CONSULTATION & EDUCATION
A consultation is first required for all teens to understand the concerns, to confirm the diagnosis, and to evaluate if investigations (ex. a sleep study) are required. After the consultation, education is provided and treatment options are discussed.
These services typically take place over 1-2 appointments*. The presence of a parent and/or caregiver is suggested for these appointments.
*Please note: During the current work-from-home circumstances, all new consultations will be arranged through the administrative staff at Dr. Ooi's other practice location, MedSleep Toronto Sleep Institute. All care is being delivered virtually.
★OHIP-COVERED CONSULTATION AND NON-MEDICATION TREATMENT FOR CHRONIC INSOMNIA★
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THE DECODE
INSOMNIA PROGRAM
A 7-week treatment program for chronic insomnia for ages 13+ in Ontario
A consultation is required to ensure this program is a good fit.
WHAT IS THE DECODE INSOMNIA PROGRAM?
The DECODE Insomnia Program offers a comprehensive, non-medication solution for insomnia, rooted in Cognitive Behavioural Therapy for Insomnia (CBT-I). The program blends personalized support with an online curriculum for self-paced, convenient learning.
HOW DOES THE PROGRAM WORK?
While knowledge is essential, it’s not enough. Achieving sustainable healthy sleep comes from taking the right steps, consistently. This requires energy, attention, and motivation–all of which are severely compromised when not sleeping well. This program was designed to provide you with a streamlined step-by-step roadmap with the personalized support, recognizing that relying on willpower alone is seldom effective. In this program, we blend strategies taught in a traditional course of CBT-I with *Habit-breaking and building strategies *Strategies from acceptance and commitment therapy (ACT) to more effectively respond to thoughts and emotions that drive unhelpful behaviours *A focus on other ‘tricky-to-navigate’ moments that derail healthy sleep (bedtime procrastination, waking up, being active, managing fatigue) *An emphasis on aligning your sleep goals with your big picture life goals & what matters most to you, providing genuine motivation to get the most out of the program *Techniques to effectively manage the influx of thoughts that arise at bedtime The program design is also unique with the following features to support implementation and effective progress through the program: *An online platform (available on a desktop and via the program app) for convenient, on-the-go learning and the ability to revisit content at anytime *Live sessions that complement the online curriculum, ensuring a personalized approach *A workbook with lesson summaries, cheat sheets, checklists, and templates *Audio to guide action in-the-moment *A guide with resources, ideas, and recommended products
WHAT'S COVERED?
PHASE ONE
Phase One lasts 3 weeks and jumpstarts progress with powerful behavioural strategies. During this phase, participants use a two-week protocol (RESET) to address powerful factors driving chronic insomnia (an out of sync body clock, an unhelpful association with the bed). There is a strong focus on getting set up properly for the RESET as there are many common traps that can derail progress. Simple routines and a plan for when unable to sleep are created. Sleep is monitored with logs during the RESET. Phase 1 is supported by 2-3 virtual OHIP-covered clinic visits with a physician.
PHASE TWO
Phase Two lasts 4 weeks and focuses on building a toolkit of skills to maintain good sleep. In this phase, participants learn how to break habits, build helpful habits, build relaxation & cognitive skills, and create realistic plans to guide difficult in-the-moment action. There is also a focus on learning skills to manage the volume of thoughts that arise at bedtime. Participants learn to better navigate other ‘tricky moments’ that derail sleep (waking up, powering down/bedtime procrastination, managing fatigue, staying active). At the end of Phase 2, a relapse prevention plan is created. Phase 2 is delivered in 4 weekly sessions with a psychotherapist.
THE PROGRAM ROADMAP
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PARTICIPANT EXPERIENCES
The DECODE program has made a profound impact on my quality of life. When I started the program I was struggling so much with my sleep I truly believed nothing could help. Fast forward to a few months later having completed the program and not only has my sleep improved, but I am leaving with so many new strategies and skills that I can apply to various areas of my life. I feel so much more confident, empowered and hopeful. The program is thoughtfully designed, very supportive, and I am so grateful for the DECODE team!
~R.M., Program Participant
PROGRAM FAQ
WHAT IS THE COST OF THE PROGRAM?
Program pricing can be discussed following consultation. The program cost includes four individual psychotherapy sessions, program platform access for 6 months, and lifelong access to the program audio via a private podcast. A letter and invoice can be provided for insurance purposes. Program pricing is subject to change.
IS IT COVERED BY INSURANCE?
There's a possibility that the program may be covered by your insurance. A letter can be provided for your insurance company confirming your diagnosis and treatment with the first-line recommended treatment for insomnia (cognitive-behavioural therapy for insomnia, CBT-I) with a registered psychotherapist.
WHAT IS THE TIME COMMITMENT?
During Phase 1, participants have 2 or 3 virtual clinic visits with the physician every 1-2 weeks and devote ~1-2 hours per week between appointments to program-related activities. During Phase 2, participants meet with the psychotherapist weekly for 50 minutes (virtual or in person in midtown Toronto). In between sessions, ~1 hour per week is required to watch the video lessons and complete the worksheets.
WHAT IF I CAN'T AFFORD THE PROGRAM?
This program is not the only treatment option. The Sprint is an OHIP-covered option that utilizes CBT-I strategies. While less comprehensive than the DECODE Insomnia Program, the Sprint is still a structured, effective, and can yield significant benefit in 2-3 weeks. Treatment options and fit are discussed following a consultation. The Sprint is currently available to youth (13-26) and is being piloted with adults (27+). An OHIP-covered consultation alone is worthwhile to gain clarity regarding your sleep concern, to get started effectively, and to learn about your options. In the future, we plan to introduce group treatment options and a scholarship program for youth. We also hope to partner with other organizations to provide more accessible options.
WHAT IS COGNITIVE-BEHAVIOURAL THERAPY FOR INSOMNIA (CBT-I)?
CBT-I is a structured and evidence-based therapeutic approach designed to treat insomnia. It focuses on addressing the underlying thoughts, behaviours, and habits that contribute to sleep difficulties. CBT-I involves various techniques such as sleep restriction, stimulus control, and relaxation training to improve sleep quality and duration. 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 often comparable to or even surpasses that of medication with the added benefits of avoiding medication risks (side effects, dependance, development of tolerance, etc.) and more sustained results. CBT-I leads to significant improvements in sleep latency (the time it takes to fall asleep), sleep efficiency (percentage of time in bed spent asleep), and overall sleep quality. The DECODE Insomnia Program is based on CBT-I techniques, adjusted for self-paced learning via our online portal and supported by appointments for accountability, troubleshooting and therapeutic interventions.
WHAT IS ACCEPTANCE AND COMMITMENT THERAPY (ACT)?
Acceptance and Commitment Therapy (ACT) is a type of psychotherapy that helps individuals accept their thoughts and feelings rather than trying to eliminate or suppress them. It emphasizes being present in the moment, clarifying personal values, and taking action in alignment with those values.
WHAT IF I HAVE DEPRESSION, ANXIETY, CHRONIC PAIN OR OTHER HEALTH CONDITIONS?
There is evidence to show that CBT-I is effective if you have concurrent conditions like depression, anxiety, and chronic pain. In addition, addressing insomnia with CBT-I can have a positive impact on these co-occurring conditions.
HOW IS CBT-I DIFFERENT FROM CBT FOR MOOD & ANXIETY? CAN MY THERAPIST PROVIDE CBT-I?
While there is some overlap, CBT for mood and anxiety does not cover critical interventions for chronic insomnia. Working with a therapist with training in CBT-I and experience working with individuals with chronic insomnia is highly recommended.
WHAT ARE THE ALTERNATIVES?
There are lots of free resources on this site (see 'Tools') that provide education and general strategies. While general strategies for sleep can be helpful, these strategies alone may not be enough. Addressing insomnia in the long-term requires breaking unhelpful habits, building helpful habits, and building skills. For some, committing to a treatment program with a clear roadmap and the right support is what is required to get traction and for sustainable progress. There are also various ways of accessing CBT-I or CBT- I strategies including books, apps, and other programs. There is also an additional brief behavioural treatment option called the Sprint. This option is currently available to youth (ages 13-26) and is being piloted in adults.
HOW DO I ENROL?
Consultation is first required at the DECODE Insomnia Clinic before enrolling in this program. Please speak to your physician regarding a referral to the clinic. This virtual clinic provides OHIP-covered consultation for patients 13+ in Ontario, Canada only. If you have already had a consultation at the DECODE Insomnia Clinic (or a consultation with Dr. Ooi at the Toronto Sleep Institute): If it has been more than one year since the consultation or chronic insomnia treatment was not discussed during a previous consultation, request a consultation through the portal and speak to your physician about another referral. If it has been less than one year and you had previously discussed returning at a later time for chronic insomnia treatment, please email decodeinsomnia@protonmail.com to arrange an appointment to discuss next steps.
MY CHILD IS 12 OR YOUNGER. WHAT ARE MY OPTIONS?
Currently, the DECODE Insomnia Program is not available for children ages 12 or younger. Education and strategies from the free DECODE resources, however, may benefit a younger age group.
I DON'T LIVE IN ONTARIO. WHAT ARE MY OPTIONS?
Currently, the DECODE Insomnia Program is only available for individuals living in Ontario, Canada. There is the possibility that this program may be available outside of Ontario in the future. For now, get started with the DECODE tools and consider treatment for insomnia in your area.
ARE THERE ANY OTHER TREATMENT OPTIONS FOR YOUTH?
There is an additional brief behavioural treatment option called the Sprint for youth ages 13-26 that can be discussed at the time of consultation. This is an option that is currently also being piloted in adults (27+).
WHY START WITH SLEEP?
Sleep concerns are very common and have a profound impact on mental and physical health. Poor sleep impact mood, motivation, focus and performance and undermines the ability to learn new skills, to change habits, and to benefit from other interventions. If delivered in a digestible way with the right support, evidence-based sleep interventions are quick and very effective. Perhaps most importantly, the strategies, frameworks, principles that are learned by getting sleep on track can be applied to other challenges such as managing anxiety and depression.