When people write in with lots of questions about insomnia, I’ll often recommend seeing a sleep specialist or a sleep therapist who can provide cognitive behavioral therapy for insomnia (CBT-I).
But finding sleep specialists and sleep therapists can be tricky. Here’s why you might want to consult one and how to locate the right provider.
Why a Sleep Specialist?
Many people turn first to a primary care provider for help with insomnia. Some PCPs may know enough about sleep disorders to diagnose your problem and give you the help you need.
But a 10-minute appointment may not be long enough for a doctor to correctly diagnose your sleep problem—let alone figure out the most appropriate treatment. Also, sometimes I hear complaints about how PCPs respond to people with insomnia. The complaints go something like this:
“He didn’t seem to have much sympathy for my situation.”
“All she wanted to do was prescribe another sleeping pill.”
In contrast, a sleep specialist
- Will probably have more empathy for your problem. A doctor who completes a one-year fellowship in sleep medicine after a 3- or 4-year medical residency is likely to take insomnia complaints more seriously and show more compassion than doctors without this training.
- Will spend enough time with you to make an accurate diagnosis. There’s no objective test for insomnia, so sleep doctors have to figure out what’s wrong based on clinical interviews alone. Just because you have insomnia symptoms does not mean the underlying problem is actually insomnia disorder, or that the insomnia is not occurring in conjunction with another health problem. A good sleep specialist may spend 45 or 50 minutes with you in order to arrive at an accurate diagnosis.
- Has in-depth knowledge of (1) sleep and sleep disorders, (2) the clinic- and home-based tests used to diagnose sleep disorders (rarely used if the suspected diagnosis is insomnia), and (3) the array of treatments available—and is qualified to administer those treatments.
- May or may not be a certified provider of CBT-I.
Find a Board-Certified Sleep Medicine Specialist
To make sure you’re going to get good care, you’ll want to consult a sleep medicine specialist who is board certified. This means that he or she has passed the certification examination administered by the American Board of Sleep Medicine.
Board-certified sleep specialists are often affiliated with sleep centers accredited by the American Academy of Sleep Medicine. Use this AASM locator tool to find an accredited sleep center (and a sleep specialist) near your home.
Help with Cognitive Behavioral Therapy for Insomnia
But say you’re reasonably certain that yours is a case of persistent insomnia uncomplicated by any other disorder. You might want to try CBT-I and be looking for someone to guide you through it. If so, your quest for help with sleep will follow a slightly different path.
There’s a branch of sleep medicine called behavioral sleep medicine. It addresses the learned behaviors and thought patterns that typically disrupt sleep, and changes that can be made to improve sleep. Providers certified in this field are the ones who can help you out.
Some sleep specialists are certified in behavioral sleep medicine as well. (The credential is written CBSM, which stands for “Certified in Behavioral Sleep Medicine.”) MDs of all stripes are eligible to undergo training and become certified. So are psychologists (PhDs and PsyD’s), nurses, and some master’s-level health care professionals.
Unfortunately, certified CBT-I providers are still somewhat scarce. They tend to cluster in urban areas—which is also where most sleep centers are located.
Find a CBT-I Provider
But help is closer now than ever before. The Society of Behavioral Sleep Medicine has published a list of behavioral sleep medicine providers. The great thing about this list is that the providers are listed alphabetically by state (rather than by providers’ names). So click on this list of CBT-I providers, find your state (or a nearby state), and set up a consult.
It’s never too late!
If you’ve consulted a sleep specialist or a CBT-I therapist, how did you locate that person and were you satisfied with the help you got?