Sleep Coaching Versus Sleep Therapy

What do you really need to know?

My Dad recently sent me a text message with a link to a recent Men’s Health article around Sleep Coaching versus Sleep therapy and what a Sleep Doctor had to say.

“Looks like fear of turf battles” He said.

Now, upon trying to read the article, I found out that it was paywalled12—but I think it’s a very important topic that is worth being unpacked.

In short, we need all types of sleep practitioners.

What is the difference?

First, it’s probably really important to understand the difference between different sleep practitioners and what their roles and scopes of practice are. These are not exhaustive, but the main categories are: medical doctors who specializes in sleep, clinical sleep psychologists, licensed mental health professional who is familiar with sleep as it relates to mental health, and sleep coaches.

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Medical Doctors

Medical doctors who specialize in sleep are incredibly important. These are people who have gone to medical school and have a MD license. Much of their schooling is the biological, physiological, and anatomical background of the human experience and they are trained specially and specifically to address sleep issues from a Westernized, evidence-based lens. They are able to prescribe medicine and often work with individuals on a diagnostic basis. Typically, their individual time with their patients 1:1 is very short and the most expensive option and are often backed by a robust team of other medical support staff (nurses, physicians assistants (PAs), etc.). They also have the ability to bill healthcare insurance. Their treatment and care is crucial for individuals who have not yet ruled out life-threatening situations that are interfering with sleep.

Clinical Sleep Psychologists

Clinical Sleep Psychologists are PhD level clinicians who have spent their graduate training in both research and working with people on a therapeutic or human behavior level. They have a therapeutic clinical license, often have run their own independent research, and often have a very specialized area of sleep disorder they help treat. Much of their schooling is likely framed in a bio-psycho-social model of learning, which means they are looking at the whole system of the person within the environment that person exists. Depending on the state, they are sometimes able to prescribe medicine and often work with individuals on a diagnostic basis. Although there is no “normal” structure for a clinical level sleep psychologist, because they are in such high demand, they typically work on a short-term basis with clients to diagnose very specific sleep disorders and then move them towards other forms of care. They also have the ability to bill healthcare insurance.

Licensed Mental Health Professional

Licensed mental health professionals are often Master’s level clinicians who have spent their graduate training working with people on a therapeutic or human behavior level. They have a therapeutic clinical license and are trained in general mental health. Because nearly all forms of mental health diagnoses overlap with particular sleep patterns, mental health professionals are often exposed to the reality that sleep disturbances go hand in hand with a therapeutic journey. Much of their schooling is experiential and not often specialized towards sleep. While they are able to diagnose mental health disorders, many are not qualified to diagnose sleep-specific disorders. Many licensed mental health therapists work with clients on a minimum of a 6 - 8 week basis, but often do not directly address sleep issues. They also have the ability to bill healthcare insurance.

Sleep Coaches, Guides, and Consultants

Sleep coaches, guides and consultants do not have any requirements for their training in order to work with people. They have a variety of backgrounds, specialties and levels of experience and understanding of what sleep is and how to navigate issues of sleep health. Coaches, guides, and consultants often are much more accessible and practical with their sleep health advice, and may be willing to spend more individual time with a client navigating the process of what works for someone and what does not. They cannot bill health insurance and often charge out of pocket.

The Pitfalls of Inappropriate Sleep Health

Why do people get so up in arms about different types of practitioners?

Well, it isn’t without good reason. If you’ve ever suffered a stint of insomnia, or identify as someone who is a fussy sleeper—you’ll know how unpleasant, and sometimes how downright excruciating it is to not get the rest you’re hoping for.

When people are not sleeping well, our ability to emotionally regulate and make sound decisions is diminished. It’s very easy to take advantage of someone looking to fix their relationship to sleep. Many people wait until they feel desperate before seeking help around sleep issues and are willing to try anything. When in this state of desperation, it is very easy to overshoot or undershoot the level of care that is needed to begin shifting the relationship with sleep.

The truth is, many people don’t know enough about sleep to make an educated decision around what kind of care they should be seeking.

It makes sense that articles like the one in Men’s Health would be wary of sleep coaches and advocate for heading straight to a clinical sleep psychologist or a medical doctor who specializes in sleep disorders. These medical doctors and clinical psychologists hold the uppermost standards for being regulated, educated, and experts in their field. However, they are not without their shortcomings. Giving a “one-size-fits-all” approach to sleep health is not useful, and truthfully, not very accessible for everyone seeking services3. Many of these practitioners do not have time for individualized care of their clients and patients, even if their clients can afford the steep price of entry.

On the opposite end, many folx out there who are having sleep difficulties do not have a diagnosable sleep disorder, and might drastically benefit from education around sleep health, sleep hygiene, and a personalized approach to making behavioral steps towards better rest. The pitfalls of going to someone who identifies as a coach, guide, or consultant is that these individuals may not be well educated enough on when they are operating outside of their scope of practice. Not only may they not recognize they are over their heads, they might also not know how to help refer their clients towards a higher level of care.

Finding the Right Fit For Your Sleep Health Needs

First of all, 70% of adults are not getting adequate sleep.

It is likely that if you are an adult, there is a higher than average chance that you could probably brush up on your sleep health. Whether it’s a small tweak to a fairly well-rounded sleep regimen or you’ve chronically suffered from insomnia your whole life—most people do not seek out support for their sleep health until it has dramatically impacted their lives.

A good rule of thumb is if you’re even slightly dissatisfied with your sleep for more than 3 months in a row, it might be time to seek out some support for a tune up.

Rule Out The Big Sleep Health Shit First

If you’re really worried about your sleep health and you have really good health insurance, go rule out the big dogs first4. Talk to a sleep specialist about getting tested for sleep apnea, broadly screened for severe sleep disorders, and if you’re really serious about going for the full-monte—go ahead and sign up for that CBT-i course.

Once You Rule Out The Big Sleep Health Scaries…

An honest assessment with yourself about where your mental health is goes a long way. Sleep and mental health are often intricately intertwined and perhaps a few shifts to help support your stress levels or your mental health might just do the trick. If you’re actively seeing a therapist, be sure to mention this as a component.

If You’ve Determined Your Sleep Health Issues Aren’t Dangerous…

Working with a sleep coach, sleep guide, or sleep consultant is not a bad way to go once you’ve ruled out all of the big, scary pieces. If you’re looking to get a better night’s rest, working with someone who can help you fine-tune your own specific sleep health needs at a steady pace is likely to have an outcome that alleviates stress. Of course, be discerning about who you choose to work with and why. Looking for individuals with research backgrounds and diverse skillsets in working with stress management when it comes to sleep is ideal. Bonus points if you can find a sleep coach who can help you discern if you need a higher level of care and can actually walk you through the specific steps towards securing that next level of support.

Quality Sleep Health is About Discernment

In an ideal world, sleep doctors, sleep psychologists, and sleep coaches would use a “team” care approach and bolster each other’s strengths and help fill in the weaknesses. Medical doctors would ask sleep researchers more questions about over-prescribing sleep medication. Sleep coaches would create long-term and consistent relationships with their local sleep psychologists and ask how they could help fill in the gaps. Journalists wouldn’t paywall important information without having other accessible articles free for anyone to learn about their own sleep health.

Everyone would work on a sliding scale so that these resources would be accessible to the general public, regardless of their income or education level.

Maybe someday we’ll get there.

In the meantime, the best thing we can do is prioritize our own rest and help support each other in theirs.

Do you know someone who might benefit from some sleep health education? If so, let them know that you care about their rest.

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This sub-section of The Art of Rest, is all about—you guessed it—The Rest.

As a trained sleep scientist, here we explore the everything related to rest. Whether we are unpacking the newest evidence-based sleep health tips, exploring day-to-day tools for bolstering and protecting rest, or diving into a world of dreams, “The Rest” is going to regularly touch into what a restful life is, and how to move towards one.5

Looking For A Sleep Health Guide?

Although my busy season is just on the horizon, I currently have a few spots available for sleep health guidance. I offer individualized 1:1 sleep health guidance for those who just need a tune up all the way towards those who are dealing with chronic sleepless nights. Shoot me an email at dagnyrose@theartofrest.me to inquire about getting started.