Question 1

I am an existing patient.  Can you help me with technical issues (logging into a virtual visit, navigating the clinic portal, using the program platform)?

Accepted Answer

Please visit our Tech Support page.

Most problems can be resolved quickly using the guidance there. If you continue to experience difficulty after trying those steps, please email 
decodeinsomnia@protonmail.com for assistance with virtual visit or the clinic portal
decodeinsomnia@gmail.com for assistance with the program platform

Question 2

Who is this clinic for?

Accepted Answer

This clinic provides care for individuals 13 and older in Ontario who are dealing with insomnia or sleep timing issues. We offer different options for teens/young adults (13-25) and for adults.

Question 3

Does this clinic see patients younger than 13?

Accepted Answer

Because our programs aren’t designed for school-age children, we generally adhere to a minimum age of 13 to ensure a good fit and consistency for both referring physicians and families. That said, we can often make an exception for teens who will be turning 13 within a few months of a consultation. In the meantime, we offer various resources on our website:
Parents: www.decodeinsomnia.com/parents
Interested teens: www.decodeinsomnia.com/start

Question 4

What if I have a sleep concern other than insomnia or sleep timing?

Accepted Answer

This clinic is not a general Sleep Medicine clinic. During your consultation, the physician will do a brief screen for other sleep disorders—such as sleep apnea, restless legs syndrome, parasomnias, or excessive sleepiness disorders. If another sleep disorder seems likely, a referral to a general Sleep Medicine clinic may be recommended for further assessment and management.

Question 5

How do I obtain a consultation?

Accepted Answer

A physician referral is required. Please speak with your doctor and use the referral information provided here.

Question 6

Is there a cost for a consultation?

Accepted Answer

Consultation is covered by OHIP.

Question 7

How long is the wait for a consultation?

Accepted Answer

Current wait time for an adult consultation is approximately 3-4 months. Current wait time for a teen consultation is approximately 1-2 months. Earlier appointments are often available through our cancellation list.

Question 8

My physician has submitted a referral.  What are the next steps?

Accepted Answer

You will receive an email from the clinic with next steps.

If a referral was sent but you have not been contacted, please email decodeinsomnia@protonmail.com to check on the status of your referral.

Question 9

What steps do I need to take to prepare for the initial consultation?

Accepted Answer

To prepare for the consultation, please ensure the following:

You have submitted your intake questionnaires at least one week before your appointment. If they aren’t received at least two full business days ahead of time, we’ll need to cancel the visit and the spot will be offered to someone on the waitlist.

You will be physically located in Ontario (OHIP-covered care cannot be provided outside the province) for the visit.

You have a reliable internet connection, working audio/video, and a private space for the appointment.

If you are new to Zoom, you have tested your Zoom connection ahead of time.  If you will be using a mobile device, download and test the Zoom app in advance.

For teens: A parent/caregiver will be present for the consultation.

Optional but recommended:

Adults: Watch and implement the strategies in the video training Sleep Tips: What Works (And Why They May Not Be Enough) HERE, and review treatment options after consultation HERE

Parents of Teens: Review information about teen services HERE and take a look at parent resources HERE

Question 10

What technology do I need for virtual care?

Accepted Answer

A device with a camera and microphone (laptop, tablet, or smartphone) and a stable internet connection. Zoom must be installed and tested. Headphones are recommended to increase privacy and audio quality.

Question 11

Can I attend an appointment from work or my car?

Accepted Answer

Yes—if privacy and safety can be maintained. Appointment cannot be held in a public location or while driving.

Question 12

What should I expect during the consultation?

Accepted Answer

When you click the visit link in your confirmation or reminder email, you’ll enter the physician’s virtual waiting room. Your physician will bring you into the visit once they’re available.

Before the appointment, your physician will have reviewed your intake questionnaire. During the visit, they’ll gather more information to better understand your sleep concerns.

By the end of the consultation, you’ll receive personalized feedback about your sleep concerns, priority areas to focus on, first steps, general recommendations, and resources. You’ll also discuss whether CBT-I–based treatment is appropriate and whether one of the DECODE programs may be a good fit. There will be time to ask questions.

For teens: The physician will meet with both the teen and a parent/caregiver together as well as  separately.

Question 13

What are potential options after consultation?

Accepted Answer

People move forward in different ways after consultation.

Some start treatment right away.  For adults, treatment is with the DECODE Sleep Program.  For teens, treatment is with the Sleep Sprint Program.  If you are a young adult (18-26y), you will speak to your physician about which program is a better fit.

For adults: Some start with general strategies from the consultation — using the resources provided — and then decide whether to move into treatment later. If you'd like more guidance before deciding to move forward with the DECODE Sleep Program, you can join a group follow-up appointment to review the initial general recommendations and learn more about the programs. We don’t offer individual follow-ups just for general strategies — this keeps wait times shorter and ensures those who need treatment can access it.

Question 14

What if I need a sleep study?

Accepted Answer

A sleep study is not needed to diagnose insomnia. A study may be warranted if symptoms raise concern for other sleep disorders (e.g., sleep apnea). Sleep studies are not performed at this clinic, but recommendations for how to access sleep investigations will be provided during the consultation.

Question 15

Is medication for sleep prescribed in this clinic?

Accepted Answer

In most cases, medication is not required or plays only a limited role in managing insomnia and sleep timing concerns. When medication is considered, we begin by focusing on the non-medication strategies as consistency with these strategies helps determine whether medication is needed and how it might best be used. In cases where medication is recommended alongside non-medication treatment, it is typically prescribed for short-term use only.

Medication is not prescribed at the time of consultation.

Question 16

What is cognitive-behavioural therapy for insomnia (CBT-I) and how is CBT-I delivered through the DECODE programs?

Accepted Answer

Cognitive-behavioural therapy for insomnia (CBT-I) is the gold-standard for treatment insomnia. CBT-I has a strong evidence base, with research indicating that it is effective for around 70-80% of individuals with chronic insomnia. This success rate is comparable to that of medication with the added benefits of more sustained results and avoiding medication side effects, dependance, and tolerance.

Adults: The DECODE Sleep Program combines the core behavioural strategies from CBT-I (sleep restriction, stimulus control, and sleep hygiene) in a focused, consistent 3-week reset. The DECODE Therapy Extension adds relaxation training and cognitive therapy, along with additional therapeutic tools drawn from ACT (Acceptance and Commitment Therapy).

Teens: The Sleep Sprint Program combines the core behavioural strategies from CBT-I (sleep restriction, stimulus control, and sleep hygiene) in a focused, consistent 2- week effort.  As compared to the DECODE Sleep Program, this program is less comprehensive.  There is the option to do private therapy to learn relaxation and cognitive strategies with registered psychotherapist Sara Davidson after the Sprint Program.

Question 17

What is the difference between the DECODE Sleep Program (DSP) and the DECODE Therapy Extension (DTE)?

Accepted Answer

The DECODE Sleep Program (DSP) focuses on the core behavioural strategies of CBT-I and is delivered through an online learning platform with support available through group office hours. It also integrates with medical visits at the DECODE Insomnia Clinic for added guidance and personalization.
 
The DECODE Therapy Extension (DTE) offers therapist-guided sessions that integrate relaxation training and thought work from CBT-I with ACT (Acceptance and Commitment Therapy) skills—practical strategies that help you relate differently to stress, racing thoughts, and difficult emotions so they have less impact on your sleep. Many people find ACT tools especially helpful because they focus on aligning actions with personal values and can be used not only at night, but in any challenging moment throughout the day. Each session includes light pre-reading and short prompts to help you get the most out of the work, along with tools such as a workbook and audio practices to support momentum between sessions. DTE incorporates

Question 18

Who is a good fit for the DECODE programs?

Accepted Answer

The DECODE programs are a good fit if you have chronic insomnia or sleep timing issues, are motivated to improve your sleep, and can commit to the process. The programs are a particularly good fit if you generally require structure, clear steps, and accountability to take consistent action.

The DECODE Sleep Program (DSP) is a good fit if you prefer flexible, on-demand learning, are comfortable accessing resources online, and value the integration of education, support, and medical care.

The DECODE Therapy Extension (DTE) is a good fit if you’ve already implemented the behavioural strategies properly and need additional tools, or if you’re motivated to build more tools to help with sleep and other challenges such as anxiety, mood, pain, or stress. The design of this program is also well suited to people who have struggled to maintain momentum between therapy sessions in the past.

Question 19

Who is not a good fit for the DECODE programs?

Accepted Answer

The DECODE programs may not be a good fit if you prefer not to use core CBT-I strategies such as stimulus control or sleep restriction, are uncomfortable with virtual care or technology, or are unable to commit time or energy to the process right now. They are also not well suited for people looking for a quick fix or for those who are not eligible for integrated medical care or psychotherapy through the clinic, such as individuals not living in Ontario.

Question 20

What is the cost for the DECODE programs?  Are the programs covered by insurance?

Accepted Answer

Three months of access to the DECODE Sleep Program—including the online learning platform and regular virtual office hours (usually twice weekly)—is $297*. You can extend for an additional three months for $197*. Sliding-scale pricing is available if finances are a significant barrier. The DECODE Sleep Program is typically not covered by insurance.

The optional DECODE Therapy Extension (DTE) is provided by a registered psychotherapist, and fees are based on the therapist’s hourly rate. Psychotherapy invoices are provided, and you may have coverage through your insurance plan.

The Sleep Sprint Program is free.  Clinic visits to provide support for this program are covered by OHIP-covered.

*Pricing is subject to change. Details about sliding-scale options will be provided at the time of consultation. As of March 1, 2025, HST will be applied in accordance with Canadian tax regulations.

Question 21

What is the time commitment for the programs?

Accepted Answer

For the DECODE Sleep Program, active treatment lasts about 4–6 weeks.
 To get the most out of the program, participants typically spend:
3–4 hours per week during the first two weeks to watch video lessons, complete worksheets, and complete preparations for the 3-week reset
~1 hour per week during the 3-week reset to troubleshooting and monitoring progress with sleep logs

For the optional DECODE Therapy Extension, treatment spans  4–6 fifty minute sessions with a psychotherapist (virtual or in person in Toronto). Participants are encouraged to set aside about 1 hour before each session for light pre-reading and a few prompts from the program workbook. In week 2, participants begin a nightly 20-minute practice integrated into the bedtime routine. In week 3, a second 20-minute daily practice is added to process the thoughts captured the night before.

Question 22

I’ve done CBT before. How is CBT-I different?

Accepted Answer

While CBT for other conditions like depression and anxiety teach some elements that are helpful for insomnia—like relaxation strategies and cognitive tools—CBT for other conditions does not include the key behavioural interventions for sleep.

CBT-I targets the specific mechanisms that fuel insomnia/sleep timing concerns, and the behavioural strategies are the most powerful and fastest-acting parts of treatment. For some, these strategies alone are enough to resolve insomnia or sleep timing issues, even when these sleep concerns have been present for decades.

As with any treatment, training and experience matter. Working with someone who specializes in CBT-I and regularly treats chronic insomnia/sleep timing concerns is strongly recommended for the best results.

Question 23

What if I’ve tried CBT-I before and it didn’t work?

Accepted Answer

The strategies in CBT-I are powerful, but it’s consistent implementation that creates results. Even with a good understanding of the tools, it’s easy to miss key steps, fall into common traps, struggle to stay consistent, or not know how to adjust the plan when something isn’t working. The DECODE programs assume taking action is challenging but doable with the right structure and support. They help you apply the strategies properly, consistently, and for long enough to unlock the full benefits of these evidence-based approaches.

Question 24

I’ve had insomnia for decades. Is it possible to sleep better?

Accepted Answer

Yes. Cognitive Behavioural Therapy for Insomnia (CBT-I) is highly effective, even for individuals with long-standing insomnia. With the right roadmap and support, significant and sustained improvement in sleep is possible.

Question 25

I would like to come off medication for sleep. Will CBT-I help?

Accepted Answer

Yes. many people are able to reduce or discontinue their sleep medications as their sleep improves with CBT-I strategies. If tapering is appropriate, your physician can guide you through a safe, gradual plan while you work through the program, ensuring that changes to medication are coordinated with your progress in treatment.

Question 26

Does CBT-I work if I also have concurrent depression, anxiety, chronic pain, or another medical condition?

Accepted Answer

CBT-I works well even if you also have depression, anxiety, chronic pain, sleep apnea, or other medical conditions. Research shows that CBT-I not only improves sleep in people with these concerns, but it can also lead to better mood, reduced anxiety, and improvements in pain and daytime functioning. It remains effective when used alongside other treatments (such as CPAP for sleep apnea) and is recommended as the first-line, gold-standard treatment for chronic insomnia by major medical organizations.

Question 27

How do the DECODE programs compare to other ways of accessing CBT-I?

Accepted Answer

What sets DECODE apart is our focus on realistic implementation—the piece that most people struggle with and the piece that creates real results.

The DECODE Sleep Program combines the convenience of online, on-demand learning with optional support through virtual office hours (typically twice weekly). For Ontario patients, the program also integrates with OHIP-covered individual visits at the DECODE Insomnia Clinic, providing medical guidance from clinicians with expertise in sleep, added accountability, and personalization.

Apps, books, and videos can offer helpful information, but they lack support, troubleshooting, and accountability, which are critical for real-world change.
Traditional 1:1 CBT-I or weekly group programs can also be effective, but they typically:

Provide less frequent support
Do not include on-demand learning tools
Have higher overall costs
Do not integrate easily with medical care (e.g., CPAP adherence guidance, medication tapering, or medical considerations)

The DECODE Sleep Program brings these pieces together so you get the structure, support, and medical oversight needed to actually put CBT-I into practice.

The optional DECODE Therapeutic Extension offers therapist-guided sessions that integrate relaxation training and thought work from CBT-I with ACT (Acceptance and Commitment Therapy) skills—practical strategies that help you relate differently to stress, racing thoughts, and difficult emotions so they have less impact on your sleep. Many people find ACT tools especially helpful because they focus on aligning actions with personal values and can be used not only at night, but in any challenging moment throughout the day.

Question 28

How are the DECODE programs designed to support implementation?

Accepted Answer

The DECODE programs are designed to make proper implementation possible by combining flexible learning with regular support.  Both programs are grounded in habit and behaviour-change principles—such as building early wins, shaping your environment, and making decisions ahead of time—to help you take consistent action and see meaningful progress.

In the DECODE Sleep Program (DSP), you follow a step-by-step online curriculum at your own pace and have access to twice weekly group office hours for support.

In the DECODE Therapy Extension (DTE), you receive one-on-one therapeutic support, along with a workbook and audio tools to help you maintain momentum between sessions.

Question 29

How is treatment with the DECODE programs different from general sleep advice?

Accepted Answer

Sleep tips can be helpful, but they often fall short because tackling insomnia or sleep timing concerns requires the right combination of strategies, applied in the right order, consistently, and for long enough to see benefit. Without guidance, structure, and support, many people don’t see enough progress to stay motivated, which leads to discouragement and setting aside strategies that could ultimately be very effective. Successful treatment requires personalization, coaching, and accountability—things that even the best tips or advice can’t provide.

Question 30

Can I start the DECODE Sleep Program before my consultation?

Accepted Answer

Yes — and you don't need a referral to apply. Motivated individuals can apply to begin the program before a consultation. An application is required, and a short conversation with the program coordinator may follow to confirm fit. If the program is a good fit and you wish to proceed, referral and consultation is then required for integrated medical support during the program.

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Question 31

Why is access to the DECODE Sleep Program only 3 months?

Accepted Answer

The three-month access period is intentional and designed to help you stay focused, supported, and successful as you work through the program.  Here’s why the three-month access period works well:

A meaningful deadline helps you stay on track: We often take as long as we’re given to complete something—this is called Parkinson’s Law—where the time required expands to fill the time available. A clear three-month window provides the structure to keep you focused and moving forward. Many people find that having a defined timeframe—and knowing that extending access has an additional cost—creates helpful momentum and accountability.
You receive a high level of support during this period: Your enrollment includes access not only to the online program but also to twice-weekly virtual office hours, offering guidance, troubleshooting, and regular support.
Three months is typically more than enough time: Most participants complete the key steps comfortably within this window. The preparation stage is intentionally short (1–3 weeks) to keep up momentum, followed by the structured 3-week Reset.
An extension is optional if needed: If you’d like more access to the platform and the office hours, you can extend your access for an additional three months for $197. You’ll automatically be offered this option when you near the end of your initial access period.

Question 32

What if I’m interested in joining the DECODE Sleep Program, but I’m going on vacation soon or it’s not a good time for me to devote a lot of attention to the program?

Accepted Answer

To get the most out of the DECODE Sleep Program, it’s important to have enough bandwidth to commit to it properly. The program has two phases:

Reset Preparation: Though it’s recommended to complete this phase in 1–2 weeks to keep up momentum, it can be done at your own pace. You’ll learn and begin using early strategies, and some people notice improvements with these strategies alone.
The Reset: This is the fixed 3-week period where you combine various strategies in a structured and consistent way. For best results, it’s important to choose a time when you can be very consistent—for example, not during a vacation, a move, a particularly demanding period at work, or holidays when routines are more disrupted.

You have two options:

1. Wait to sign up: You can choose to wait and sign up for the program when the timing works better for you. When you’re ready, simply use the sign-up link you received after your consultation.

2. Join now but move more slowly through the initial strategies: Many patients prefer to join right away so they can get immediate access to the online program and office hours. You can work through the early steps at your own pace as you prepare for the Reset. If moving slowly through the initial material means you won’t complete the program within the three-month access period, you can extend your access to the online platform and office hours (at an additional cost). However, this is rarely necessary because the three-month window generally provides a generous buffer.

Regardless of when you plan to begin the Reset, we recommend joining office hours as soon as you enroll. Office hours help you get oriented, support your onboarding, maintain momentum, and provide accountability as you work through the program.

Question 33

Should I start with the DECODE Therapy Extension? Will the DECODE Sleep Program help if my main issue is anxiety or a busy mind at night?

Accepted Answer

Surprisingly, yes. Many people with significant nighttime anxiety or racing thoughts see full resolution with behavioural strategies alone, even after years—or decades—of insomnia.

This is because the behavioural components of CBT-I:

Build strong signals for sleep and this sleepiness help to override a busy mind
Reduce conditioned hyperarousal (an unhelpful association with your bed in which bed triggers a state of higher activation and alertness)
Boost confidence through fast, concrete progress

Relaxation and thought tools become more effective after the behaviour-based foundations are in place. Starting with them before addressing the behavioural pieces often leads to limited or no benefit.

Question 34

Do I need medication in addition to CBT-I?

Accepted Answer

In many cases, medication is not necessary or plays only a small role in managing insomnia or sleep timing concerns. CBT-I is the first-line, most effective long-term treatment, and many people see significant improvement—sometimes full resolution—with CBT-I alone.

During your consultation, you and your physician can discuss whether medication is appropriate based on your specific situation and treatment goals. If medication is recommended, it is generally used short-term and in combination with CBT-I, with guidance on how to use it safely and effectively.

Question 35

Is this program appropriate if I have sleep apnea (or suspected sleep apnea)?

Accepted Answer

If your sleep apnea is treated, the program proceeds as usual. If sleep apnea is suspected or untreated, you can still complete all steps before the 3-Week Reset as is. The Reset may need adjustments and can be discussed with your physician at the clinic.

Question 36

Is this program appropriate if I work shift work?

Accepted Answer

Yes—many shift workers benefit from CBT-I and the DECODE programs. Adaptations are usually needed, and these can be discussed during a consultation.

Question 37

Why are there different options for teens?

Accepted Answer

Teens often experience insomnia for different reasons—most commonly body clock/circadian rhythm delays—and they face different challenges when it comes to motivation and implementation.

Because ambivalence is common in teens, the Teen Sleep Sprint is intentionally less intensive, requires less work, and will always be free or very low cost to reduce the barriers.

Question 38

I’m interested in the DECODE programs but I’m not eligible.  What are my options?

Accepted Answer

Thank you for your interest!

At this time, the DECODE Sleep Program is not available for individuals 12 or younger and is not recommended for those 18 or younger (the Teen Sleep Sprint program is available for ages 13–26). The DECODE programs are also currently limited to individuals living in Ontario, Canada, due to their integration with OHIP-covered medical care at the DECODE Insomnia Clinic and psychotherapy delivered by Ontario-licensed clinicians.

You can still access and benefit from DECODE approach, including the free on-demand Sleep Tips: What Works (And Why They May Not Be Enough) training and resources for parents of teens.

Frequently Asked Questions

I am an existing patient. Can you help me with technical issues (logging into a virtual visit, navigating the clinic portal, using the program platform)?