long-term use they lose their effectiveness, cause dependence and daytime grogginess, and in older people they increase the risk of falls. If a person has been taking a sleeping pill for a long time, the psychiatrist helps reduce the dose gradually without triggering a return of insomnia.
Sleep hygiene and routine
A regular wake-up time even on weekends, daylight in the morning, limiting caffeine after lunch, not using alcohol as a sleep aid, a cool dark bedroom, and no screens for an hour before bed. On their own, these rules rarely cure chronic insomnia, but without them CBT does not work. A Akalam specialist helps you introduce changes gradually and realistically.
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
MythAlcohol helps you fall asleep
FactAlcohol speeds up falling asleep but disrupts the structure of sleep: the second half of the night becomes shallow, with frequent awakenings. Over time, the amounts increase and there is a risk of dependence. Alcohol is not a suitable treatment for insomnia.
MythIf you can’t sleep, you should lie in bed and wait for sleep
FactLying awake for a long time reinforces the link between the bed and wakefulness and anxiety. According to the CBT approach, if you cannot fall asleep within about 20 minutes, it is better to get up, do something calm in dim light, and go back when you feel sleepy.
MythYou can take sleeping pills for years if they help
FactMost sleeping pills are recommended only for short courses. With long-term use, the effect wears off, dependence develops, and memory and attention during the day get worse. It is safer to complete CBT and gradually reduce the medication under a doctor’s supervision.
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
How many hours of sleep does an adult need?
Most adults need 7–9 hours, but individual needs vary. The main criterion is not the number of hours but how you feel during the day: if you are alert, focused and able to work, your sleep is most likely sufficient. If you have severe fatigue and sleepiness during the day, it is worth discussing this with a doctor.
Does melatonin help with insomnia?
Melatonin can help with circadian rhythm disorders, for example jet lag, and in some older people. In chronic insomnia, its effect is usually small. It is better to consult a doctor before taking it: it is important to understand the cause of your sleep problems.
Can I get insomnia treatment online?
Yes. CBT for insomnia works well online: the main work is based on a sleep diary and step-by-step changes to your routine. An in-person appointment is needed if a neurological cause or sleep apnea is suspected, or if the picture is complicated by other disorders. You can start from any city in Kazakhstan.
Why do things get worse at the start of CBT?
Restricting time in bed increases daytime sleepiness in the first 1–2 weeks. This is an expected stage: sleep pressure builds up, and falling asleep gradually gets faster. During this period you must not drive if you feel sleepy. The specialist adjusts the schedule so that the strain remains manageable.
Can insomnia be a sign of another illness?
Yes. Sleep problems often accompany depression, anxiety disorders, bipolar disorder, alcohol misuse, thyroid disease and sleep apnea. If insomnia comes with low mood, anxiety or, on the contrary, an unusual surge of energy, be sure to tell your psychiatrist.
What should I do if I have been on sleeping pills for a long time?
Do not stop the medication abruptly: this can bring back insomnia and cause withdrawal symptoms. See a psychiatrist, who will assess the situation, offer a course of CBT, and draw up a schedule for gradually reducing the dose. This usually takes several weeks or months, depending on the medication and how long you have been taking it.
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