Most people looking for insomnia treatment in Las Vegas have already tried the usual fixes. The melatonin. The blackout curtains. No coffee after noon. A nightcap that helps for an hour and then doesn't. If you're still lying awake, or falling asleep fine and then waking at 3 a.m., another trick probably isn't the answer. A real evaluation might be.
Swanlight Behavioral Health is a telehealth psychiatric practice licensed in Nevada. We look at what's keeping you up, treat the conditions that often travel with poor sleep, and build a plan with you. Every appointment happens by secure video, so there's no drive across town after a bad night. New patient virtual intake appointments start at $49. Call or text 702-832-0429 or contact us to get started.
Everyone has a bad night now and then. A bad few weeks usually has a reason behind it. It's worth making an appointment when several of these keep showing up:
Lying awake a long time before you fall asleep
Waking in the middle of the night and not getting back to sleep
Waking much earlier than you meant to, most mornings
Sleep that never feels restful, however long it lasts
Dragging through the day: tired, short-tempered, foggy, making mistakes
Dreading bedtime, or watching the clock
Needing alcohol or an over-the-counter sleep aid to get through the night
About 1 in 10 adults has chronic insomnia. Sleep specialists define that as trouble sleeping at least three nights a week for three months or more. You don't have to wait three months to ask for help, though. If your sleep has been off for more than a few weeks, or it's starting to affect your work, your mood, or your driving, that's reason enough.
Sometimes insomnia really is the whole problem. More often it's one piece of something bigger. Two people can say "I can't sleep" and mean completely different things, so your evaluation spends time on what's underneath before anyone talks about treatment.
Here's some of what we look at:
Mood. Insomnia and depression tend to feed each other. A review of 34 studies found that people with insomnia were more than twice as likely to go on to develop depression. Anxiety works in a similar way. The mind gets loud right when the room gets quiet.
Bipolar disorder. A sudden drop in how much sleep someone feels they need can be an early sign of a mood episode. That's one reason a change in sleep deserves a careful look instead of a quick prescription.
ADHD. A mind that won't slow down at bedtime and a body clock that runs late are both common with ADHD, and some ADHD medications can affect sleep when the timing is off. Our page on ADHD evaluation for women goes into more detail.
Trauma. Nightmares, waking up on high alert, or never quite feeling safe enough to let go at night. Our article on healing childhood trauma later in life talks about this.
Life changes. Retirement, a newly empty house, grief, money worries. We wrote about these in Why Can't I Sleep?.
Your body and your habits. Perimenopause and other hormonal changes, pain, caffeine, alcohol, and medications you take for something unrelated can all get in the way of sleep.
One more thing worth knowing: insomnia that starts during a stressful stretch doesn't always leave when the stress does. It can take on a life of its own. Good care looks at the trigger and at the sleep problem itself. That's why sleep difficulties sit alongside mood, anxiety, and trauma in our areas of support.
What insomnia care looks like with us
Before your first visit. If you can, keep a simple sleep log for a week or two. Note when you went to bed, roughly when you fell asleep, when you woke up, and how you felt the next day. It doesn't have to be exact, and it gives us far more to work with than "I sleep badly."
Your intake. Your first appointment runs about 30-60 minutes. We'll go over your sleep pattern, your work schedule, when the trouble started and what else changed around then, your mood, your medical history, the medications and supplements you take, and what you've already tried.
A plan you agree to. Depending on what we find, your plan might include a referral for CBT-I (more on that below), treatment for anxiety, depression, or another condition that's feeding the insomnia, a visit with your primary care provider to check something physical, and medication when it makes sense. Before you decide anything, we'll walk through each option: what it's meant to do, how long it's meant to be used, and the tradeoffs.
Follow-up. Sleep plans usually need some adjusting. At follow-up visits we look at what's helping, what isn't, and whether a medication is still needed at all.
CBT-I comes first, and we'll tell you so
For long-term insomnia, the treatment with the strongest research behind it is cognitive behavioral therapy for insomnia, or CBT-I. It's a short, structured program that retrains your sleep habits and the thought patterns that keep you awake. The American College of Physicians recommends it as the first treatment for chronic insomnia in adults, and the 2025 VA and Department of Defense guideline puts it ahead of medication too.
Swanlight provides psychiatric evaluation and medication management. We don't provide therapy, and that includes CBT-I. We'd rather tell you now than after you've booked an intake. If CBT-I is right for you, we'll help you find it:
The Society of Behavioral Sleep Medicine keeps a directory of behavioral sleep medicine providers that you can search by state.
Some programs offer CBT-I by video with sleep psychologists licensed in Nevada, and many insurance plans cover it as a behavioral health service.
CBT-i Coach is a free app from the VA (iPhone, Android). It's made for people working through CBT-I with a provider and for anyone who wants to build better sleep habits, and it includes a sleep diary.
Medication can still be part of the plan, especially when insomnia is tied to another condition or when CBT-I alone isn't enough. It's one tool among several. We review it at every follow-up, and nothing happens without your understanding and consent.
Sleep in a 24-hour town
Las Vegas never really closes, and a lot of the people who keep it running are trying to sleep while the sun is up. One analysis of Census data found that about 1 in 6 workers in the Las Vegas area start their shift between 4 p.m. and 5 a.m. That's the highest share of any large metro in the country.
Think casino floors, hospitals, hotels, security, first responders, warehouses, delivery. Graveyard, swing, and rotating shifts ask your body to sleep when its internal clock says to be awake. Then add a desert summer, bright mornings, a household running on a normal schedule, and days off spent switching back to daytime hours. It's not surprising that sleep falls apart.
When sleep trouble comes straight from a work schedule, clinicians call it shift work disorder. It's common, and it often overlaps with anxiety or depression or gets mistaken for them. That's why we ask about your schedule in detail. A plan built for someone who works 9 to 5 won't help someone who clocks out at 7 a.m.
Video visits make this easier. Appointments are Monday through Friday, 8:00 AM to 6:00 PM. If you work nights, book a time just before you go to sleep or after you wake up so the visit doesn't cut into your sleep. Plenty of people take the call from their car in the employee lot.
When a sleep medicine specialist should come first
Some sleep problems call for a sleep study rather than a psychiatric evaluation. Talk with your primary care provider or a sleep medicine specialist if you notice:
Loud snoring, gasping, or choking in your sleep, or someone has seen you stop breathing
Morning headaches or a dry mouth most days
An uncomfortable urge to move your legs in the evening
Acting out your dreams, or other unusual behavior during sleep
Falling asleep during the day when you don't mean to
If you're nodding off while driving, treat it as a safety issue and get checked soon. Swanlight doesn't do sleep studies. If anything in your evaluation points that way, we'll tell you, and we can keep working on the mood and anxiety side while you get it checked.
All appointments are conducted through secure, HIPAA-compliant video visits, so you can receive psychiatric care from anywhere in Nevada. Whether you are balancing work, school, parenting, or a full schedule, telehealth makes insomnia evaluation and treatment more accessible without sacrificing personalized care.
Our core service area is Henderson, Las Vegas, North Las Vegas, Paradise, Spring Valley, and Enterprise. We also see patients in Reno, Carson City, Elko, and rural communities where the nearest psychiatric provider can be hours away. All you need is a private spot and a phone, tablet, or laptop.
About 87 percent of Nevadans live in a federally designated mental health professional shortage area, and that includes everyone in the state's rural and frontier counties. For a lot of people, video is the most practical way to get care.
Do I need a sleep study before I see you?
Usually not. Insomnia is typically diagnosed through a careful conversation about your sleep, your health, and your history. If your symptoms point toward sleep apnea or another sleep disorder, we'll recommend a sleep study through your primary care provider or a sleep specialist.
Can you prescribe sleep medication over video?
Some sleep medications can be prescribed after a video evaluation when medication is the right fit. Others are controlled substances, and the federal rules for prescribing those through telehealth are being updated. Your provider will explain which options are available to you and why. We don't promise any specific medication before an evaluation.
Do you offer CBT-I?
No. Swanlight provides psychiatric evaluation and medication management, not therapy. When CBT-I fits, we'll recommend it and help you find a provider.
I work nights. Can you still help?
Yes. Shift work is one of the most common reasons sleep falls apart in Las Vegas. We plan around your real schedule, and you can book your video visit for before or after you sleep.
I've been using alcohol or over-the-counter sleep aids to fall asleep. Should I mention it?
Please do. It's very common, and there's no judgment. Knowing about it helps us understand what's going on and what's safe to change.
How long does treatment take?
That depends on what's behind the insomnia. CBT-I is short-term by design. If medication is part of your plan, the first few weeks usually involve some adjusting, and follow-up visits check whether you still need it.
Do I need a referral?
No. You can book directly.
Do you take insurance?
Not currently. Swanlight is self-pay, and the $49 intake is there so cost isn't the reason you keep putting this off. You can submit a receipt to your insurer for possible out-of-network reimbursement, but we can't promise what they'll do with it.
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Ready to begin?
Your first step toward feeling like yourself again can start today. If you are located in Nevada, please reach out here to schedule your $49 virtual intake — no insurance, no referral, no hassle. Or just reach out to us via call/text below.