Psychiatrist and sleep medicine physician Nishi Bhopal, MD explains why chronic insomnia can persist despite sleep hygiene, medications, supplements, melatonin, and even CBT-I, outlining three commonly missed issues in clinical practice.

Dr. Nishi Bhopal MD, a psychiatrist and sleep medicine physician, explains how to evaluate patients who wake every few hours despite a “normal” sleep study, emphasizing that a single study especially a home sleep apnea test does not rule out sleep apnea or other causes of sleep fragmentation because it mainly measures breathing rather than sleep architecture, limb movements, or narcolepsy.