Insomnia in Iranian Americans: California Guide

When an Iranian family in Los Angeles laughs loudly around a dinner table at 10:30 PM, it often looks like joy from the outside. But as a neurologist and sleep specialist, I’ve learned that what happens after that beautiful, noisy gathering is just as important:

📱 Midnight WhatsApp calls to Tehran.
💻 Late-night work or study to “catch up.”
🧠 A brain that refuses to slow down because of stress, worry, and unspoken anxiety.

I’m Dr. Mostafa Amiri, neurologist (University of Tehran) and sleep specialist (trained in Spain). In my neuropsychiatry and sleep clinic, we see a pattern again and again:

Iranian Americans—especially those in California—are carrying one of the heaviest burdens of insomnia and sleep disorders of any immigrant group, but most of it stays hidden behind good clothes, good grades, and good manners.

This article is a detailed, science-based, but deeply human guide about insomnia in Iranian Americans in California—especially Los Angeles, Orange County, San Diego, Sacramento, the Bay Area and beyond.

1. How big is the problem? A hidden epidemic in our community

Iranian Americans in California: the “Tehrangeles” effect

Iranian Americans are one of the largest Middle Eastern immigrant communities in the United States. Roughly half live in California, especially:

• Los Angeles (Tehrangeles) – Westwood, Beverly Hills, Brentwood, Encino, Tarzana
• San Francisco Bay Area – San Ramon, Walnut Creek, Silicon Valley
• Orange County, San Diego, Sacramento – smaller but dense communities

This concentration is a double-edged sword:

• ✅ It creates strong communities, Persian-language services, and cultural familiarity.
• ❌ It also reinforces silent norms: “Don’t talk about depression,” “Insomnia is just stress,” “Sleep pills mean you’re weak.”

What we know from Iran: a baseline snapshot

Recent large-scale data from Iran show how serious sleep problems already are before migration:

• Around 44% of adults have at least one sleep disorder
• About 35% meet criteria for insomnia
• Nearly 80% have poor sleep quality on standardized measures
• High rates of:
  • Parasomnia (unusual behaviors during sleep)
  • Circadian rhythm disorders (late sleep, jet-lag-like patterns)
  • Restless legs syndrome (RLS) – very frequent, especially in women
  • Obstructive sleep apnea (OSA) – surprisingly prevalent

Now imagine taking this already fragile sleep system, placing it in the stressful, expensive, competitive environment of California, and adding:

• Immigration stress
• Discrimination
• Time zone problems with family in Iran
• High academic and career expectations

🎯 The result? A perfect storm for chronic insomnia.

2. What makes insomnia in Iranian Americans different?

2.1 Acculturative stress: living between two worlds

Many of my patients describe life in California like this:

“Doctor, it’s like my body is here, but half of my brain still lives in Tehran.”

This acculturative stress is not simple “normal stress.” It includes:

• 💸 Financial and legal worry – expensive rent, uncertain immigration status, supporting family back home
• 🗣️ Language barriers – even highly educated professionals feel “less smart” in English
• 🧩 Identity confusion – not fully “Iranian,” not fully “American”
• 🎓 Academic pressure – parents pushing for medicine/engineering/law, children afraid to disappoint
• 📝 Paperwork stress – visas, green cards, insurance, unfamiliar systems

Biologically, this is crucial:

• Chronic stress activates the HPA (hypothalamic-pituitary-adrenal) axis
• Cortisol stays elevated in the evening
• The brain’s arousal system doesn’t shut down
• Result: hyperarousal insomnia – you’re exhausted, but your brain behaves as if it’s on stage under bright lights 🎭

2.2 Discrimination and “on-guard” physiology

Since 9/11, and again during periods of political tension, many Iranian Americans report:

• Being randomly “selected” at airports
• Workplace microaggressions (“Where are you really from?” said with suspicion)
• Fear about saying their real name or nationality
• Assumptions about terrorism, politics, or religion

The body responds to this with:

• Heightened vigilance (“always on guard”)
• Increased sympathetic nervous system activity (fast heart rate, muscle tension)
• Nighttime rumination: replaying humiliating or frightening encounters

🛏️ In bed, this looks like:

Lying in the dark, heart pounding, mind replaying that one comment from your boss or TSA, over and over again.

2.3 Time zone trap: when love keeps you awake

Between California and Iran, there is roughly an 11.5–12.5 hour time difference, depending on daylight saving changes. That means:

• When it’s 8 PM in Los Angeles, it’s already early morning in Tehran the next day
• Many families schedule calls late at night California time so everyone in Iran is awake

Patients often tell me:

“Doctor, my only free time to talk to my mother is after midnight. Otherwise I don’t hear her voice for days. What am I supposed to do? Sleep, or be a good daughter?”

This creates a pattern I call “time-zone social jet lag”:

• Regular bedtime moves to midnight–2 AM
• Wake time cannot shift as much (work, school, children)
• Sleep shrinks to 4–6 hours on many nights
• The brain never builds a stable circadian rhythm

Over time, this pattern converts into chronic insomnia and circadian rhythm disorder. It’s not a “bad habit”; it’s a love-driven sleep sacrifice that becomes a medical problem.

2.4 Mental health stigma: aberu vs. wellbeing

In many Iranian families, especially in tight-knit communities like Westwood or Beverly Hills, there is a persistent fear of “what people will say.”

• Aberu (reputation, honor, image) is seen as fragile glass.
• Depression, panic attacks, or insomnia may be seen as a weakness, not a treatable condition.
• Some parents hide a child’s insomnia or anxiety for fear it will “ruin their marriage prospects.”

So instead of professional help, people try:

• Self-medicating with alcohol, sedatives, or multiple cups of tea/coffee ☕
• Herbal remedies without guidance
• Ignoring symptoms until they cause serious daytime impairment

As a clinician, I’ve seen many intelligent, successful Iranian Americans who waited years before admitting their insomnia was more than “just stress.”

3. How does insomnia actually look in Iranian Americans?

3.1 Typical sleep pattern

Based on Iranian and diaspora data, common patterns include:

• Later bedtimes, especially in:
  • Younger adults
  • University students
  • Highly educated professionals working with global teams
• Long sleep onset latency – taking more than 30–40 minutes to fall asleep
• Frequent awakenings – 2–4 times per night, sometimes with racing thoughts
• Reduced sleep efficiency – lots of time in bed, less time actually asleep
• Daytime dysfunction – headaches, irritability, forgetfulness, decreased productivity, and a familiar phrase: “Doctor, I’m always tired, but at night my brain won’t stop.”

3.2 The comorbid conditions that make everything worse

Insomnia rarely travels alone. In Iranian Americans, we often see:

• Depression and anxiety
  • Strong two-way relationship with insomnia
  • Many patients first present with sleep complaints, then reveal deep emotional pain
• Restless Legs Syndrome (RLS)
  • Very high rates in Iranian populations
  • Worse in women, often related to iron deficiency
  • Patients describe: “ants inside my legs,” “electric crawling feeling,” “I must move.”
• Obstructive Sleep Apnea (OSA)
  • Surprisingly common in Middle Eastern populations
  • Many Iranian Americans do not present with classic “sleepy” OSA
  • Instead: insomnia-dominant OSA – trouble falling or staying asleep, frequent awakenings, sometimes without obvious snoring
• Cardiovascular disease & metabolic issues
  • Poor sleep increases risk of hypertension, diabetes, weight gain, and heart disease
  • In those already at risk (family history, sedentary lifestyle), insomnia acts as a force multiplier

4. A quick comparison: how is Iranian American insomnia unique?

📊 Table – A Tale of Two Insomnias

5. Cultural beliefs about insomnia: between saffron tea and brain “dystemperament”

In Persian culture, insomnia is often described as:

• Sahar – sleeplessness
• Caused by stress (feshar-e ravani), “too much thinking,” or “brain dryness” in traditional Iranian medicine

Common home strategies:

• Warm saffron or chamomile tea 🍵
• Avoiding heavy late dinners (ideally… though 11 PM koobideh still happens)
• Burning esphand (wild rue) for protection and calm
• Using herbal mixtures without full understanding of interactions with medications

These practices are not “wrong” by default. Many are actually compatible with modern sleep medicine—if used in balance and with safety. The problem appears when:

• People rely on them instead of proper diagnosis (especially for OSA or RLS)
• Herbal sedatives are mixed with benzodiazepines or alcohol, increasing risk
• Serious insomnia is minimized as “just overthinking”

6. Myth or Reality: common beliefs about Iranian American insomnia 🧠🌓

Myth or Reality #1: “Insomnia is just a sign of being a hard worker.”

❌ Myth.
Chronic insomnia is a medical and psychological condition, not a badge of honor. In fact, long-term insomnia:

• Impairs concentration and memory
• Increases risk of anxiety and depression
• Raises cardiovascular risk

Myth or Reality #2: “If I go to a doctor, they will just give me addictive pills.”

❌ Myth (with a grain of truth).
Modern, evidence-based sleep care uses Cognitive Behavioral Therapy for Insomnia (CBT-I) as the first-line treatment, not medication. Short-term medication is sometimes helpful, but it is not the only or main tool.

Myth or Reality #3: “Talking to a psychologist will put shame on my family.”

❌ Dangerous myth.
Seeing a psychologist or psychiatrist is like seeing a cardiologist for blood pressure. It is a sign of responsibility and maturity, not shame. Many families only begin to heal once one person has the courage to seek help.

Myth or Reality #4: “If I sleep 4–5 hours but function, I’m fine.”

❌ Mostly myth.
Some people think they function well on 4–5 hours. But studies show increased accident risk, errors, irritability, and health problems. We often don’t notice how impaired we are until sleep is restored.

Myth or Reality #5: “Insomnia in Iranian Americans is normal because immigration is stressful.”

⚠️ Partly reality, but not destiny.
Yes, immigration increases insomnia risk. But “common” is not the same as “hopeless.” With culturally sensitive care, we can dramatically improve sleep—even in the middle of immigration stress and family separation.

7. The newest, strangest, most interesting insights about Iranian American insomnia

7.1 Sleep as a bridge between discrimination and depression

Recent research in Middle Eastern/North African populations suggests:

• Experiences of discrimination don’t only cause depression and anxiety directly.
• They first disrupt sleep—especially insomnia and sleep-related impairment.
• That poor sleep, in turn, magnifies emotional vulnerability.

In simple terms:

Discrimination → Insomnia → The world looks darker, heavier, and more hopeless.

This opens up an exciting clinical opportunity: improving sleep can reduce the emotional damage of discrimination—even if we cannot immediately change the outer world.

7.2 “Negative acculturation”: the longer you stay, the worse you sleep

Counterintuitively, some immigrant groups sleep worse the longer they live in the U.S.:

• More exposure to stress, racism, and demanding work culture
• More irregular schedules, tech use at night, and 24/7 availability
• Disconnection from protective cultural rituals (structured meals, family time, spiritual routines)

For Iranian Americans in California, this often means:

• First few years: insomnia from acute immigration stress
• Later years: chronic insomnia from burnout, overwork, and unresolved trauma

7.3 Obstructive sleep apnea wearing an “insomnia mask”

One of the strangest things we see in the clinic:

• Many Iranian patients with sleep apnea don’t complain about sleepiness.
• They complain about:
  • Frequent awakenings
  • Difficulty falling back asleep
  • Morning headaches
  • “Non-refreshing sleep”

Polysomnography (overnight sleep study) then reveals moderate to severe OSA with an insomnia-dominant phenotype.

This is why in our clinic we emphasize:

If insomnia persists despite good sleep habits and CBT-I techniques, we must rule out apnea and RLS with proper testing.

8. Evidence-based treatment: what really works for Iranian Americans in California

8.1 CBT-I: the gold-standard, brain-focused treatment

Cognitive Behavioral Therapy for Insomnia (CBT-I) is the main scientifically proven treatment for chronic insomnia. It usually includes:

• ⏱️ Sleep restriction – temporarily limiting time in bed to match the actual amount of sleep, then gradually increasing
• 🛏️ Stimulus control – bed is for sleep and intimacy only; no phones, TV, or 2-hour Instagram scrolls
• 💭 Cognitive therapy – challenging catastrophic sleep thoughts like:
  • “If I don’t sleep 8 hours, I will ruin my brain.”
  • “My insomnia is permanent.”
• 🌙 Sleep hygiene – light exposure, caffeine timing, evening routines
• 🧘 Relaxation techniques – breathing, muscle relaxation, imagery

For Iranian Americans, we adapt CBT-I to realities like:

• Time-zone communication with Iran
• Multi-generational households
• Cultural beliefs about “garm” and “sard” (hot/cold foods and body temperament)
• Stigma around psychological terms

8.2 Special cultural adaptations that actually help

In our clinic, when working with Iranian Americans, we frequently:

Adaptation 1: Map the full 24 hours

We don’t just ask, “What time do you sleep?” but:

• When do you talk to family in Iran?
• Which nights are “mehmooni” (social gatherings)?
• When do you check news from Iran?

We then:

• Design compromise schedules – maybe calls earlier in the evening or on specific days
• Discuss rotation of responsibility among siblings for calls to reduce burden

Adaptation 2: Gently involve family

Because of collectivist values, insomnia is rarely an individual issue. We may:

• Invite a spouse or parent to one session (with consent)
• Explain insomnia as a physical and psychological condition, not laziness
• Help families adjust expectations (“No, your child doesn’t need to study until 2 AM every night to succeed.”)

Adaptation 3: Directly talk about stigma

Instead of avoiding the topic, we name it:

“Many Iranian families worry that seeing a psychologist means something is ‘wrong’ with them. Let’s talk about that belief.”

This simple, respectful conversation often opens a door.

Adaptation 4: Use familiar metaphors

We might explain hyperarousal like this:

“Your brain is like a samovar that never turns off. It’s always boiling at level 3. CBT-I helps us slowly turn the flame down, so the tea is warm when needed, not boiling all night.” ☕

Patients smile—and understand.

8.3 Sleep medication: when and how

Medication is not first-line for chronic insomnia, but it can be useful:

• For short-term crises (acute grief, severe stress)
• While CBT-I skills are being learned
• In selected comorbid conditions

Important principles in Iranian American patients:

• Respect fear of dependence, explain realistic risk-benefit
• Avoid combining sedatives with alcohol or unregulated herbal remedies
• Always screen for sleep apnea before long-term sedative prescribing
• Use shared decision-making: “We have several options. Let me explain them, and we decide together.”

9. Creative highlight: a simple table to guide decisions

📊 CBT-I vs. “Just Give Me a Pill, Doctor”

10. People’s real opinions about insomnia in Iranian Americans from all over the world 🌍💬

(All names and stories are fictional but based on real-life patterns I see in clinic.)

1️⃣ Neda, 42, Westwood (Los Angeles) – Corporate lawyer

“I moved from Tehran at 26, did my LLM at UCLA, and now work crazy hours. My insomnia started around the time of the travel ban. Every night at 1 AM, I’d be scrolling through Twitter and Persian news, terrified something would happen to my parents and I couldn’t visit them. I’d fall asleep around 3–4 AM and wake up at 7, feeling like a zombie in designer clothes.

I always thought therapy was for ‘people who couldn’t handle life.’ When my heart started racing at night and I feared I’d die in my sleep, I finally came to a sleep clinic. It was the first time a doctor acknowledged both my legal stress and my Iranian identity. CBT-I, plus setting rules about late-night news and calls with my parents, changed my sleep more than any pill I ever tried.”

2️⃣ Reza, 21, UC Berkeley student, originally from Irvine

“In high school, my parents kept saying, ‘Medical school, Reza, only medical school.’ I was taking AP everything, playing piano, volunteering. I stayed up until 2–3 AM regularly. In college it became worse: gaming + classes + feeling like I had to be perfect to justify my parents’ sacrifices.

By sophomore year I was sleeping 4 hours a night, drinking energy drinks all day, and feeling empty. I finally talked to a counselor after a friend insisted. Talking with someone who understood how Iranian parents talk about success made me feel seen. We worked on a real sleep schedule, and I slowly realized my value isn’t only my grades.”

3️⃣ Shirin, 36, San Diego, pharmacist, mother of two

“I came as an international student, then stayed. My husband works nights as a resident. My insomnia wasn’t just one thing—babies, exams, worrying about my family in Shiraz, shifts at the pharmacy.

I always thought I had ‘weak nerves.’ When Dr. Amiri explained that my nervous system was stuck in ‘fight or flight’ and that we could retrain it, I cried from relief. We involved my husband in one session so he understood why my 1 AM WhatsApp calls had to change. Now we plan family calls for weekends, and my mother finally understands—it didn’t mean I loved her less; it meant I needed to survive.”

4️⃣ Hamed, 55, Walnut Creek, tech engineer

“I snored loudly for years, woke up many times at night, and felt angry every morning. I blamed stress, politics, and my commute. I never thought I had sleep apnea because I wasn’t ‘that fat’ and I didn’t feel sleepy, just wired.

A friend finally pushed me to see a sleep specialist. The sleep study showed moderate OSA with frequent awakenings. Using CPAP plus CBT-I, my mood improved so much that my wife jokes she finally got back the man she married. I wish I had tested 10 years earlier.”

5️⃣ Mahsa, 30, Tehran → Sacramento, PhD student

“My insomnia began back in Iran during protests. After I moved to the U.S., it got worse. Every siren I heard at night reminded me of danger. I’d wake at 3 AM, heart pounding, refresh Telegram and Instagram for hours.

When I found a Persian-speaking psychologist through a local clinic, she helped me see how my trauma, immigration, and insomnia were all connected. We used both CBT-I and trauma-focused techniques. I still have bad nights during difficult news cycles, but now I have tools—and I no longer feel crazy for reacting this way.”

6️⃣ Parvaneh, 67, retired teacher in Tarzana

“I thought bad sleep is just part of being old. But my ‘restless legs’ got so bad that I would walk around the house all night. I felt ashamed to talk about it. My grandson finally booked me an appointment.

Turned out my iron was low and I had restless legs syndrome. With iron treatment and some medication, plus simple sleep tips, I sleep longer blocks now. It’s not perfect, but I am no longer pacing the hallway every night. I wish more older Iranians knew this is treatable.”

7️⃣ Amir, 34, Toronto (originally from Karaj), software developer

“I don’t live in California, but the pattern is similar. Remote job, meetings across time zones, parents in Iran, and me stuck between. I’d go to bed with my laptop and phone, tell myself I’d ‘just check one more email.’

A podcast about sleep led me to seek help. The therapist I saw explained CBT-I and set strict rules: no screens in bed, fixed wake time, and thinking of my bed as a sacred place for rest. The first two weeks were hard. Then suddenly it clicked—my body remembered how to sleep.”

8️⃣ Laleh, 29, Paris (Iranian French), artist

“For years I thought my insomnia was the price of creativity. I painted at 2 AM, listened to Persian music, smoked on the balcony, watching the city lights. But my mood got darker and darker.

When an Iranian-French psychiatrist explained the link between circadian rhythm, mood, and creativity, I felt less romantic but more free. We gradually shifted my sleep earlier and used light therapy. Now I still create—but in the late evening, not all night. My art didn’t die; my depression slowly did.”

11. Community-level solutions: what California can actually do

To meaningfully reduce insomnia in Iranian Americans in California, we need more than individual therapy. We need:

• 🕌 Community education in Farsi and English – at cultural centers, mosques, community events, even mehmoonis
• 🩺 Training for healthcare providers – understanding Iranian values, time-zone realities, stigma, and trauma
• 📲 Telehealth, especially in Farsi – so people from Bakersfield to San Diego can access Persian-speaking specialists
• 🧑‍🤝‍🧑 Support groups – for Iranian students, caregivers, and new immigrants dealing with insomnia and anxiety
• 🏛️ Policy advocacy – pushing insurers and systems to cover CBT-I, sleep tests, and culturally adapted care

In our neuropsychiatry clinic, we’ve built services that combine:

• Sleep disorder diagnosis and treatment
• Sleep tests (polysomnography, home studies)
• Neuropsychiatric evaluations
• Psychiatric and psychological counseling
  …with specific understanding of Iranian culture, language, and immigration stress.

12. Where this field is heading: a small “future map” 🔮

In the coming years, I expect we’ll see:

• AI-assisted, Farsi-enabled digital CBT-I apps tailored to Iranian diasporas
• Wearables that detect OSA and insomnia patterns more accurately in MENA populations
• Integrated sleep + mental health programs for immigrants, recognizing sleep as the bridge between stress and emotional resilience
• More research on how discrimination “gets under the skin” through sleep and inflammation

For now, the most powerful tools are still quite “human”:

• Honest conversations
• Respectful, culturally sensitive therapy
• Scientific humility and empathy

13. A gentle, practical call to action 🌙

If you recognize yourself or your family in this article—

• Late-night calls to Iran
• A brain that refuses to rest
• Heavy eyelids with light sleep
• Fear of stigma, shame, or judgment

—please know this very clearly:

Insomnia is not your fault. But it is treatable.

As Dr. Mostafa Amiri, neurologist and sleep specialist, my team and I are committed to providing culturally informed, scientifically rigorous care for:

• Insomnia and other sleep disorders
• Sleep tests and accurate diagnosis
• Neuropsychiatric problems, depression, anxiety, trauma
• Psychiatric and psychological counseling, in Farsi and English

We also offer telehealth consultations that are especially helpful for the Iranian community in Los Angeles, Orange County, San Diego, the Bay Area, and all of Southern California.

Tonight, when you turn off the light, ask yourself one question:

“Do I want to keep surviving my nights, or start healing them?”

If the answer leans toward healing, then it may be time to let a specialist join your story—
so that California’s nights become not just Persian, but peaceful. 🌙