How can I get help with an *extremely* bad, intractable sleep problem?
December 31, 2013 7:18 AM   Subscribe

I need help finding an exceptional sleep specialist or sleep center to help with a complex, long standing problem with insomnia. I need to find someone really good who's serious.

I have severe, chronic sleep insomnia going back decades. I've been to multiple doctors, including my regular GP, psychiatrists, and a sleep specialist. I've you've heard of a sleep remedy, I've tried it.

Sleep apnea has been ruled out. This is some other kind of problem.

It's destroyed me professionally, laid waste to my social life, and directly caused one car wreck and numerous near-misses.

I'm at the end of my rope.

I recently read this article...

The quote that stood out for me was...

"The therapy that Dr. Manber, Dr. Carney and the other researchers are using is called cognitive behavior therapy for insomnia, or CBT-I for short...This kind of therapy is distinct from what is commonly known as sleep hygiene: exercising regularly, but not too close to bedtime, and avoiding coffee and too much alcohol in the evening. These healthful habits do not amount to an effective treatment for insomnia."

Does anyone know where I can go in the San Francisco Bay Area to get CBT-I?

Or anything effective?

I know there's Google.

Here's the thing with Google:

In every profession, every area of life, 99 percent of the people in it are good enough to be usually adequate. They can get your car running or your tub to drain or fix your toothache or get your cat to stop throwing up, as long as the problem isn't severe or unusual.

Those are the people you can find using Google, and I've already been to see them. I've spent decades going to see them.

They can't help me.

I need the other one percent. But who they are is a secret you can only find out via a direct recommendation by someone who's been to see them.

Any help would be greatly appreciated.
posted by trevor_case to Health & Fitness (9 answers total) 9 users marked this as a favorite
Dr Amy Jenks is among one of the many people on the Psychology Today listings who offer insomnia treatments, but it looks like CBT-I is one of her specialties. I have no knowledge of her independently, however, so I can't vouch for her.

I don't know if this therapy will work for you or not, but I wish you luck.
posted by inturnaround at 7:34 AM on December 31, 2013

Dr Rocky Garrison is a CBTI specialist in Portland, OR. Not sure if CBTI would be appropriate for you as it isn't effective for everyone but it's worth a shot to at least have a consultation with one. Maybe Dr Garrison's office could suggest someone to you in your area.
posted by teamnap at 8:29 AM on December 31, 2013

Are you using any medications? My psychiatrist has gotten very involved my sleep, and we've experimented with a lot of medications for sleep. I've been very happy with a high-ish dose of Seroquel + a low dose benzo; that seems to work well for me, where lunesta and ambien haven't.

I think with any kind of head doctor, CBT therapist or shrink, it takes a while to find one you click with.

I know my shrink does Skype appointments (from his Orinda, CA office), but I think most insurances don't cover those. memail me if you're interested in his info.

But I'd shop around for a psychiatrist who knows his sleep meds, and try to find a cocktail that works for you.
posted by colin_l at 8:34 AM on December 31, 2013

With the right ability to dig and interpretation skills you can find that 1% on google. I have had many health issues where I see hints at forward-thinking doctors, call that doctor. Chances are that he/she could have a local contact doing the same thing that they would know from a conference. Sometimes you can even get an email with proper digging.
I wish you the best in this struggle. I hope you persevere and find a cure.
posted by femmme at 8:36 AM on December 31, 2013

If money is no object (and you're already in CA, so travel/in-network coverage may not be a big deal), the Stanford Sleep Center is one of the best in the world.
posted by blue suede stockings at 8:49 AM on December 31, 2013 [1 favorite]

In the SF Bay Area, my knee-jerk answer for all health specialty stuff is always "Stanford."
posted by radioamy at 9:21 AM on December 31, 2013 [1 favorite]

I had a work friend who would go to the head of the (relevant) department at the local hospital when she had a difficult medical problem. So, perhaps look for someone in that capacity. Or, the local teaching medical facility. Stanford does sound like a good suggestion.
posted by vignettist at 3:13 PM on December 31, 2013

This guy taught my Psych 101 class and he is an award-winning sleep researcher. I don't know if he would be able to help you but he might be able to direct you to the top sleep treatment option in your area.
posted by bq at 4:09 PM on December 31, 2013

My best recommendation is to go to the nearest well respected academic medical center and look for someone on their faculty who specializes in your problem. This is the relevant webpage for Stanford with the Sleep Center faculty list. For example, Dr. Rachel Manber specializes in "non-pharmacologic treatments of insomnia".

Physicians who work at academic medical centers don't get paid nearly as much as physicians in private practice, so the reason they work there is probably because they really care about what they do (and about teaching physicians in training). Also, in order to get promoted, you have to do a lot of research, for example, Dr. Manber is a full Professor. She's done almost 75 peer reviewed research articles, many of them relating to insomnia. Anyway, I also note that she is a PhD and not an MD - she might not even see patients clinically, she might be mainly a researcher, I'm just using her as an example. Doing research on a subject doesn't mean you are a great doctor, but it does mean you probablly have a lot of very specialized knowledge.

Don't go to the chair, for two reasons. 1, the chair is generally one of the oldest physicians in the department. This person likely trained 20-30 years ago. They're probably very good, but not necessarily up to date on the latest/cutting edge therapies. 2, the way you get to be chair is by being a good administrator and a person who's interested in administrating/buying down your clinical time. You want someone who loves and is immersed in clinical medicine.
posted by treehorn+bunny at 10:24 PM on December 31, 2013

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