Sleep Disorders & Insomnia · Online Across India & New Delhi
Chronic insomnia, 3 a.m. waking, racing thoughts at bedtime, years on sleeping pills: sleep problems are among the most common reasons people quietly struggle, and among the most treatable. Dr. Shaurya Garg, MD Psychiatry (AIIMS New Delhi), treats sleep disorders with evidence-based care, online across India and in New Delhi.
A structured, clinician-reviewed evaluation of your sleep pattern, habits, and contributing conditions, with a personalised plan. Shared after a consultation.
Understanding Insomnia
Most chronic insomnia starts with a trigger, stress, illness, a life change, and then outlives it. The bed becomes associated with effort and frustration instead of sleep, and the harder you try, the worse it gets.
This is why advice like "just relax" fails, and why sleep deserves proper clinical assessment. Insomnia is diagnosed when difficulty falling asleep, staying asleep, or waking too early occurs at least three nights a week for three months or more, with daytime consequences: fatigue, poor concentration, irritability, low mood. It also travels with other conditions: anxiety and depression disturb sleep and are worsened by poor sleep, ADHD commonly delays the body clock, and loud snoring with daytime sleepiness can signal obstructive sleep apnoea, which needs its own evaluation and is screened for before insomnia is treated as purely psychological.
What the Evidence Says
International guidelines are unambiguous: cognitive-behavioural therapy for insomnia (CBT-I) is the first-line treatment for chronic insomnia, ahead of medication. It is a structured, short-term approach that retrains the sleep system: rebuilding the bed-sleep association, correcting the schedule, reducing the mental effort around sleep, and dismantling the 3 a.m. worry loop. Its effects last after treatment ends, which no sleeping pill can claim.
Medication still has a place: short-term use in acute situations, and treating the underlying condition when insomnia is driven by anxiety, depression, or another disorder. What deserves caution is the years-long nightly sleeping pill, often self-continued without review. If that is where you are, the answer is not abrupt stopping, which can rebound badly, but a planned, gradual, medically supervised taper alongside CBT-I-informed treatment.
Beyond the clinic, Dr. Garg is a seed investor and clinical advisor to a US-based sleep-technology startup, where he helped conceptualise a sleep aid during its early development. Sleep, here, is not a side interest.
Sleep Care
Each pattern has a different mechanism, and a different fix.
Treatment
You have already heard the standard advice: no screens, no caffeine, keep the room dark. Useful, and rarely sufficient for chronic insomnia. Treatment here starts with a structured assessment: your sleep pattern and history, mood, anxiety, attention, medication and substance use, caffeine and alcohol timing, and screening for medical sleep disorders. The plan is then built around the actual mechanism: CBT-I-informed behavioural treatment, body-clock strategies for delayed sleep phase, treatment of underlying anxiety, depression or ADHD where present, medication review and supervised deprescribing where needed, and structured follow-up until sleep is stable.
As a wind-down before bed, many patients find the free guided muscle relaxation (JPMR) exercise on this site useful, available in Hindi and English. It is a support for sleep, not a treatment for insomnia.
Supplements and Sleep Aids
Melatonin is a hormone, not a sedative, and it is usually taken for the wrong problem. Its real use is in shifting the body clock: delayed sleep phase, shift work, jet lag. For chronic insomnia in adults the American Academy of Sleep Medicine's guideline recommends against using it, because the evidence for benefit is weak. Where it is used at all, timing matters more than dose, and the right timing depends on what it is being used for: to shift a delayed body clock it is taken well before the intended sleep time rather than at bedtime, which is not how most people take it. Analyses of melatonin sold over the counter have also found the actual content varying widely from the figure on the label.
Magnesium is the supplement patients ask about most, and the honest answer is that the evidence is thin. The best available synthesis, a meta-analysis of three randomised trials in 151 older adults, found people fell asleep about seventeen minutes sooner than on placebo, and the authors graded that evidence as low to very low quality. Seventeen minutes is not nothing, but magnesium can cause loose stools, interact with some medicines and accumulate in kidney disease. It is still not a treatment for insomnia.
The same caution applies to sleep aids bought without a prescription. “Over the counter” does not mean harmless: products can cause next-day sedation, falls, interactions or problems in pregnancy and in people with kidney, liver, breathing or other medical conditions. Where a medicine genuinely is needed, the decision is made deliberately, with a plan for review and stopping, rather than drifting into a nightly habit that becomes its own problem.
Medication Education
CBT-I is first-line for chronic insomnia. A medicine may sometimes be used briefly, or for a specific coexisting condition, but the choice changes when the real problem is delayed body clock, sleep apnoea, restless legs, bipolar disorder, substance use, depression, anxiety or medication withdrawal.
Guidelines make only weak recommendations for selected hypnotics, including zolpidem, eszopiclone and certain benzodiazepines. Zopiclone is a related prescription hypnotic used in some countries, including India. Dependence, impaired driving, falls, breathing risk and rebound insomnia matter, and none should drift into long-term nightly use without review.
Depending on the diagnosis, clinicians may discuss low-dose doxepin, ramelteon or an orexin antagonist such as suvorexant. Availability changes and should be checked rather than assumed. Sedating antidepressants such as trazodone, mirtazapine or amitriptyline are also used off-label in selected situations, usually when a coexisting condition or previous response is relevant. They are not interchangeable or routine first-line treatments for insomnia; the AASM guideline specifically suggests not using trazodone for chronic insomnia because evidence for benefit is limited.
The AASM recommendation against melatonin for chronic insomnia is weak and based on very low-quality evidence, not proof that it never has a role. Magnesium evidence is limited; kidney disease, interactions and the cause of insomnia must be considered before treating it as a harmless supplement.
This is not a shopping list. Do not combine sedatives with alcohol, opioids or other sedating medicines, do not drive when impaired, and do not stop a long-used sedative abruptly. Timing, formulation and tapering need an individual plan.
Clinical references: American Academy of Sleep Medicine pharmacological guideline and American College of Physicians CBT-I recommendation.
In Delhi and Online
In-person consultations take place at Annova Health, inside The Face Centre, 3rd Floor, 41 Ring Road, Block Q, Lajpat Nagar 4, New Delhi 110024, Monday to Saturday, 11 am to 7 pm, by appointment. The building is on Ring Road itself and is reached easily from Defence Colony, Jangpura, South Extension, Greater Kailash, East of Kailash, CR Park, Kalkaji and Nehru Place. Moolchand and Lajpat Nagar metro stations are both close by. Directions and a fuller clinic guide are on the Lajpat Nagar clinic page.
Insomnia is one of the conditions that transfers best to video, because the work is largely behavioural and depends on what happens at home rather than what can be examined in a room. Where snoring, witnessed pauses in breathing or daytime sleepiness point towards sleep apnoea, a sleep study is arranged rather than guessed at, and that part cannot be done remotely.
An in-person consultation is ₹3,000 for 30 minutes. Online is ₹2,500 for 30 minutes, or ₹4,000 for a pre-booked 60 minutes. Follow-up consultations are charged at the same rate. Full details are on the fees page.
Common Questions
For chronic insomnia, major guidelines recommend cognitive behavioural therapy for insomnia as first-line treatment because benefits can persist after treatment. Medication can still have a role in selected situations after benefits, risks, duration and alternatives are considered.
Some sleep medicines can cause physical dependence, but that is not identical to an addiction diagnosis. Do not stop long-term medication abruptly. A prescriber can assess the medicine, dose, duration, withdrawal risk and whether a gradual taper alongside insomnia treatment is appropriate.
Possibly not. If you sleep well when allowed to sleep late, the problem may be delayed sleep phase, a body-clock condition common in students and young adults, rather than classical insomnia. The distinction matters because the treatments differ entirely.
That combination, particularly with daytime sleepiness, warrants medical screening for obstructive sleep apnoea. A sleep study may be indicated, and treatment depends on the findings and the person's broader health.
Online consultation can support insomnia assessment, sleep diaries, CBT-I-informed planning and medication review. Suspected sleep apnoea, unusual movements, neurological symptoms or other medical concerns may require examination or a sleep study locally.
A little, possibly, and not enough to treat insomnia. The best available evidence is a meta-analysis of three randomised trials in 151 older adults, in which people fell asleep about seventeen minutes sooner than on placebo, and the authors themselves graded that evidence as low to very low quality. Magnesium can cause diarrhoea, interact with some medicines and accumulate in kidney disease. Ask a clinician or pharmacist before using it if you take regular medicines, are pregnant, or have kidney or other significant medical problems. The larger risk is treating a supplement as the answer and postponing a proper look at what is keeping you awake.
Melatonin is a hormone rather than a sedative, and it is most useful for shifting the body clock in delayed sleep phase, shift work and jet lag rather than for chronic insomnia. The American Academy of Sleep Medicine recommends against using it for chronic insomnia in adults, because the evidence for benefit is weak. Short-term use at low doses is generally well tolerated. Analyses of melatonin sold over the counter have found the actual content varying widely from the label, which is worth knowing before taking it nightly for months.
Several explanations are possible: the underlying sleep problem may still be active, tolerance may have developed, the timing may no longer fit the sleep pattern, or another medical, psychiatric or substance-related factor may have changed. Raising the dose without review can increase harm without solving the cause. A clinician can reassess the diagnosis, add CBT-I where appropriate and, if a reduction is needed, plan it gradually rather than stopping abruptly.
A consultation is ₹3,000 for 30 minutes in person in Lajpat Nagar, or ₹2,500 for 30 minutes online, with a pre-booked 60-minute online session at ₹4,000. Follow-ups are charged at the same rate. CBT-I is usually delivered across several appointments rather than one, and where a sleep study is needed that is arranged separately and charged by the sleep laboratory. The full fee list is published on the site.
Annova Health, inside The Face Centre, 3rd Floor, 41 Ring Road, Block Q, Lajpat Nagar 4, New Delhi 110024. The building is on Ring Road itself, a short drive from Defence Colony, South Extension, Greater Kailash and East of Kailash, with Moolchand and Lajpat Nagar metro stations both nearby. Consultations are Monday to Saturday, 11 am to 7 pm, by appointment.
Unlock sleep evaluation
A structured sleep evaluation and personalised plan are shared after clinical assessment. Message on WhatsApp or email to book, online across India or in person in New Delhi.