Areas of focus
Insomnia and anxiety disorders frequently occur together: worry and tension keep you awake, and lack of sleep wears down the resources you need to handle anxiety. This page sets out what treatment looks like in each case.
Focus 1
Chronic insomnia is diagnosed when difficulty falling or staying asleep occurs on several nights a week for at least three months and noticeably affects your daytime functioning. In Germany, an estimated six to ten per cent of adults are affected.
Cognitive behavioural therapy for insomnia is a structured approach made up of several components. National and international guidelines name it as the first-line treatment — including alongside co-occurring psychological or physical conditions, and ahead of sleep medication.
One important point first: not every sleep problem is insomnia. Sleep apnoea, restless legs syndrome, thyroid conditions or medication side effects can cause similar complaints and require different investigation. Whether a physical assessment is advisable, or has already taken place, is something we clarify at the outset.
People who sleep badly tend to spend more and more time in bed — and lie awake there longer and longer. Managing time in bed rebuilds sleep pressure. It is the most effective component and also the most demanding; we set the pace together.
The bed should be associated with sleep again, rather than with lying awake, ruminating and frustration. This involves clear rules about what happens in bed — and what you do when you wake during the night.
Circling thoughts, worry about the next day, calculating how much sleep is left. We use techniques that move rumination out of the night — among them scheduled worry time during the day.
“I absolutely need eight hours.” “One bad night ruins the whole day.” Beliefs like these raise the pressure and with it the tension. We test them against your own sleep-diary data.
Methods for physical relaxation and a realistic evening routine that fits your actual life — not an idealised daily schedule.
Bad nights will still happen. What matters is what comes afterwards. At the end we write down which steps apply during such phases.
Throughout the treatment you keep a sleep diary. It costs you two minutes a day and forms the basis for almost everything else: it reveals patterns that nobody reliably remembers in hindsight, makes change visible, and provides the data against which we test sleep-related beliefs. Alongside it I use standardised questionnaires such as the Insomnia Severity Index to make progress measurable.
Focus 2
Anxiety disorders are the most common group of mental health conditions among adults — figures from the Robert Koch Institute put the twelve-month prevalence at around 15 per cent. They include panic disorder, generalised anxiety disorder, social anxiety disorder and specific phobias.
They share a mechanism: avoidance brings short-term relief and maintains anxiety in the long run. Because the feared catastrophe does not occur, the brain attributes this to the avoidance — and the anxiety goes unchallenged. This is precisely where cognitive behavioural therapy intervenes.
Treatment takes place by video. We prepare exposure exercises together; you carry them out in your everyday life, in some cases with support by phone. Where an in-person setting would clearly be more appropriate, I will say so openly and help you find someone locally.
Anxiety is a sensible bodily response caught in a false alarm. We build a model of how your anxiety arises, what relieves it in the short term — and why exactly that maintains it in the long term.
Avoidance is rarely obvious. It also hides in safety behaviours: carrying a water bottle, keeping an eye on the exit, distracting yourself internally. We map these patterns before changing them.
Catastrophic thoughts get examined — not argued away, but tested against reality. The aim is an assessment that matches the actual probabilities.
The core of anxiety treatment: facing anxiety step by step, planned and supported, instead of avoiding it. We build the steps together, at a pace you can carry. Nothing happens by surprise.
Between sessions you continue practising independently. These exercises are not an add-on — they are where the change actually happens.
Co-occurring conditions
Insomnia and anxiety frequently occur alongside depression, burnout or persistent stress-related symptoms. Where sleep or anxiety is the reason for treatment, these are treated as part of it — keeping them out of the therapy would be neither possible nor sensible.
This is exactly where the difference to a standardised programme lies: a digital sleep training runs the same way for everyone. Treatment that overlooks an accompanying depression may not work for you — not because the method is poor, but because it starts in the wrong place.
Online treatment is not the right format for every situation. With acute suicidality, severe addiction, acute psychosis, or where close crisis support is needed, you need a different setting — usually in person and with medical involvement.
If the intake call shows that what I offer does not fit, I will tell you — and help you look in the right place.
Further reading
These sites are not part of my practice. I link to them because they inform reliably — regardless of whether you decide to work with me.
The German professional body for sleep medicine, with patient information and a directory of accredited sleep laboratories — useful if a physical assessment is needed.
Accessible information on sleep and sleep disorders for those affected (in German).
The US professional body, behind the international guidelines that name CBT-I as the first-line treatment for insomnia.
In the free intake call we establish whether and how treatment with me makes sense for you.
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