Can Ketamine Therapy Help with Sleep?

Sleep disorders affect an estimated 50-70 million Americans annually.¹ For many people with insomnia, conventional treatments present a difficult choice: months of therapy with variable outcomes^{14, 15}, sedating medications that don't address the root cause, or sleep aids that have been associated with long-term risks like falls, dependency, and cognitive decline.^{11, 12, 13}

Mindbloom sleep outcomes snapshot

In Mindbloom's preliminary real-world analysis of 13,963 clients reporting sleep disturbances at baseline, 67% reported meaningful improvement after session two, and 77% by session six (defined as a ≥1-point improvement on PHQ-9 item 3 sleep disturbance scale, which on the 0-3 scale represents clinically significant change).²

‍This is a preliminary, observational analysis based on self‑reported outcomes and is not a randomized controlled trial.² These improvements occurred in the context of treatment for underlying mental health conditions such as anxiety, depression, or trauma, rather than as a stand-alone sleep intervention.

How does ketamine therapy work for sleep?

Research suggests ketamine may influence sleep-related symptoms in part by acting on the brain’s glutamate system and supporting neuroplasticity (the brain’s ability to form new connections).³ For some people—especially when sleep disruption is linked with anxiety, stress, or trauma—insomnia may involve a state of heightened arousal that makes it hard to downshift into sleep.⁴ Ketamine therapy may work by helping restore the brain's ability to regulate this stress response and form new patterns that support restful sleep.

The mechanism at different levels:

At the most basic level, ketamine acts as an NMDA receptor antagonist within the brain’s glutamatergic system, triggering downstream signaling cascades that promote synaptic plasticity—the brain’s ability to form and strengthen new neural connections.^3,5 This increase in synaptic plasticity may help the brain reorganize maladaptive neural patterns that contribute to persistent sleep disruption, particularly in the context of stress and mood dysregulation.⁶

At a deeper level, research suggests ketamine may also influence broader neurotransmitter systems involved in mood regulation and the control of sleep-wake cycles, including glutamate, GABA, and monoaminergic pathways.^{7, 8}

During ketamine sessions at therapeutic doses, clients may experience altered perception and a sense of calm.⁹ This state may create opportunities for insight and shifts in perspective. The integration work that follows—coaching, reflection, and structured practices between sessions—is designed to help translate these experiences into lasting changes in sleep patterns.

Mindbloom Sleep Outcomes (Real-World Data)

How effective is ketamine therapy for sleep?

In Mindbloom’s preliminary real‑world analysis of 13,963 clients reporting sleep disturbance at baseline: 77% reported meaningful improvement by session 6 (defined as a ≥1‑point improvement on PHQ‑9 item 3, scored 0–3).² Improvement often appeared early: 67% met the same threshold by session 2.²

• 77% reported meaningful improvement by session 6 (defined as a ≥1‑point improvement on PHQ‑9 item 3, scored 0–3).²
• Improvement often appeared early: 67% met the same threshold by session 2.²
• Mean sleep-disturbance severity improved by 49% from baseline to endpoint (percent change in mean PHQ‑9 item 3 score).²

For people whose suffer from anxiety, depression, and/or PTSD and their sleep hasn’t improved with first-line approaches such as CBT‑I or commonly prescribed sleep medications, ketamine therapy may be an alternative to discuss with a licensed clinician. Individual results vary, and ketamine isn’t prescribed solely for sleep.²

How quickly does ketamine therapy reduce sleep disturbances?

Many clients in Mindbloom’s analysis reported early improvement, with 67% meeting the meaningful-improvement threshold (≥1‑point improvement on PHQ‑9 item 3) by session 2—often within the first two weeks, depending on scheduling. Overall, response increased from 67% after session 2 to 77% after session 6.² 

• Session 2: 67% response rate
• Session 4: 75% response rate
• Session 6: 77% response rate

For context, conventional treatments have different timelines. Cognitive behavioral therapy for insomnia (CBT-I) typically involves weekly sessions over several weeks.¹⁴

It's important to note that while many clients notice rapid initial improvements, sustained recovery may be supported by ongoing integration work. The neuroplastic changes facilitated by ketamine may create windows of opportunity for healing, but lasting transformation may benefit from actively working with those insights between sessions through coaching and integration practices.

How do conventional sleep treatment compare (mechanisms and timelines)?

Conventional approaches can work well for many people, but they operate through different mechanisms and timelines:

• SSRIs are sometimes used when insomnia is driven by underlying conditions such as depression or PTSD, but their effects on sleep are indirect and typically take several weeks to emerge, reflecting gradual changes in serotonergic signaling and symptom improvement¹⁰
• Benzodiazepines and Z-drugs like Ambien promote sedation but are associated with suppression of slow-wave sleep, reduced sleep quality, and increased risks of dependence, cognitive impairment, and falls—particularly with longer-term use^{11, 12, 13}
• Cognitive behavioral therapy for insomnia (CBT-I) is an evidence-based treatment, but it typically requires multiple weekly sessions over several weeks, and real-world dropout rates of approximately 20–30% have been reported^{14, 15}

Ketamine works through an entirely different mechanism, rapidly enhancing the brain's flexibility and capacity for change.

Important note: While research suggests these therapeutic mechanisms, the complete neurobiological pathways through which ketamine affects sleep are still being studied, and ketamine therapy does not work for everyone.

Treatment Options and What to Expect

How do I get started?

Getting started with Mindbloom's ketamine therapy is straightforward:

1. Complete a brief online assessment to share information about your mental health history, symptoms, and medical history
2. Schedule a consultation with a licensed Mindbloom clinician who will evaluate your eligibility 
3. Discuss whether Tablets or Injectables might be best for you, based on your history and goals
4. Receive your personalized treatment plan if ketamine therapy is appropriate for you
5. Get your medication delivered to your door with all necessary supplies
6. Begin your first guided session with support from your clinical team and guide

Throughout your treatment, you'll have access to continuous clinical oversight, guide coaching, and integration support to help you get the most from your experience.

What does the Mindbloom program include?

Mindbloom's ketamine therapy program is designed as a structured, clinician-guided experience that integrates medicine, preparation, and integration. The program includes:

Clinical care & monitoring

• An initial video consultation with a licensed psychiatric clinician to assess eligibility and personalize your treatment plan
• Ongoing clinical oversight throughout the program, with support available between sessions
• Adjustments to your protocol as needed, based on your progress and experience

Guided ketamine sessions

• 6, 12, or 18 ketamine sessions, completed at home over several weeks
• A dedicated digital platform (the Mindbloom App) to support your sessions with intention-setting tools, therapeutic soundscapes, and real-time guidance
• Options for sublingual tablets or subcutaneous injectables, selected in collaboration with your clinician

Integration & support

• One-on-one coaching sessions with a trained Mindbloom Guide
• Structured integration practices and exercises to help process insights between sessions
• Tools to capture reflections, including voice journaling
• Access to a private peer support community

Preparation & education

• A comprehensive onboarding process to prepare you for treatment
• Resources on topics like sleep science, neuroplasticity, and ketamine therapy
• Guidance on how to create a supportive set and setting for at-home sessions

Mindbloom's program is built to address both biological and psychological dimensions, with a focus on safety, structure, and support throughout the healing process.

At-home vs in-clinic: what's the difference?

Mindbloom's at-home ketamine therapy protocol has demonstrated promising outcomes in preliminary analyses.

Effectiveness data:

According to Mindbloom’s preliminary real-world analysis of sleep outcomes, clients experienced a 49% average reduction in sleep disturbance severity after six ketamine sessions, as measured by PHQ-9 item 3.² Improvements were observed early, with a 39% mean reduction after two sessions and a 46% mean reduction after four sessions,² suggesting a rapid improvement trajectory for many clients.

One way to contextualize these findings is to compare them with published esketamine (Spravato) trial data that reported change on a single sleep-related item (MADRS item 4, “reduced sleep”).¹⁷ Because these results come from different studies with different populations, dosing schedules, and outcome measures, this is a descriptive comparison—not a head‑to‑head trial—and shouldn’t be interpreted as one treatment being superior.¹⁷ With that context, Mindbloom’s analysis shows:

• Larger observed percent change on the respective single‑item sleep measures by treatment completion (PHQ‑9 item 3 vs MADRS item 4): 49% vs 38%
• Faster early improvement, with larger reductions observed at earlier treatment stages
• Less frequent dosing, with six at-home sessions over 4–6 weeks compared to twice-weekly in-clinic dosing in the esketamine study

Accessibility & affordability:

• At-home ketamine therapy through Mindbloom can be less expensive than in-clinic IV ketamine infusions, which often cost several hundred dollars per session. See pricing for full details.
• No need to travel to a clinic or take time off work
• Treatment available across the United States, not just in major cities

Comfort & therapeutic benefit:‍

For some people with sleep disturbance, particularly those who experience anxiety in unfamiliar medical settings, the ability to undergo sessions in a familiar, safe home environment may enhance treatment tolerability and engagement. Additionally, receiving therapy in your own bedroom—the literal context where sleep difficulties occur—may provide unique benefits for addressing sleep-specific concerns. The concept of 'set and setting'—that environment influences therapeutic experiences—is well-established in the research literature.¹⁶ 

Comprehensive support:

Mindbloom's model includes guide coaching, structured preparation and integration, and ongoing clinical monitoring alongside ketamine treatment. Published research on psychedelic-assisted therapy suggests that therapeutic support and integration practices may be important factors in treatment outcomes.¹⁶ 

The choice between at-home and in-clinic treatment is personal. Some people prefer the structure of a clinical setting, while others find the comfort of home more conducive to deep therapeutic work. What matters most is finding an approach that feels right for you and provides comprehensive support for your healing.

Who is a good candidate for ketamine therapy for sleep?

Ketamine therapy may be particularly valuable for people who:

• Have sleep problems that haven’t improved after trying first‑line approaches (for example, CBT‑I and/or commonly prescribed sleep medications), as determined with a licensed clinician
• Struggle with anxiety or depression alongside sleep disturbances
• Experience nightmares related to trauma or PTSD
• Have difficulty tolerating the side effects of traditional sleep medications (grogginess, cognitive effects, dependency risks)
• Need faster relief than conventional treatments can provide
• Are motivated to do deep therapeutic work and address the underlying drivers of their sleep issues

You may not be a candidate if you:

• Have uncontrolled hypertension or certain cardiovascular conditions
• Have a history of psychotic disorders
• Are currently struggling with active substance use disorders
• Are pregnant or breastfeeding
• Have certain other medical or psychiatric conditions that could increase risk

The best way to determine if ketamine therapy is right for you is through a comprehensive evaluation with a Mindbloom clinician. During your initial consultation, a licensed medical provider will review your medical and psychiatric history, current sleep patterns, treatment history, and personal goals to assess whether ketamine therapy is appropriate and safe for your situation.

Every person's experience with sleep disruption is unique. Mindbloom's clinical team is committed to matching you with the treatment approach that offers the best potential for meaningful recovery.

What if ketamine therapy doesn't work for me?

While Mindbloom’s preliminary real-world analysis research suggested high response rates, ketamine therapy doesn't work for everyone. If you don't experience meaningful improvement, Mindbloom's clinical team will work with you to explore alternative treatment options or adjustments to your protocol. The goal is always to find an approach that supports your healing.

Safety, Side Effects, and FDA Status

Is ketamine therapy safe for sleep treatment?

Ketamine therapy has an established safety profile when administered with proper medical oversight. Ketamine has been used in medical settings since 1970, accumulating over 50 years of clinical experience.¹⁸ When used at therapeutic doses for mental health treatment, ketamine therapy produces a different side effect profile than traditional sleep medications.

In Mindbloom's preliminary real-world analysis of 13,963 clients, adverse events were generally mild and transient. Most common experiences during sessions included temporary dissociation (altered perception) and mild elevation in blood pressure, which resolve within hours. Nausea occurred in a subset of clients but was typically mild.

Peer-Reviewed Safety Data: In Mindbloom's separate peer-reviewed published studies detailing outcomes for anxiety and depression, less than 5% of participants reported side effects, and less than 0.5% of clients discontinued treatment due to adverse events.²⁰ Among those who experienced side effects, the most common were temporary dissociation, mild blood pressure elevation, and nausea, which resolved within hours of the session.

Known Side Effects: Potential side effects of ketamine therapy include dissociation (altered perception), elevated blood pressure, nausea, dizziness, and cognitive effects.¹⁹ Not all clients experience these effects, and severity varies. Your Mindbloom clinician will discuss your individual risk profile during your consultation.

Ketamine therapy is not appropriate for individuals with uncontrolled hypertension, history of psychotic disorders, active substance use disorders, certain cardiovascular conditions, or those who are pregnant or breastfeeding. 

Is ketamine therapy FDA-approved for sleep?

Ketamine is not FDA-approved for the treatment of sleep disorders, and clinicians do not prescribe ketamine solely for sleep. Ketamine is FDA-approved as an anesthetic and is prescribed off-label by licensed clinicians for certain mental health conditions, including depression, anxiety, and post-traumatic stress disorder (PTSD), based on clinical judgment and a growing body of research evidence.

Off-label prescribing is a common and legal medical practice in the United States, with estimates suggesting that approximately one in five prescriptions are written for off-label uses.²¹

Can I continue my current medications during ketamine therapy?

In most cases, yes. Many clients continue their existing psychiatric medications during ketamine therapy. However, certain medications may need to be adjusted or temporarily paused. Your Mindbloom clinician will review all your current medications during your consultation and provide guidance specific to your situation.

Pricing & Coverage

Does insurance cover ketamine therapy?

Currently, most insurance plans do not cover ketamine therapy as it is prescribed off-label. However, Mindbloom offers flexible payment options and our costs are often significantly lower than in-clinic IV ketamine or repeated doctor visits for sleep medication refills.

Treatment with Mindbloom is also often HSA/FSA eligible, although this should be confirmed with your plan administrator.

Disclaimers:

DATA SOURCE DISCLOSURE

Efficacy percentages cited in this post are from Mindbloom's preliminary real-world analysis of 13,963 clients. This analysis: (1) has not been peer-reviewed or published in a medical journal; (2) represents only clients who completed treatment (selection bias); (3) is company-generated and not independently validated; and (4) should not be compared to results from peer-reviewed clinical trials. For details on methodology, see the white paper here. 

IMPORTANT SAFETY INFORMATION

‍Ketamine is not FDA-approved for PTSD, depression, anxiety or sleep dysfunction. Common side effects include dissociation, increased blood pressure, nausea, dizziness, and cognitive impairment. Ketamine has abuse potential and is not appropriate for patients with uncontrolled hypertension, psychotic disorders, or substance use disorders. Do not drive or operate machinery until the day after treatment. Individual results may vary.

Full safety information: www.mindbloom.com/safety-information

‍OFF-LABEL USE DISCLOSURE

‍Ketamine is FDA-approved only as an anesthetic. Use for mental health conditions represents off-label prescribing by licensed clinicians based on clinical judgment. Schedule III Controlled Substance - DEA regulations apply.

Citations

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