Reviewed by: Pavel Kornilov, MD, psychiatrist · updated 6 Nov 2026
Key facts
- ICD-10 code
- F51.0
- Who leads care
- A psychiatrist and a psychotherapist trained in CBT for insomnia
- Format
- Video consultations, a sleep diary, weekly online sessions
- Duration
- First appointment 50 minutes; a CBT-I course usually takes 6–8 sessions
- Confidentiality
- Medical confidentiality under the Kazakhstan Code “On Public Health”
- When it is urgent
- Several days without sleep with agitation, confusion, or suicidal thoughts — call 103 or 112
- Outcome
- You fall asleep faster, wake up less at night, and have more energy during the day
What you should know
Insomnia is not just “sleeping badly.” It is a condition in which poor sleep persists for a long time and interferes with daytime life: fatigue, irritability, and mistakes at work set in. Clinical guidelines distinguish acute insomnia, which is linked to stress and passes within a few weeks, from chronic insomnia, which is no longer driven by the original cause but by habits that have taken hold and by the fear of not falling asleep. That is exactly why sleeping pills often help only temporarily.
Why does a vicious circle develop? A person lies awake for a long time, worries, tries to “catch up” on sleep during the day or goes to bed earlier — and this weakens the sleep mechanisms even further. CBT-I breaks this circle. At Psychiatry Online, treatment takes place over video: convenient for people who, after a long day at the office, do not want to travel to a clinic in the evening, especially in winter, when it gets dark early and the wind makes the trip across the bridge exhausting.
Signs and Symptoms of Insomnia
- taking more than half an hour to fall asleep almost every night
- frequent nighttime awakenings followed by difficulty getting back to sleep
- waking up early and being unable to sleep until the alarm
- feeling unrefreshed in the morning, even after many hours in bed
- daytime sleepiness, irritability, and poor concentration
- anxiety and tension in the evening at the thought of having to go to bed
- a habit of “catching up” on sleep on weekends or during the day to make up for lost sleep
If at least two points apply and the state lasts longer than two weeks, it is worth seeing a specialist. Phone consultation is free. If life is at risk, call 112 or 103.
What Causes Insomnia
Sleep is regulated by two mechanisms: homeostatic sleep pressure, which builds up during waking hours, and the circadian rhythm — the internal clock synchronized with light. Insomnia develops when one of them is weakened or the two fall out of step, while the brain stays in a state of heightened arousal. The “3P” model describes how it develops: predisposing factors (a tendency toward anxiety), precipitating factors (stress), and perpetuating factors (unhelpful sleep habits).
Local conditions put extra strain on the circadian rhythm. A long winter and short days reduce the amount of morning light that “sets” the internal clock, while bright summer evenings shift it in the other direction. The demanding schedules of the civil service and corporate offices, with late meetings and working on a laptop in bed, increase arousal before sleep. Insomnia can also be a symptom of depression, anxiety, sleep apnea, and physical illnesses.
How Online Treatment for Insomnia Works
Before the first video consultation, it is useful to keep a sleep diary for one to two weeks: when you went to bed, how long it took to fall asleep, how many times you woke up, when you got up, and how you felt during the day. The doctor reviews the entries, asks about stress, mood, medications, caffeine, and alcohol, and uses questionnaires to assess the severity of insomnia. At the end, you receive a personalized CBT-I plan and a schedule of sessions. You will need headphones and a stable connection.
Polysomnography — an overnight sleep study in a laboratory — cannot be done online. If you snore with pauses in breathing, have severe daytime sleepiness, or move your legs at night, the doctor will refer you for an in-person evaluation. Whether medication can be prescribed and a prescription issued depends on Kazakhstan law. If you have gone several days without sleep, or agitation, confusion, or suicidal thoughts have appeared, call 103 or 112.
How we help
CBT for insomnia
International guidelines name CBT-I as the first-line treatment for chronic insomnia, ahead of medication. It includes several components that act on the mechanisms of sleep, not just the symptom. Unlike sleeping pills, its effect lasts after the course ends. A course usually takes 6–8 sessions and works well online.
Sleep restriction
This is a key component of CBT-I. Time in bed is temporarily cut down to the time you actually sleep, in order to build up sleep pressure and make sleep deeper. Time in bed is then gradually increased. The method requires guidance from a specialist: the first few days can be hard, and the settings are based on your sleep diary rather than guesswork and adjusted every week.
Stimulus control and working with thoughts
Your bed should be associated with sleep, not with work, your phone, and anxiety. So if you cannot sleep for more than 15–20 minutes, you are advised to get up and return when you feel sleepy. At the same time, you work on beliefs such as “if I don’t fall asleep, I’ll fail at everything tomorrow,” which keep arousal high and make it hard to relax.
Light routine and medication when indicated
Bright light in the morning and dim light in the evening help synchronize your rhythm, which is especially important in winter. Medications for insomnia are used sparingly and in short courses; the class of medication is decided by the doctor. At Psychiatry Online, the specialist helps you find a routine you can realistically keep with your work schedule.
Myths and facts
MythYou need exactly eight hours of sleep
FactSleep needs are individual and vary from person to person. Trying to “make up” the quota by lying awake in bed only makes insomnia worse. Sleep quality and how you feel during the day matter more than an exact number of hours.
MythSleeping pills are the best solution
FactSleeping pills can help for a short period, but they do not address the causes of chronic insomnia and become habit-forming with long-term use. Clinical guidelines prioritize CBT-I, whose effect lasts for a long time.
MythAlcohol helps you fall asleep
FactAlcohol may help you fall asleep faster, but it disrupts the structure of sleep: sleep becomes shallow, and awakenings become more frequent in the second half of the night. As a result, you sleep worse and feel more drained in the morning.
How an online appointment works
- Message or callWrite on WhatsApp or call — our coordinator replies within minutes, day or night. You don't have to give your surname.
- Doctor and timeWe match you with a psychiatrist, addiction specialist or psychotherapist and agree on a time — often the same day.
- Video consultationA secure 50–60 minute video call: the doctor takes a detailed history and uses standardised scales if needed.
- Treatment planYou receive a clear summary, recommendations and a plan: what we do online and what needs an in-person visit or home call.
- Follow-upOnline follow-up sessions, messenger contact with your doctor, and treatment adjustments until you get a stable result.
Prices in Astana
| Online psychiatrist consultation (50–60 min) | 15 000 ₸ |
| Follow-up online consultation | 12 000 ₸ |
| One month of online psychiatric care | 60 000 ₸ |
The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.
Where to get help
You can book in Astana online or at one of two branches: 72 Bogenbay batyra St., Astana, 37 Petrova St., office 23, Astana. Our coordinator replies on WhatsApp within minutes at any time, and a doctor usually connects by video the same day; home visits are available too — all city districts and nearby settlements.
Confidential and private
Information about your visit, diagnosis and treatment is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”. We never share it with your employer, school or relatives without your consent; the only exceptions are those expressly set out by law. For an online consultation your first name is enough, video runs over a secure channel and nothing is recorded without your consent.
Questions and answers
When does insomnia need treatment?
If sleep problems occur at least three times a week for more than a month and make you feel worse during the day, it is worth seeing a doctor. The earlier treatment starts, the easier it is to break the vicious circle before perpetuating habits take hold.
Can insomnia be treated online?
Yes. CBT-I is built on analyzing a sleep diary, education, and step-by-step changes in habits — all of which can be done effectively over video. Research confirms that remote CBT-I gives good results, comparable to in-person treatment, as long as the patient keeps a diary.
Why is sleep worse in winter?
Short days reduce the amount of morning light that synchronizes the internal clock. The rhythm shifts, making it hard to wake up in the morning and hard to fall asleep at night. Morning light, a walk during daylight hours, and a consistent wake-up time, even on weekends, all help.
Do I need to give up coffee?
Not necessarily completely. Caffeine works for several hours, so the usual advice is to avoid it in the second half of the day. Using your diary entries, the doctor will help you understand how much coffee affects your sleep in particular and work out a sleep-friendly routine.
How long does treatment take?
A CBT-I course usually takes 6–8 weeks, and the first improvements are often noticeable after two or three weeks. If insomnia is linked to depression or anxiety, treating the underlying disorder may take longer, and the doctor will discuss this in advance.
Is it confidential?
Yes. Information about your consultation at Psychiatry Online is protected by medical confidentiality under the Kazakhstan Code “On Public Health and the Healthcare System.” You can seek help anonymously, and information may be disclosed only in cases expressly provided for by law.
Where can I be seen in Astana?
Online — from anywhere in the city or region. In person — at two branches: 72 Bogenbay batyra St., Astana and 37 Petrova St., office 23, Astana. Both are open 24/7; home visits cover all city districts and nearby settlements.
Sources and methodology
This page was prepared by the Psychiatry Online medical editorial team based on:
- International Classification of Diseases ICD-10 and ICD-11, World Health Organization
- Clinical diagnosis and treatment protocols of the Ministry of Health of the Republic of Kazakhstan
- Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”
- NICE (UK) and APA (US) guidelines on the treatment of mental disorders
- WHO recommendations on telemedicine and digital health
This information is for reference only and does not replace a consultation with a specialist. Editorial policy
