What is insomnia?
Insomnia is a health condition involving difficulty falling asleep, difficulty staying asleep, and/or waking too early in the morning. It can also involve poor quality sleep. Often, those with insomnia report having an “active mind” at night, and they feel anxious or frustrated about not sleeping. Daytime consequences of insomnia can involve fatigue, sleepiness, difficulty concentrating, and feeling anxious or out of sorts.
Insomnia can be short term, caused by something stressful, such as school starting or a job change. Insomnia can become chronic. Insomnia can be related to another health problem, such as a medical or psychiatric condition. Insomnia can also exist on its own. Research has found that cognitive-behavioral therapy for insomnia is effective in people with various health conditions such as cancer, fibromyalgia, depression, and chronic pain.
How long does cognitive-behavioral therapy for insomnia take?
Each session with Dr. Loomis is 45 minutes, and the first session is an assessment, in which Dr. Loomis asks you questions about your sleep and health. The cognitive-behavioral therapy for insomnia program lasts on average about 6-8 additional sessions. The number of sessions can be hard to predict, however, because every individual is different.
What other sleep disorders do you treat?
Dr. Loomis cannot perform or order a sleep study or diagnose sleep apnea. Dr. Loomis does briefly screen for all sleep disorders when she meets with you. If she suspects another sleep disorder like sleep apnea or restless leg syndrome, she will refer you to your primary care physician or a board-certified sleep medicine physician for further evaluation. An overnight sleep study is usually not indicated if the diagnosis is insomnia and other sleep disorders are not suspected.
In addition to insomnia, Dr. Loomis treats the following conditions:
- Difficulty adjusting to CPAP treatment for sleep apnea, including claustrophobia
- Frequent nightmares
- Dysfunctional sleep patterns (being an extreme “morning lark” or “night owl”) or circadian rhythm disorders
- The effects of shift work
What ages do you work with?
Dr. Loomis works with patients ages 15 and up.
Does my insurance pay for these services?
Because Dr. Loomis is a licensed psychologist, the services are covered under “outpatient behavioral/mental health” benefits. The services Dr. Loomis offers are routine outpatient behavioral health services (the codes billed are 90791 and 90834).
When calling your insurance company, it is recommended that you ask the following questions:
Is Dr. Catherine Loomis (licensed psychologist) an “in-network provider”, if so, at what locations?
If she is not in the network: What are my “out of network” benefits for routine outpatient behavioral/mental health?
If she is in network: Do I need a preauthorization for services, and if so, can I get preauthorized now (they will give you a preauthorization number)?
Is there a copay or coinsurance I have to pay?
Do I have a deductible, and if so, how much has already been met?
What if I’m interested in medications for sleep?
Medications can be effective in the treatment of insomnia. They can also be used along with behavioral treatment. Because Dr. Loomis has a Ph.D. and not an M.D., she doesn’t prescribe medications for sleep. If you want to learn more about medications for sleep, you could talk with your primary care physician, a sleep medicine physician, or a psychiatrist (who can be helpful if you are also dealing with anxiety or depression). If you work with Dr. Loomis and eventually wish to discontinue sleep medications, she can consult with your physician to develop a plan. Medications and cognitive-behavioral therapy for insomnia both have advantages and disadvantages that can be explored with Dr. Loomis or your physician.
What are my options if the location isn’t convenient or I’m outside the Milwaukee area altogether?
The Resources section of this website links to two directories of behavioral sleep medicine specialists. You can call your local sleep disorders center and ask them if they provide cognitive-behavioral therapy for insomnia, or go in for an evaluation. A directory of accredited sleep centers is located at www.sleepeducation.org. There are also cognitive-behavioral therapy for insomnia online programs that have research that demonstrates their effectiveness. Examples of two of these are Shut-I and Sleepio.
What will meeting with Dr. Loomis be like?
When you first come in, you will sit with Dr. Loomis and talk about your sleep. She will ask you questions about your sleep and health. The first meeting involves Dr. Loomis getting a sense of your sleep problem, and she will introduce you to the sleep log that you can complete at home.
Sessions are usually once a week because that allows you to keep focused on your goals. If it is difficult to meet that often because of your schedule, meetings can be less frequent.
If you are participating in cognitive-behavioral therapy for insomnia, each session has a structure to it, and the agenda will be set at the beginning of the session. You will be asked what you would like to add to the agenda, and the sessions can be flexible enough to address the topics you’d like to talk about.
For other sleep disorders, our sessions can be very specific and directive, or more like a conversation. For example, when Dr. Loomis works with people who have circadian rhythm disorders, there may be a very specific schedule the person is asked to follow, but there also might be more general conversation about how the person is coping with the sleep problem.
You will determine with Dr. Loomis how many sessions you will have, depending on how you are progressing.