You bet! While I specialize in sleep, I'm a therapist who works with anxiety, depression, relationship issues, life transitions, burnout, performance concerns, and pretty much everything else that brings people to therapy. Sleep just happens to be my specialty area – like how some doctors specialize in hearts but can still treat a broken arm.

I hear you, and you're definitely not alone! CBT-I (Cognitive Behavioural Therapy for Insomnia) is the most researched and evidence-based approach for insomnia, but it doesn't click for everyone.

That's why I take the most effective elements of CBT-I (the behavioural strategies that have the strongest research backing) and combine them with Acceptance and Commitment Therapy (ACT). This creates a hybrid approach that blends CBT-I and ACT-I (Acceptance and Commitment Therapy for Insomnia). Both frameworks are evidence-based.

In my clinical work, this hybrid approach has been practical for most people because it's not a one-size-fits-all approach. Sleep is deeply personal, and what works depends on YOU: your nervous system, your relationship with sleep, your patterns, and what resonates with you.

If traditional CBT-I hasn't worked, this approach might be what makes the difference.

CBT-I is typically delivered over 6 to 8 sessions, though some people see meaningful improvement and graduate in as few as 3 to 4 sessions. The number depends on how long you've had insomnia, what's driving it, and how consistently you can apply the behavioural strategies between sessions. Treatment is tailored to your schedule and what's actually maintaining your sleep problems.

Insomnia is more than a few bad nights. You may have insomnia if you regularly struggle to fall asleep, wake up during the night and can't get back to sleep, or wake earlier than you'd like — and this happens at least three nights per week for three months or more. Daytime symptoms matter too: fatigue, difficulty concentrating, irritability, or relying on caffeine to function are all signs that your sleep is not doing its job. If you're spending enough time in bed but still waking unrefreshed, that's a meaningful signal. A formal assessment can confirm whether what you're experiencing meets criteria for chronic insomnia and whether CBT-I is the right fit.

If poor sleep has been affecting your daytime functioning for more than a few weeks, it's worth talking to someone. You don't need to be at crisis point. Signs it's time to seek support include: lying awake for 30 minutes or more before falling asleep, waking frequently through the night, dreading bedtime, relying on sleep aids or alcohol to get to sleep, or feeling like no amount of sleep leaves you rested. The longer insomnia goes untreated, the more entrenched the patterns become and early intervention makes treatment faster and easier.

Yes. Insomnia is the most common sleep concern, but it's not the only one. Miles Psychology also works with nightmare disorder and trauma-related sleep disturbance. Ashley Miles is certified in Cognitive Behavioral Therapy for Nightmares (CBT-N), an evidence-based treatment that reduces nightmare frequency and intensity without medication. If you're dealing with recurring nightmares, difficulty sleeping due to hypervigilance, or sleep problems connected to trauma or PTSD, this may be a good fit. Reach out to discuss whether what you're experiencing is something we can work on together.

Why does anxiety cause sleep problems, and can therapy help?

Anxiety and insomnia are closely linked. Anxiety activates the nervous system, which is the opposite of what sleep requires. Racing thoughts, physical tension, and hypervigilance at bedtime are all anxiety responses that make falling and staying asleep harder. Over time, the bed itself can become associated with that activation — so even when you're exhausted, lying down triggers wakefulness rather than rest. This is one of the reasons sleep problems persist long after the original stressor is gone.

CBT-I addresses this cycle directly through stimulus control and cognitive work. When anxiety is a significant driver, treatment at Miles Psychology integrates ACT, IFS and nervous system regulation alongside the behavioural protocols - so we're working on the anxiety and the sleep at the same time, not treating them as separate problems.