Frequently Asked Questions

We treat all types of sleep disorders in children and adults ages 5 and up. Some examples include obstructive sleep apnea, insomnia, hypersomnia, narcolepsy, circadian rhythm disorders, restless leg syndrome, parasomnias, nightmares, fatigue. We also specialize in addressing sleep difficulties in adults and children with neurologic and psychiatric disorders such as ADHD, Alzheimer’s, Parkinson’s disease, autism spectrum disorders, epilepsy, migraine, Bipolar 1 and 2, anxiety disorders, depression.

In addition to treating sleep disorders, we can help you make evidence-based lifestyle and behavior changes to manage hyperlipidemia, diabetes, obesity, gastrointestinal disorders and autoimmune conditions.

Our office is located in beautiful Mill Valley, CA, right off of Highway 101. We offer both tele-medicine and in-person appointments and you can choose how you want to be seen. If you choose to have an in-person visit, it can take place indoors in one of our spacious meeting rooms, outdoors, or even while strolling along the Mill Valley bike path or at a local playground (for pediatric visits). Home visits can also be arranged for an additional fee. If needed, home sleep testing equipment will be mailed to you directly with detailed set-up instructions.

Despite us practicing evidence-based medicine and following the guidelines set by the US Preventative Services Task Force, insurance reimbursement for a Behavior and Lifestyle-focused medical practice remains too low to cover operating costs in the Bay Area. 

Consequently, we are an out-of-network provider for most insurances and have “opted out” of Medicare. We will charge you the cost listed on our “pricing” page at the time of your visit. If you have one, you can use your FSA or HSA to cover the cost of the visit. We suggest you contact your insurance company prior to your initial visit to discuss your out-of-network benefits and determine the actual anticipated cost to you.

You can cancel your appointment up to 24 hours beforehand. If you cancel your appointment with less than 24 hours notice you will be charged a $200 no-show fee.

As a Lifestyle Medicine focused clinic, we care about work-life balance for our providers as well as our patients. This means it may take a few days for us to respond to your inquiries. Please be patient and contact your primary care physician or go to an emergency room for urgent matters.

Lifestyle Medicine (LM) is a board-certified speciality that uses evidence-based, whole-person, prescriptive lifestyle change to treat and reverse chronic conditions. LM studies the science of what constitutes a healthy lifestyle and the science of how to help people achieve a healthy lifestyle on both a societal and individual level.

There are six pillars of lifestyle medicine: Nutrition, Exercise, Sleep and Circadian, Social Relationships, Minimizing Risky Substances, and Stress Management

At Lifestyle Sleep, we will evaluate and treat your sleep and medical problems in the context of these 6 pillars.

It is always our goal at Lifestyle Sleep to help you learn to sleep naturally, without medications. If a person is already taking sleep medications, however, it can be unsafe to abruptly stop those medications so we may take over prescribing the medication while we work together to taper the dose. In some cases, this may involve changing to a different medication that is easier to taper. We are also happy to work with people who wish to continue their sleeping medications and also optimize their sleep and lifestyle. Once they have finished optimizing their sleep, if someone chooses to continue indefinitely on sleeping medications we will ask them to transfer prescribing back to the provider who originally gave them the medication. We do not force anyone to stop any medications and leave the choice entirely up to you. We do not provide new prescriptions for sleeping medications to people who are not already on them. We take a similar approach to stimulant medications and any other medications used for sleep and wakefulness: we do not prescribe these medications but are happy to work with someone who is taking them, even if they are not interested in stopping.

Before your first visit, you will be sent a comprehensive questionnaire about your health history and lifestyle habits. Additionally, if desired, you will be sent a sleep and fitness tracker (or you can use your own) to wear for 2 weeks.

During your initial visit you will meet 1:1 with our physician who will ask you additional questions about your sleep and habits. After your visit you will be sent a comprehensive “Care Plan” with recommendations for how to proceed with the evaluation and management of your sleep concerns.

Your personalized Care Plan will include a summary of the likely causes of your sleep issues and initial recommendations for how to assess and treat them including, for example, a sleep study, behavioral therapy, dietary changes. Part of the plan may involve participating in Group Medical Visits targeting your specific sleep needs such as a group CPAP class, group Insomnia classes or group Nutrition classes. Part of the plan may also involve working 1:1 with lifestyle medicine trained health coaches.

We are not a Functional Medicine clinic and instead follow the principles of Lifestyle Medicine. Lifestyle Medicine (LM) is a Board Certified Medical Subspecialty that uses evidence-based therapeutic lifestyle interventions as a primary modality to treat and prevent chronic conditions. LM only recommends treatments with a strong scientific basis to support their use. The prescriptions written by LM practitioners are for lifestyle changes, for example “Eat 1 cup leafy green vegetables daily” or “Go for a 10 minute walk on your lunch break 3 times per week”. LM practitioners do not recommend supplements, infusions, non-standard laboratory tests or other expensive testing and interventions that are not supported by mainstream medical research. LM practitioners aim to follow the guidelines of the US Preventative Task Force and other major medical organizations as much as possible.

Group Medical Visits and Classes offer an innovative, interactive approach to healthcare that brings patients with common needs together with one or more healthcare providers. During a typical Group Medical Visit, 3  to 15 patients are seen together in a setting that encourages asking questions, and sharing concerns and experiences. The clinicians leading the group will provide educational information about a given topic and facilitate a group discussion. Patients learn from the healthcare team and from each other in this environment.

Lifestyle Sleep takes a radically different approach to treatment than most other sleep clinics. Other sleep clinics typically rely on ever-decreasing insurance reimbursements to provide care. As insurance reimbursement has declined, these clinics have been forced to see more and more patients each day, leaving time to only provide the most basic level of care. Because we are not bound by the constraints of insurance reimbursement, at Lifestyle Sleep we will spend as long as it takes to properly diagnose and address the root causes of your sleep problems. In addition to providing standard sleep medicine diagnostics and  treatments such as Home Sleep Testing and CPAP, we will take a comprehensive look at your daily habits and other medical conditions and provide evidence-based recommendations improve both your sleep and overall health. Part of your treatment plan may include group medical visits with a clinician and other patients with similar sleep difficulties and/or 1:1 coaching sessions with lifestyle medicine trained coaches. Our goal is to help you live the healthiest, most fulfilling life possible. We will tailor all treatment recommendations to your specific needs and preferences and base them on what you tell us is most important to you.

Case example of a Traditional Sleep Clinic (TSC) approach versus Lifestyle Sleep’s (LS) approach to different sleep conditions:

Sleep Apnea:

TSC - You schedule an appointment for snoring and daytime fatigue. The physician sees you for 20-30 minutes, then recommends a home sleep test which shows that you have moderate sleep apnea. The clinician then recommends a Continuous Positive Airway Pressure (CPAP) machine and sends a CPAP prescription to a local medical equipment company. You receive minimal support in adapting to using your CPAP machine and the clinician follows-up with you once a year for 20 minutes or less.

LS - You schedule an appointment for snoring and daytime fatigue. You receive a comprehensive intake questionnaire which they physician reviews prior to your visit. At the time of your visit, the physician spends 60 minutes with you obtaining a sleep history as well as information about your other health conditions and how you spend your days and nights. The physician recommends a home sleep test to check you for sleep apnea in addition to working with a lifestyle medicine coach who can help you figure out how to improve your dietary quality and add more movement to your day, both of which will help to reduce snoring. The physician also recommends breathwork training which can be done alone or through a structured group program. Your home sleep test shows moderate sleep apnea. The physician offers you a trial of a CPAP machine or you can work on the dietary, exercise and breathing changes previously recommended and repeat sleep testing in a few months to determine the effectiveness. You decide to try CPAP while making the recommended lifestyle changes and the physician sends a prescription for CPAP to a local medical equipment company, who gives you the machine which will be paid for by insurance, or you can purchase the machine out of pocket from an online vendor. Once you have received your CPAP machine you attend 3 group sessions with a sleep technologist and other new CPAP users where you can try different mask styles and types, have the settings adjusted on your machine, and learn other techniques to allow you to adapt to using a CPAP machine as well as possible.

At Lifestyle Sleep, we believe that a well-balanced diet can provide all the essential minerals and supplements for sleep. A comprehensive dietary assessment is part of our intake process and we will make dietary recommendations to help improve sleep and overall health. For instance, we may recommend adding foods that are high in melatonin and/or magnesium at dinner (such as walnuts). We recommend oral B12 supplementation to any patients on a vegan diet and, in rare cases, may occasionally recommend oral or IV iron and/or melatonin supplementation for a limited period of time. 

No, we do not sell or recommend cannabis products for sleep. Although cannabis products do come from nature, most modern cannabis has been bred to contain unnaturally high levels of many components. Additionally, cannabis compounds act on neurotransmitters in a way that commonly causes tolerance and dependence. Our goal at Lifestyle Sleep is always to minimize the use of any prescription, OTC and herbal substances and instead help you learn to use lifestyle and behavioral strategies to optimize your sleep.

A comprehensive care plan is emailed to patients after every visit. Short logistical question email exchanges requiring less than 5 minutes of clinician time are provided for free to both members and non-members. Emails from non-members that require more than 5 minutes of the clinician’s time to evaluate and/or respond to will be billed at a rate of $100 for up to 20 minutes of time. Emails inquiries that will require more than 20 minutes of clinician time will need to be addressed during a follow-up visit. Email communications of all lengths are included in a membership.

At Lifestyle Sleep we trust the medical research showing that healthy lifestyle habits are beneficial regardless of body weight. We take a “health first” rather than a “weight first” approach to care. This means we will help you to improve your lifestyle habits according to the six pillars of lifestyle medicine at whatever pace feels best to you. 

Yes! A Lifestyle Medicine approach is beneficial for anyone who is interested, regardless of what medications they are taking. The decision about whether to continue or wean medications is completely up to you and the prescribing physician.

We are currently only able to provide services for patients in the state of California.

Yes! We offer phone interpreter services. Please inform us when you book your appointment that you would like an interpreter to give us adequate time to arrange this.