Frequently Asked Questions

What can I expect at my first visit?

If you are a new patient to us, your first visit will be either 60 or 90 minutes long and be conducted with either Dr. Cetel or Dr. Loewy, depending on the nature of your sleep complaint. A comprehensive sleep evaluation will be conducted and may include a brief physical examination. You will also be asked to complete a sleep disorders questionnaire that can be emailed to you for completion in advance of your visit. Based on the information obtained at this initial visit, the sleep specialist will formulate a diagnosis and offer a recommended treatment plan for your consideration which may or may not involve an overnight sleep study.

Do you conduct overnight sleep studies at your center?

Sleep studies are not conducted at our offices. If an overnight sleep study is deemed necessary, you will be referred to one our affiliated sleep laboratories located nearest you. You will then have a follow-up visit scheduled with Dr. Cetel to discuss the study results and any treatments that may be appropriate.

What if I have sleep apnea? Do I have to wear one of those “masks” for the rest of my life?

If you are diagnosed with obstructive sleep apnea (OSA) a number of treatment options may be available, one of which is the “mask”, known as CPAP or Continuous Positive Airway Pressure. CPAP is the most effective known treatment for OSA. It may take some getting used to but there is a wide array of mask types and fits available. Depending on the severity of your OSA, alternative treatments may be available and will be discussed in detail. CPAP doesn’t have to be for life. Weight loss or certain surgical procedures have the potential to eliminate the need for CPAP in some cases. We will work with you to help identify the best treatment match for you.

Is Cognitive Behavioral Therapy for Insomnia (CBTI) covered by insurance?

CBTI is fully covered by Medicare and TriCare. If you have private insurance, the CBTI program is treated as an “out of network” service. Payment is due at each treatment visit and you will need to submit receipts to your insurance carrier for reimbursement after the fact. Will provide any documentation you may need to facilitate your reimbursement. CBTI is considered a mental health service.

Do I need a referral from my doctor for CBTI?

In general, a referral is not required however you may want to consult with your insurance carrier.

What is the cost of the Program?

New patients must first have an initial consultation visit to ensure that CBTI is the most suitable treatment in their case. Initial consultations are about 60 minutes long and the fee is $100. The CBTI Program is offered in both individual and group treatment formats. The cost of individual treatment is $450 for a total of five sessions. The cost for the group is $250 for five sessions.

What are the differences between individual treatment and group CBTI treatment?

The content of the individual and group formats is almost identical. The advantage of the individual format is that there is more opportunity to fully customize the treatment to the individual and more time is available to explore issues in depth. The advantage of the group format is the support and sharing of information from others with similar sleep difficulties. This can be a very empowering experience for some patients. Both formats are highly effective.

How large are the CBTI groups?

Groups are small consisting of only 3 to 5 patients each. The group CBTI format is not a classroom environment but is more of a roundtable discussion involving sleep education and counseling directed by Dr. Loewy.

What is the success rate with CBTI?

Success with CBTI can be defined in a number of different ways including, taking less time to fall asleep, spending less time awake at night, getting better quality sleep, a reduction in sleep anxiety, or a reduction or discontinuation of sleep medication use. About 80% of patients completing CBTI program have found it to be very effective in these areas.

How long does CBTI take?

The basic CBTI program is comprised of a consultation for new patients and four treatment sessions conducted over a five week period. A fifth follow up visit is scheduled one month later. Some patients have achieved their sleep goals before the five week period is over while still a few others have needed a little more time.

How is CBTI better than sleep medication?

Sleep medication can be very effective for insomnia but it is often associated with side effects, tolerance (needing higher dosages to get the same effect), physical or psychological dependence, and withdrawal symptoms. Additionally, sleep medication treats only the symptom of insomnia which is being awake at night more than you would like. By contrast, CBTI targets the causes of chronic insomnia which then leads to symptom improvement. The only potential known side effect of CBTI is some additional short term daytime sleepiness, but this is temporary.

Do I need to be off sleep medication to participate in CBTI?

No. If you are already taking sleep medication on either a regular or occasional basis you can still participate in and benefit from CBTI. If, however, you are seeking to either reduce of discontinue sleep medication use, CBTI provides an excellent opportunity to do so. CBTI offers guided support, and alternative sleep strategies to minimize any possible medication withdrawal effects.

Is CBTI effective for all types of insomnia?

Insomnia can take many forms such as difficulty falling asleep, difficulty staying asleep or waking up too early. The techniques of CBTI are tailored to address any combination of these insomnia types.

Is the CBTI Program available at all Integrative Sleep locations?

Yes. The CBTI program is available at our Mira Mesa, Kearny Mesa, and Oceanside offices. It will depend on the day of the week however as we are at different locations on different days. Information about locations and days of the week can be obtained by calling us at 858-224-1866.

Are evening or weekend CBTI sessions available?

We realize that it may be difficult for some individuals to come in for multiple visits during the work-week. CBTI sessions in the evening or on weekends are made available based on the demand. Please contact us to inquire.

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