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Let us help your insomnia patients
Dr. Medalie’s mission is to improve access to the first-line treatment recommendation for insomnia – Cognitive Behavioral Treatment for Insomnia and Behavior Therapies.
Our team will call your patient within 24 hours to get them scheduled.
If these times do not work for you, please email Dr. Medalie directly to find an alternate time
PEDIATRIC SLEEP PHYSICIAN
David Gozal, MD, MBA, PhD (Hon)
The scarcity of behavioral sleep specialists and the exponentially increasing demands for cognitive and behavioral therapy have led to a huge demand that cannot be met along with a surge in digital platforms offering such services. DrLullaby provides an integrated set of digital and telehealth solutions for such sleep issues allowing physicians and healthcare practitioners to focus their efforts and time on all other aspects of sleep medicine. In my experience, the referral process is simple and seamless, and patient satisfaction has been the rule.
Hrayr Attarian, MD
I have been in, exclusively sleep medicine, practice for over 20 years and have learned the immense value of cognitive behavioral therapy for insomnia (CBT-I). Since April of 2020 and with increasing pandemic related stress the referrals for insomnia to my clinic have exponentially increased. My psychologist colleague has been booking several months out. I needed to find an adjunctive treatment option to meet the rising demand for CBT-I. I contacted Dr. Medalie in April of 2021 and she suggested the app Dr Lullaby. Since then I have prescribed Dr Lullaby to a dozen of patients and they all have been very satisfied with it. The referral process is very user friendly as well.
PRIMARY CARE PHYSICIAN
Adam Cilfu, MD
As an general internal medicine physician, I see many patients with insomnia. These patients range from healthy, young people whose sleep issues are their significant medical problem to older or chronically ill patients whose sleep disturbances worsen their underlying diseases, complicate disease management, and negatively affect their overall wellness. Many of my patients have had great success using CBT-I. This treatment has been especially beneficial in people who have used sleep promoting medications for years and have been able to come off these medications with therapy.
ADULT SLEEP PULMONOLOGIST
Babak Mokhlesi, M.D., M.Sc.
Non-pharmacological management of chronic insomnia through cognitive behavioral therapy has empowered many of my patients to take better control of their sleep, without having to rely on hypnotic medications or unproven over- the- counter substances. Moreover, by managing chronic insomnia in patients with sleep apnea, CPAP usage improves. My patients have experienced a measurable improvement in their quality of life by completing cognitive behavioral therapy for insomnia.
ADULT SLEEP NEUROLOGIST
Kenneth Lee, MD
As a dedicated sleep physician at the University of Chicago, I see a wide variety of sleep disorders from sleep apnea, narcolepsy as well as disrupted sleep and insomnia. Unfortunately, in these challenging times with the day-to-day stress of life, as well as living in times of a global pandemic, the number of people with insomnia has also been on the rise. In addition, there has been a sharp increase in the number of prescriptions for sleeping medications. However, sleeping pills can also cause issues with dependence, and eventual habituation – where the medication simply stops working as well as it had. Luckily, I have access to refer to one of the strongest treatments – cognitive behavioral therapy for insomnia (CBT-I). I often counsel patients that this can retrain the body and brain how to sleep again without the use of medication, and/or in the setting of weaning off medications that a patient has taken. Also, patients tend to have fairly rapid improvement of their sleep even after a couple weeks; in fact evidence demonstrates that CBT-I is as effective as a sleeping medication early on, and is better than a sleep pill long-term wise. I have had many patients that have been essentially cured of their insomnia and weaned off sleeping pills by engaging in CBT-I; without relapse of symptoms. And since sleep is such an important part of our life and overall mental and physical health, we see improvement of other symptoms, including headaches, high blood pressure, depression and anxiety.
PRIMARY CARE PHYSICIAN
Lisa M Vinci MD MS
I have several patients who I have referred over the years that were able to discontinue sleep medications after completing CBT-I with Dr. Medalie. They all reflected that the program changed their life and allowed them to manage their anxiety and insomnia more effectively.
Access to care problems that DrLullaby aims to solve
There are not enough trained providers to manage the high prevalence of complaints:
Healthcare providers from many disciplines hear insomnia complaints from patients
- You may not have the clinic time for, or background in, behavioral sleep treatment
There are still less than 200 board-certified Behavioral Sleep Medicine Specialists, and many of those boarded providers have extensive waitlists.
Dr. Medalie digitized the work that a Board-Certified Behavioral Sleep Medicine specialist provides for adults and children in clinic:
- This solution includes the ideal combination of telehealth – allowing for customization and personalized services; AND digital health – allowing for optimal adherence and results
- Our services are reimbursable – We have licensed providers in several states.
- In the states where we have a licensed provider, patients can submit to insurance for reimbursement.
Many insomnia patients take sleep medications nightly for decades, or take multiple sleep aids:
- Many providers aimed to prescribe sleeping pills only temporarily, then patients continue to request refills.
- Habit forming.
- Stopping a sleeping pill often results in severe insomnia relapse.
- The recommended sleeping pill termination plan involves CBT-I in parallel (again we have access to care issue)
- No FDA approved sleep medication for children.
- Increased risk of falls and cognitive side effects for some medication after the age of 65 years.
DrLullaby providers can support gradual sleep medication tapers in conjunction with CBT-I:
- Our providers work closely with prescribing physicians to gradually taper off sleep aids in conjunction with evidence-based behavioral interventions
- Our telehealth providers do not prescribe medication, but, with approval from the prescribing physician, they can support goals for tapering and customize behavior plans to help meet such goals
Comorbidities: Insomnia symptoms can interfere with progress in other symptoms you are trying to manage.
- As well, many insomnia patients have complex medical, mental health, neurodevelopmental symptoms, and medication effects that can impact insomnia.
DrLullaby providers tailor protocols to address medical and mental health symptoms and work closely with other physicians on the care-team:
- Common medical comorbidities: chronic pain, irritable bowel syndrome, migraines, cancer, reflux, allergies, hypertension, etc.
- Common mental health/neurodevelopmental comorbidities: depression, anxiety bipolar I & II, schizophrenia, Attention Deficit Hyperactivity Disorder, autism, developmental delay, obsessive compulsive disorder, panic disorder etc.
Medically-based sleep symptoms alongside insomnia complaints – insomnia patients can have underlying medically-based sleep disorders (e.g., sometimes they think they have insomnia, but they have untreated sleep apnea and “feel like they are awake all night”)
- Insomnia patients may have both insomnia and a medically-based sleep disorder
- These patients can be challenging to treat.
DrLullaby can address complex comorbid sleep symptoms with sensitivity:
- DrLullaby providers can do a brief screen for medically-based sleep symptoms, if they have not yet been screened.
- Our providers will know how and when insomnia diagnosis/treatment is still warranted vs when referral to sleep medicine is the only action needed
- DrLullaby providers can arrive at a conceptually based reason for which to address first when 2 sleep disorders are suspected (e.g., insomnia and sleep apnea)
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