Stellate Ganglion Block (SGB) for Sleep in Anxiety, Depression, and PTSD
Many people living with anxiety, depression, or PTSD sleep poorly because the body stays on alert for too long. Stellate ganglion block (SGB) briefly quiets the nerve signals behind that alert state. A 2026 meta-analysis found longer sleep and better sleep quality scores after SGB, although most participants were in other groups. At YOUNIFY Clinic, a Healthy Aging & Wellness Center based in Bangkok, Thailand, SGB is offered as an add-on option to support sleep, alongside your existing mental health care. It is not a treatment for anxiety or depression. Starting from THB 37,500. Results vary by individual.
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Doctors
Dr. Rarinthorn Choomsai Na Ayuthaya
Pain Medicine / Anesthesiologist
Diploma of Pain Medicine
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Key points
- Anxiety, depression, and PTSD commonly cause trouble falling asleep, waking at night, or light sleep, and poor sleep in turn makes mood and anxiety symptoms harder to manage.
- SGB does not treat the underlying condition. It is studied as a way to support better sleep by easing an overactive stress response.
- The sleep evidence is still limited and the PTSD evidence is mixed. This page shows both sides.
- You do not need to stop your psychiatric medication or therapy. SGB is used alongside them, not instead of them.
- The procedure is performed by an anesthesiologist under image guidance at YOUNIFY Clinic, medical facility licence 10101005069. Most patients go home the same day.
Why anxiety, depression, and PTSD disturb sleep
Ongoing stress or anxiety keeps the sympathetic nervous system, the system that prepares the body to fight or flee, working too hard. The heart races, muscles stay tense, and thoughts keep looping, so the body resists switching into rest. People with depression often wake too early or sleep lightly, and people with PTSD may wake with a start, have nightmares, or feel on guard at night.
Poor sleep then makes anxiety and low mood worse, which creates a cycle that is hard to break. Helping sleep improve is therefore an important part of care.
How SGB may support sleep
The stellate ganglion sits in the lower neck and carries sympathetic signals to the head. An image-guided injection of local anesthetic here briefly reduces those alert signals. Researchers propose that this helps calm the brain's arousal circuits, so the body can settle into sleep more easily in some people. The exact mechanism is still being studied.
What the evidence shows
| Topic | What studies found | Limits |
|---|---|---|
| Sleep quality | A 2026 meta-analysis of 7 studies and 440 participants found longer total sleep time and better sleep quality scores after SGB compared with control groups. | Most participants were recovering from surgery, follow-up was short, and the studies differed considerably. No study has yet focused on people whose poor sleep comes from anxiety or depression. |
| PTSD | A 2020 randomized trial (113 participants) found greater reduction in PTSD symptoms than a sham injection over eight weeks, while a 2016 randomized trial (42 participants) found no significant difference. | Both studied US service members over a short period. |
| Anxiety and depression | There are no high-quality studies in people diagnosed with an anxiety disorder or depression, only small studies that measured anxiety or mood in other groups, such as surgical patients. | SGB is not a treatment for anxiety or depression. Psychotherapy and medication prescribed by a psychiatrist remain the main treatments. |
Using SGB for sleep problems is an off-label use, considered case by case with your doctor, who explains the level of evidence before you decide.
Who SGB may suit, and who it may not suit
May suit
- Adults aged 18 and over with long-standing poor sleep alongside stress, anxiety, depression, or PTSD, who have been assessed by a doctor
- People who have already worked on their mental health care or sleep habits, and whose sleep still affects daily life
- People looking for an option other than adding sleeping pills, while continuing care with their psychiatrist or psychologist
May not suit, or other care comes first
- Current thoughts of self-harm or an acute psychiatric crisis, which need urgent care first
- A bleeding disorder, or blood thinners that cannot safely be paused
- An infection in the neck, or allergy to local anesthetic
- Certain heart rhythm or lung conditions
- Pregnancy, unless your doctor decides it is appropriate
Your doctor decides suitability case by case, after reviewing your history and examining you.
Your care pathway at YOUNIFY Clinic
- Message us on WhatsApp or LINE @younifyclinic. Our coordinator asks a few questions and arranges a physician consultation.
- Physician assessment of your sleep, covering physical causes (such as breathing during sleep, hormones, and medications) and mental health. If you see a psychiatrist or psychologist, please bring a treatment summary. If not, your physician recommends mental health care alongside.
- Agree on goals and measures before the procedure, such as a sleep quality questionnaire and an anxiety or mood measure, so that change can be tracked.
- The procedure is performed by an anesthesiologist under image guidance at YOUNIFY Clinic, medical facility licence 10101005069. It uses a needle only, with no general anesthesia, and you are observed before going home.
- Follow-up. We review your progress against the agreed measures, decide together whether a further injection makes sense, and can share a summary with your own doctor.
Temporary effects and risks
Temporary effects that show the medicine is working in the right place are common: a drooping eyelid, red eye, a blocked nostril on one side, a hoarse voice, or warmth in the arm on that side. These fade as the anesthetic wears off.
Less common risks include bleeding or bruising, infection, injection into a blood vessel, and temporary difficulty swallowing. More detail is on our SGB overview page.
Price
| Item | Starting from (THB) |
|---|---|
| Stellate ganglion block (SGB) | 37,500 |
This is a starting price. The number of sessions and the final price are confirmed in a written quotation after your physician consultation.
References
- Wu J, et al. A novel application of stellate ganglion block to improve sleep: a systematic review and meta-analysis. Front Psychiatry. 2026;17:1753003. doi:10.3389/fpsyt.2026.1753003
- Rae Olmsted KL, et al. Effect of stellate ganglion block treatment on posttraumatic stress disorder symptoms: a randomized clinical trial. JAMA Psychiatry. 2020;77(2):130-138. doi:10.1001/jamapsychiatry.2019.3474
- Hanling SR, et al. Stellate ganglion block for the treatment of posttraumatic stress disorder: a randomized, double-blind, controlled trial. Reg Anesth Pain Med. 2016;41(4):494-500.
- Edinger JD, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an AASM clinical practice guideline. J Clin Sleep Med. 2021. doi:10.5664/jcsm.8986
- Piraccini E, et al. Stellate Ganglion Blocks. StatPearls; 2023. https://www.ncbi.nlm.nih.gov/books/NBK507798/
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Frequently asked questions
Can SGB help if stress or anxiety keeps me awake?
SGB is studied as an add-on option to support sleep by easing an overactive stress response, but most research has not yet focused on people whose poor sleep comes from anxiety. Your physician assesses the cause of your sleep problem first and considers SGB case by case.
I have depression and cannot sleep. Is SGB an option?
It may be considered case by case to support sleep, alongside care from a psychiatrist. SGB is not a treatment for depression. In Thailand, the Mental Health Hotline 1323 is available 24 hours.
Can SGB help with PTSD nightmares and waking at night?
One randomized trial found greater short-term reduction in PTSD symptoms than a sham injection, while another found no difference, so SGB is an add-on option rather than a replacement for therapy or medication.
Do I need to stop my psychiatric medication or sleeping pills?
No. Please tell your doctor about every medication you take. Blood thinners are the main medicines that may need adjusting, and your doctor discusses this with the prescriber first.
How many injections will I need?
There is no fixed number. Your physician decides based on your response after the first injection and the goals you agreed on.
How long do the effects last?
This varies widely between individuals, and studies have followed patients for a short time only, so no one can guarantee duration.
Can I travel to Bangkok for SGB?
Yes. Please message us before booking flights so that your physician can review your history and confirm suitability. Our coordinators support patients in many languages.
YOUNIFY Clinic · 2nd Floor, Room 214, United Center Building, 323 Silom Road, Silom, Bang Rak, Bangkok 10500, Thailand · Near BTS Sala Daeng (5-min walk) · Open daily 11:00–20:00
WhatsApp +66 81 556 9696 · LINE @younifyclinic · Instagram @younifyclinicthailand · info [at] younifyclinic.com
Medically reviewed by Dr. Noppachai Siranart · Last reviewed
Individual results may vary. Please consult a doctor before treatment.