Adult ADHD Psychiatrist in Back Bay, Boston
Insomnia Treatment in Boston
For nights that end at 3 a.m.
Dr. Victor Cohen, MD
Physician-led care for chronic insomnia: find out why sleep broke, treat the cause, and use medication with judgment — not as the whole plan.
Dr. Victor Cohen, MD
An Insomnia Doctor, Not a Sleeping-Pill Dispensary
Psychiatrists are best-equipped for holistic sleep care
Depression wakes people at 4 a.m. Anxiety keeps the mind running at midnight. Alcohol fragments the second half of the night; stimulants dosed too late erase it; sleep apnea masquerades as insomnia for years.
Before anything is prescribed, my job is to find which of these is yours — because treating the wrong one is how insomnia becomes chronic.
Need Urgent Assistance?
My Approach to Insomnia Treatment
During your first visit I search drivers of insomnia: mood, anxiety, medications and their timing, alcohol and caffeine, hormones, pain, and the screening questions that catch sleep apnea.
When I suspect apnea, I say so and arrange a sleep study — no insomnia treatment works well on top of untreated apnea.
Behavior before hypnotics
For chronic insomnia, the strongest evidence belongs to cognitive behavioral therapy for insomnia — CBT-I — not to any medication. It is structured, short, and durable in a way sleeping pills are not, and its core methods are part of how I treat. Guidelines are unambiguous that it should come first, and I practice that way.
Medication with judgment
Medication has a real place — bridging a bad stretch, breaking a spiral, or treating the depression or anxiety underneath the sleeplessness. When we use it, you will know why that agent, what the plan is for coming off it, and where I am conservative: long-term nightly hypnotics, and sedatives in older adults, are exactly the places insomnia care most often goes wrong.
Often the real finding is that the insomnia was the smoke, not the fire. Treat the depression, the anxiety, the mistimed stimulant — and sleep is frequently the first thing that comes back.
The Concierge Difference at My Practice
Difficulty sleeping is a symptom, not a diagnosis. At my practice, 60-minute evaluations and follow-ups mean I can focus on your personal story, not a symptom check-list.
Direct access means you can reach me when a dose needs adjusting or a side effect shows up, not leave messages and wait for callbacks. You work with the same physician, never an NP or PA, every visit.
A small patient panel means real time for your history, and it means I'm as willing to take you off a medication as I was to start it. Deprescribing gets the same care as prescribing.
How Insomnia Shows Up
Trouble falling asleep
The 3 a.m. waking
Early-morning waking
Dreading the bed
Sleeping through chemistry
Non-restorative sleep
The wired-and-tired night
Insomnia that outlived its cause
Dr. Victor Cohen
Sleep Is Treatable
When your doctor has time to listen
Chronic insomnia responds to treatment that targets its actual cause. Start with one conversation.
Reach Out To Learn More
The first step is a confidential conversation about your history.
During this initial discussion, we'll talk through your concerns, answer questions about my approach, and determine whether this practice is the right fit.
Seeking care for insomnia can feel like a significant step, especially after past appointments that felt rushed or dismissive. I want it to be straightforward, and to give you the time a real evaluation takes.