From Bethesda Magazine: How to overcome chronic sleeplessness

A Potomac psychologist uses CBT-I therapy to treat patients

By Renee Sklarew

June 9, 2026 3:00 p.m. | Updated: June 5, 2026 3:03 p.m.

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Before a D.C. lobbyist began working remotely, he considered himself a good sleeper. But his changing routines—going virtual then later back to in-person—greatly impacted his ability to fall asleep. That’s when he contacted Virginia Runko, a clinical psychologist in Potomac who specializes in behavioral sleep therapy. “He was really frustrated, and as most people do, tried to fix the problem by hyperfocusing on sleep efforts,” says Runko, 44. “That made it worse.”

Runko prescribed wearing blue light-blocking glasses at least an hour before bedtime. When he still couldn’t fall asleep, the lobbyist would try getting out of bed instead of staying there and feeling frustrated. Runko says it’s common for people with insomnia to develop wakefulness as soon as they get into bed. He also established a downtime routine he sticks to even when traveling. “People need a runway to wind down,” Runko says. “Most people realize it’s valuable but don’t carve it out for themselves.”

Everyone has an occasional night when sleep is elusive, but a 2024 survey by the American Academy of Sleep Medicine (AASM) reported that 12% of Americans 18 and older say they were diagnosed with chronic insomnia. AASM classifies insomnia disorder as having difficulty falling asleep or maintaining sleep, or early morning awakening with an inability to go back to sleep. These disturbances occur three or more nights a week, for three months or more, and cause significant distress or impairment, such as irritability and reduced concentration. 

The American College of Physicians endorses cognitive behavioral therapy for insomnia (CBT-I) as the initial treatment for chronic insomnia. The recommendation is based on evidence showing patients experienced improvements that were more effective in the long term and more durable over time than medications. In some cases, CBT-I may also benefit people with snoring problems or sleep apnea, Runko says.

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As a teen, Runko was fascinated with primatologist Jane Goodall and her studies of animal behavior. She focused her college studies on health psychology, earning a Ph.D. at the University of Miami in 2011. A one-year internship at a sleep clinic at the Miami Veterans Affairs Medical Center cemented her passion for CBT-I. “I was impressed with how quickly people got better,” she says.

After graduation in 2011, Runko pursued a postdoctoral fellowship in behavioral sleep medicine from the Johns Hopkins School of Medicine in Baltimore. She moved to Bethesda in 2011 while working part time at the Johns Hopkins Center for Sleep at Howard County General Hospital and Johns Hopkins Bayview Medical Center. She then took a job at The Ross Center, a mental health center in Washington, D.C.’s Friendship Heights neighborhood, in 2014 and purchased a house in Potomac that same year. 

To balance caring for her two young children, Runko opened a private practice at her home in 2019 and she now only sees patients virtually. She says her license allows her to treat patients in 43 states. She has a long waitlist. “I don’t have time to treat everyone, so I offer resources and referrals. There aren’t enough providers to deliver this treatment,” she says. 

CBT-I therapy is a weekly program, consisting of six to eight sessions, that introduces a collection of strategies, including maintaining a sleep log, learning breathing techniques and practicing sleep hygiene, such as cutting down on caffeine, moderating alcohol use and keeping the bedroom cool, dark and quiet. “CBT-I gets at the underlying causes of insomnia,” Runko says. “Even when patients stop going to therapy, they know the skills and can adjust their habits.” 

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CBT-I also helps people reframe their maladaptive thoughts to reduce stress around sleep. “This might be believing you will never be a good sleeper and your life will become a wreck,” Runko says. In therapy, she acknowledges what her patients are feeling while noting the positive aspects of their lives, such as support from family and friends or the ability to maintain a job despite having sleep challenges. 

Patients come to Runko with a range of problems. She recently worked with a 60-year-old who developed chronic insomnia after starting therapy for childhood sexual trauma. Runko directed
this client to track the correlation between her sleep problems and experiencing anxiety about her past. Now when she has trouble sleeping, she automatically gets out of bed and practices relaxation techniques to break the link. Along with adding in better sleep hygiene, the client reports feeling more balanced and less pessimistic.

A pregnant client with a history of depression and anxiety developed postpartum symptoms that included worrying about her baby’s sleep. Runko focused on mindfulness training and having the client listen to sleep stories on the Calm app rather than excessively researching insomnia on her phone at night. 

Runko remains steadfast about her sleep hygiene and strives to have lights out at 9:45 p.m. with the alarm set for 5:45 a.m. “I really protect and preserve it, no matter what. Even when my husband and I are watching a show with a cliff-hanger, I get up from the TV to start winding down,” Runko says. “I still toss and turn sometimes, but paFrom Bethesda Magazine: How to overcome chronic sleeplessnessrt of insomnia treatment is understanding every night is not going to be perfect.” 

This appears in the May/June 2026 issue of Bethesda Magazine.

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Originally published at Bethesdamagazine