Reviewed byArman Magzhanov, MDPsychiatrist, experience 24 years · updated 8 Nov 2026
Key facts
- ICD-10 code
- F51.0
- Who provides care
- A psychiatrist, plus a psychotherapist for CBT for insomnia
- Where
- Online by video, an office in Almaty, home visits
- Duration
- A CBT-I course of 6–8 sessions, better sleep within 4–8 weeks
- Anonymity
- No documents required and no dispensary registration
- When it’s urgent
- Insomnia with delusions, hallucinations, or suicidal thoughts — call 103
- Outcome
- Regular sleep without dependence on sleeping pills
What you should know
Insomnia is a common reason for a night call, and it’s understandable: during the day people somehow hold up, but at three in the morning, when the whole city is asleep and even Al-Farabi Avenue is empty, despair sets in. A woman calls: she hasn’t slept properly for six months, the over-the-counter sleeping pills have stopped working, and she has an important meeting tomorrow. The dispatcher checks whether there are suicidal thoughts, alcohol, or severe anxiety and suggests talking to the on-call psychiatrist by video right now.
The first thing I find out is why the person isn’t sleeping. Insomnia is almost always a symptom of something else: depression, an anxiety disorder, alcohol withdrawal, pain, sleep apnea, caffeine in the afternoon, or night shifts. Until the cause is found, sleeping pills only mask the problem, and over time they stop working and become habit-forming. So at night I help the person get through until morning, and in the morning or during the day we calmly work things out and draw up a full treatment plan.
When insomnia needs a doctor
- falling asleep takes more than half an hour almost every night
- waking up many times during the night and struggling to fall back asleep
- waking at four or five in the morning with heavy thoughts and a low mood
- feeling drained, irritable, making mistakes at work, or drowsy at the wheel during the day
- you can’t fall asleep without sleeping pills or alcohol
- sleep problems have lasted more than a month despite efforts to fix your routine
- several nights with almost no sleep along with an unusual surge of energy and activity
If two or three points apply, it is worth seeing a doctor. Phone advice is free and confidential. If life is at risk, call 103 or 112.
Why people stop sleeping
The most common causes of chronic insomnia are anxiety and depression. With anxiety, it is hard to fall asleep because of racing thoughts; with depression, waking early is typical. The second big group is alcohol: it helps you fall asleep but destroys the structure of sleep, and when you stop drinking, the insomnia becomes severe. Sleep is also disrupted by pain, thyroid problems, sleep apnea, certain medications, shift work, and coffee and energy drinks in the afternoon.
Even when the original cause goes away, insomnia can persist on its own. The person begins to fear the night, lies in bed for a long time, watches the clock, and naps during the day. The brain stops associating the bed with sleep. This mechanism is well studied, and it is exactly what cognitive behavioral therapy for insomnia targets. A separate warning sign is several nights without sleep and without tiredness: this can be the beginning of a manic phase or psychosis.
How insomnia treatment works
It is convenient to start with a video consultation, especially if you live in the Nauryzbay district or in Kaskelen and don’t want to sit in evening traffic. Before the appointment, keep a sleep diary for a week: when you go to bed, fall asleep, and wake up, plus coffee, alcohol, and daytime naps. The psychiatrist will ask about sleep, mood, anxiety, medications, and snoring. They will then explain the cause and suggest a plan: CBT for insomnia, treatment of the underlying disorder, and, if needed, short-term medication support.
Insomnia with suspected psychosis, mania, or delirium tremens, or with suicidal thoughts, requires urgent help — call a psychiatrist to the home or call 103. For insomnia caused by alcohol withdrawal, an addiction doctor is needed, and with severe withdrawal, seizures, or confusion, inpatient care. If you are falling asleep at the wheel, don’t drive until you have been treated.
How we help
Finding the cause
The psychiatrist clarifies the nature of the sleep problems and their link to mood, anxiety, alcohol, work, and illnesses. If sleep apnea is suspected, they recommend a sleep study; if thyroid disease is suspected, blood tests. Without this step, treatment will be imprecise, and sleeping pills will be a temporary patch that eventually stops working.
CBT for insomnia
According to NICE guidelines, cognitive behavioral therapy for insomnia is the first-line treatment for chronic insomnia. It includes a sleep schedule, the “bed is only for sleep” rule, limiting time in bed, working with anxious thoughts about sleep, and relaxation techniques. It usually takes 6–8 sessions, in person or online. The effect lasts long after the course ends.
Medication support
If needed, the doctor prescribes sleep medications for a short course when insomnia gets in the way of starting therapy. Benzodiazepine sleeping pills and similar drugs are prescribed only by a doctor and for a limited time because they are habit-forming. If insomnia is linked to depression or anxiety, those are treated first, and sleep recovers along with mood.
Coming off sleeping pills
Many people take sleeping pills for years and can’t fall asleep without them. Stopping abruptly causes severe insomnia and anxiety. The Narcology 24 psychiatrist draws up a plan for gradually reducing the dose alongside CBT so the person can move to natural sleep. It takes weeks, but it frees the person from depending on a pill and brings back restful sleep.
Myths and facts
MythAlcohol helps you fall asleep
FactAlcohol speeds up falling asleep but destroys the structure of sleep: you wake up more often, sleep is shallow, and you don’t feel rested in the morning. With regular use, dependence develops, along with severe insomnia when you stop.
MythYou can take sleeping pills for years without consequences
FactWith long-term use, many sleeping pills lose their effect and cause dependence, daytime drowsiness, memory problems, and falls in older people. They are prescribed for a short course and under a doctor’s supervision.
MythIf you can’t sleep, you should lie there and wait
FactLying awake for a long time increases anxiety and reinforces insomnia. If you can’t fall asleep within 20–30 minutes, it is better to get up, do something calm in dim light, and go back to bed when you feel sleepy.
How a home visit works
- Call or message usThe dispatcher answers 24/7 and in 3–5 minutes checks the person's condition, age, how long the drinking or use has lasted, chronic conditions and the address. No surname needed.
- The doctor sets offAn addiction doctor or psychiatrist comes with equipment and medication. Travel time depends on the district — usually within an hour. If inpatient care or an ambulance is needed, we'll say so straight away.
- Examination and treatmentBlood pressure, pulse, oxygen saturation, blood sugar if needed and a neurological check. Then an IV drip or other treatment as indicated, 1–3 hours.
- A plan for the next daysAdvice for the family on what to do overnight and tomorrow, phone follow-up and a repeat visit if needed.
- Further treatmentCoding, psychotherapy, rehab or psychiatric follow-up — once the acute state has passed and the person is ready.
Prices in Almaty
| Psychiatrist consultation | 15 000 ₸ |
| Follow-up consultation | 12 000 ₸ |
| Psychotherapy session (50 min) | 15 000 ₸ |
| Phone advice | free |
The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.
Where to get help
“Insomnia treatment” in Almaty is available 24/7, including weekends. Home visits: all city districts and nearby settlements. For appointments, Narcology 24 has two branches: 84 Zhandosova St., Almaty and 21 Seyfullina Ave., office 11, Almaty. If you live elsewhere in Almaty and Almaty Region, call us and we'll advise the fastest way to get help.
Confidential and private
in Almaty our doctor can come in ordinary clothes in an unmarked car. Treatment documents are given only to the patient. If you need a certificate or sick note, this is discussed separately and only at your request.
Questions and answers
How many sleepless nights are dangerous?
One or two bad nights are unpleasant but not dangerous. It is dangerous if a person barely sleeps for several nights in a row yet doesn’t feel tired, is agitated, and talks a lot — this can be the beginning of mania or psychosis. In that case, an urgent psychiatric examination is needed.
Can I buy sleeping pills at a pharmacy without a prescription?
Over-the-counter remedies are suitable only for occasional sleep problems and don’t treat chronic insomnia. Strong sleeping pills are prescription-only, and taking them without supervision is dangerous. It’s better to see a doctor once than to take pills at random for months.
What is CBT for insomnia, and how quickly does it help?
It is a structured form of psychotherapy that changes the habits and thoughts that get in the way of sleep. A course is usually 6–8 sessions. The first weeks can be difficult because of limited time in bed, but then sleep becomes deeper, and the effect lasts a long time.
What should I do about insomnia after quitting alcohol?
It is a common problem in the first weeks of sobriety. Don’t go back to alcohol to fall asleep. See a doctor: at Narcology 24, an addiction doctor and a psychiatrist will select safe treatment. If there are seizures, confusion, or hallucinations, call 103 or 112 right away.
Can I get a consultation at night when I can’t sleep?
Yes, the on-call psychiatrist is available around the clock. At night, the doctor will help ease anxiety and get you through the night, but the main consultation is best held during the day, with a clear head, when you can calmly go over your sleep diary and make a plan.
Do melatonin and herbal teas help?
Melatonin can help with a disrupted rhythm, for example after flights or shift work, but its effect in chronic insomnia is limited. Herbal teas are safe but don’t treat the disorder. If your sleep has been disrupted for more than a month, it’s better to see a doctor.
Where do doctors visit in Almaty and where are the branches?
Home visits cover all city districts and nearby settlements, 24/7. Appointments at two branches: 84 Zhandosova St., Almaty and 21 Seyfullina Ave., office 11, Almaty. Phone in Almaty: +7 (700) 309-29-88.
Sources and methodology
This page was prepared by the Narcology 24 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) guidelines on alcohol and drug misuse and mental health conditions
- WHO recommendations on the treatment of substance use disorders
This information is for reference only and does not replace a consultation with a specialist. Editorial policy
