Treatment Approach to Specific Sleep Disorders
Insomnia
As someone who formerly suffered from life-long insomnia, Dr. Michelle Jonelis knows first-hand just how unpleasant and disruptive it can be. Fortunately, during her Sleep Medicine Fellowship at Stanford, Michelle was able to learn Cognitive Behavioral Therapy for Insomnia. Being able to cure years of insomnia in herself and her patients without medication felt almost like magic to Michelle and she decided to make the techniques she learned through this Behavioral Sleep Medicine training the foundation of her clinical practice. Later in her career Michelle went on to learn Lifestyle Medicine and she now blends techniques from Cognitive Behavioral Therapy for Insomnia, Circadian Medicine and Lifestyle Medicine to create her own style of insomnia therapy that teaches us how to sleep more like our healthiest ancestors. Michelle has extensive experience managing insomnia comorbid with other medical, neurologic and psychiatric disorders, such as autoimmune conditions, epilepsy, Parkinson’s disease and anxiety disorders. She has also helped numerous insomnia patients to slowly wean off of sleeping pills. Michelle offers 1:1, group, and app-based insomnia treatment options.
Obstructive Sleep Apnea (OSA)
OSA is caused by excessive narrowing of the pharyngeal airway, usually due to a combination of jaw structure, excess oropharyngeal fat and/or edema and low oropharyngeal muscle tone. Continuous Positive Airway Pressure (CPAP) machines, the gold standard treatment for OSA, do not actually correct any of these root causes. At Lifestyle Sleep we will help you to address the underlying causes of your OSA through comprehensive Lifestyle Medicine coaching, physical therapy for low oropharyngeal muscle tone and breath work coaching to improve nasal and overall breathing dynamics. In addition, CPAP remains a crucial component of the management of OSA and at Lifestyle Sleep we are experts in helping patients adapt to using a CPAP machine. We have an extremely gifted sleep technologist on staff who will help troubleshoot any CPAP issues and make the process of learning to use CPAP as easy as possible for new users.
Pediatric Sleep Disorders
As a mom and sleep doctor, Dr. Michelle Jonelis knows how important healthy sleep is to a child’s development and well being. She will take a comprehensive look at environmental, lifestyle, behavioral and medical factors contributing to your child’s sleep difficulties and work with you to achieve healthier sleep for the whole family. Michelle has experience working with children ages 5 through teenagers and with neurodiverse pediatric populations. Due to her training as a neurologist, Michelle feels comfortable managing sleep disorders comorbid with other neurologic disorders such as epilepsy, neurodevelopmental disorders, autism spectrum disorder, ADHD and neuromuscular disorders.
Hypersomnia and Circadian Rhythm Disorders
Traditional Behavioral Sleep Medicine and Circadian Medicine techniques such as behavioral activation, scheduled napping and timed bright light therapy are helpful in the management of circadian rhythm disorders and hypersomnia but require ongoing, significant effort from both the patient and provider to maintain. Dr. Michelle Jonelis was dissatisfied with the level of ongoing effort required with traditional Behavioral Sleep Medicine approaches to hypersomnia and decided to add in core elements of Lifestyle Medicine such as coaching, increased social connectedness (especially close to waking), and dietary changes (primarily increasing dietary fiber and reducing ultraprocessed foods). Combining Behavioral Sleep Medicine, Circadian Medicine and Lifestyle Medicine techniques, while still effortful in the initial stages, seems to produce much more durable results that are easier to maintain and worth the initial effort.
Fatigue and Non-Restorative Sleep
There are many potential causes of fatigue that can be hard to sort out and even an extensive medical work-up can often be non-revealing. Dr. Michelle Jonelis can help patients with fatigue analyze and optimize circadian, lifestyle and behavioral factors that might be contributing to their symptoms.
Restless Leg Syndrome (RLS)
At Lifestyle Sleep, we can help you manage RLS with a combination of behavioral, circadian, lifestyle and general sleep medicine principles. We do this by treating comorbid sleep disorders that can cause or exacerbate RLS, stopping medications such as dopamine agonists which are known to worsen symptoms over time, improving dietary quality to increase body iron stores, regularizing sleep schedules, managing anxiety and adding in exercise and stretching. Our goal is always to help you manage your symptoms without medication. On rare occasions we may recommend either oral or intravenous iron supplementation.
Parasomnias
Parasomnias are unusual behaviors that occur at night such as sleep walking and REM Sleep Behavior Disorder. While lifestyle and behavioral derangements do not cause parasomnias, they can definitely exacerbate them. At Lifestyle Sleep, we take a comprehensive look at factors that may be contributing to parasomnias and provide guidance on how to improve these. We also provide traditional sleep medicine management recommendations when appropriate.
