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You have tried counting sheep, drinking warm milk and even taking medication but nothing seems to work. You spend your evenings wide-awake and your days half asleep. If this sounds familiar, you may be among the 20-40 percent of adult Americans plagued by insomnia.

Often brought on by stress, depression or anxiety, insomnia is most commonly found in women, the elderly, and people with other chronic health problems. To address the needs of those suffering from insomnia, specialists from New York Methodist Hospital's Division of Pulmonary and Critical Care Medicine and the Sleep Disorder Center established an insomnia clinic specifically designed to support and treat patients with this chronic sleep disorder.

"A common misconception is that insomnia can be quickly fixed with medication or a single small change in one''s routine," said Boris Dubrovsky, Ph.D., a clinical fellow with the Sleep Disorders Center at NYM, who runs the clinic with Liziamma George, M.D., director of the Hospital's medical intensive care unit and board certified physician in sleep medicine. "Patients typically come to the clinic after experiencing many months or even years of poor sleep," he said.

Physicians associated with the insomnia clinic use a focused, cognitive behavioral therapy approach to treating insomnia. Cognitive behavior therapy is a treatment method that combines changing an individual''s attitudes, beliefs and assumptions about sleep while helping the patient to understand how to implement new behavioral patterns or habits to improve their sleep. "We assist patients by teaching them how to think about sleep in a more positive way," said Dr.George.

Upon first coming to the clinic, a patient''s sleep history and physical and mental conditions are thoroughly examined. "Through carefully addressing the patient''s sleep problems from both a cognitive and behavioral viewpoint, we are able to attack the problem head on and devise techniques that work best for that individual patient," said Dr. George.

"Patients have the greatest success after one or two meetings because they begin to identify and understand the root of their problem," she said, adding that physicians usually meet from six to eight times with an individual patient. "After each meeting, the patient can go home and try out the recommended nighttime habits and hopefully get a good night''s sleep."

Although patients who visit the clinic receive an individualized sleep plan, Dr. Dubrovsky and Dr. George recommend that patients get into bed when they feel tired as opposed to when it should be bedtime, even if that means getting less sleep. They also suggest that patients cut out daytime napping and leave the bedroom if they begin to feel anxiety over not falling asleep. "The main goal of this therapy is to provide patients with successful tools that continue to work long after the therapy is terminated," said Dr. Dubrovsky.

In addition to the insomnia clinic, the Sleep Disorders Center at NYM offers diagnostic and therapeutic services for a full range of sleeping problems such as narcolepsy, snoring and sleep apnea, among others.

For more information on the insomnia clinic, please call NYM''s faculty practice office at 718-246-8600. A physician referral is required.