There has been a social stigma on mental health in the past few years, particularly with anxiety and depression. But as we move forward in this modern age, people are now more open about it. We have seen an increasing number of cases due to the pandemic as well. Our guest in today’s episode, Dr. Shelby Harris, specializes in the use of Cognitive Behavior Therapy for anxiety and depression. She is also certified in Behavioral Sleep Medicine (BSM) which is associated with the said illnesses. Listen as she shares the importance of sleeping to understand further how this affects our lives.
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Understanding The Importance Of Good Sleep With Dr. Shelby Harris
A Deep Dive Into Sleep Medicine
Welcome back to the show. I'm so excited to share with you Dr. Shelby, the Sleep Doctor, who I informally met at an event out in The Hamptons for women from the brand Womaness. I was super excited as I got more and more into the longevity space and learned more about how I can live longer and feel amazing. I have delved very deep into the whole process of getting a great night's sleep. I wanted to bring a speaker and a podcast person that can talk to you about how to maximize your sleep and all the things that come along with sleep. Here is Dr. Shelby Harris. She's going to be talking to us about all things sleep. Thank you so much for being here.
Thanks for having me.
Give everyone a little background on how you got started in this field.
I am a Clinical Psychologist by training and that's a lot of what I do. I treat patients with anxiety and depression. I work with usually young adults and older adults, but I also have a subspecialty in Behavioral Sleep Medicine. I worked at Montefiore Medical Center here in New York City. We have a very well-known sleep lab and I was the behavioral person on staff.
For over a decade, we have had patients come to us for sleep apnea, insomnia and all different things. They would come and see me treat their sleep problems, especially their insomnia, without medication because the treatments we have are very effective without using medication. It's the first-line approach. I treat patients of all ages, babies through older adults with sleep stuff.
I'm now in private practice in Westchester, New York but it's virtual. I see people from all over. I see patients for anxiety, depression and sleep treatment. In 2019, I had a book that came out as well, The Women's Guide to Overcoming Insomnia: Get a Good Night's Sleep Without Relying on Medication. It's a self-help book for insomnia. I use that a lot, and I do a lot on Instagram to try and promote sleep health.
I have a parent who gets terrible night's sleep. She's tried all sorts of sleep medications. She does not believe that you could cure sleep issues with anything other than a pill. The older generation is so used to that, whereas the younger generation knows that there are certain things that we can do. Is that something that's inherited? Should I be looking forward to that in my later years of life?
Yes, there is some inheritability of sleep issues but it doesn't always have to be that way. I hate to say it but as women, we tend to have sleep problems that come and go. We're more likely to have sleep problems than men. Some people might have no insomnia in their family, and then you have a hormonal issue and life stressors. All these things can throw it off. Sometimes there's a link. Other times patients have no idea where it came from.
Do you find that anxiety is intimately related to sleep issues? One of the questions that somebody was talking about with me in this menopause group was she gets anxious about whether or not she's going to get a good night's sleep. Do you think those two things are tied to each other? What do you recommend to people that come to you and say, "I get anxious when I get into bed that I'm not going to be able to sleep?"
That's more of sleep anxiety than a diagnosable anxiety disorder. For someone like that, the most effective treatment we have for insomnia is called CBT for insomnia. It's in my book. That's what I specialize in. It's a non-medication approach like change in bedtimes, what you're doing in bed, how you think about the bed, worries about sleep, and forcing yourself to sleep. We often try to do that to treat the sleep and the anxiety around sleep.
As women, we tend to have sleep problems that come and go.
If someone has significant other anxiety, depression or any other mood things, they can fuel sleep problems but it doesn't mean that you have to wait for the anxiety or the depression to get better. Sometimes we treat sleep from a separate standpoint. Often, if you get better sleep, it can help with depression and anxiety in some people. Sometimes you need to get separate treatment for that.
I feel like I'm in the world of this longevity kick now. Maybe I'm just becoming more aware of so many of these researchers and doctors talking about the importance of sleep, and how it impacts your lifespan. You're in that space. Are you finding that more people are coming to you with this mindset? Are you busier now than ever because people are focusing on this?
I'm busier now more than ever for a few reasons. Everyone is talking about sleep, that's good and bad in a way. There is so much more insomnia out there. Google searches for insomnia and insomnia treatment went up 50% in the first few months of the pandemic. It's crazy. A lot of people are coming to me because they are so worried about something they read somewhere, a recent study, or a book that was out there talking about all the bad things that will happen in sleep. For people who have sleep problems, it can worsen their sleep problems. A lot of what I have to work on is trying not to worry about all these things that you hear about sleep because that's worsening your problem. You're putting sleep on such a pedestal that it's making it harder to sleep.
Do you find that people are coming to you more in their 40s and 50s? Are you seeing patients in every age range?
I have a lot of women in their 40s and 50s, which is why I wrote my book because it was about sleep during perimenopause space for a lot of women. For men, there wasn't anything out there. Since the start of the pandemic, I'm seeing more patients of all ages because of the stress, insecurity and all that stuff. I see a lot of even young families, moms, dads who are struggling with sleep, even though their kids are starting to sleep better.
I used to be the person that was like, "I can survive on 4 to 5 hours of sleep." I probably still could but after doing all of the research and learning so much more about the benefits of sleep, I've completely changed my ways. One of my big questions for you is, can you share what you see to be the biggest benefits of sleep for those people that are in the mindset that I used to be in? I'm a night owl. I'm going to stay up until 1:00 in the morning, even when I was a kid. My parents used to say to me, "It's the hours before midnight that count." Is that true? What do you see as the biggest benefit for people of getting at least seven hours of sleep? Is that your number?
I hear this all the time. That's based on nothing. Some people are night owls and some are early birds. I'm an early bird. We'll talk about the number of hours of sleep in a minute, but it's about whatever you can do that's the most consistent. Your body clock gets set. If you're someone who tends to go to bed at midnight and wake up at 8:00 every day, but you do that every single day, you're all rested and refreshed and you're good to go, that's fine as long as that works in your life.
The number of hours is a range. Where they get this 7 or 8 from is mostly because of the idea that for the majority of people, it's between 6 and 9 hours. That's where they get the 7.5 to 8 hours from because it's in the middle. It's hard for a lot of people to do it, but if you can take a good week off and take out a journal, track how much sleep you're getting every night, what time you go to bed, and what time you wake up. Try to keep it as consistent for bedtime as you can. Look at how much sleep you get on average nights, 4, 5, 6 hours. The earlier part, I would throw out because you might be a little sleep-deprived and you have to pay that back. That might be your number. Maybe it's 6.5 hours and you feel well-rested and refreshed. Maybe it's 8 or 7 hours. That's where you would figure that out.
What does sleep do for us? It's the bedrock for most of our bodily and mental functions. Sleep is important for cognition, thinking, memory, mood, stress tolerance, our quality of life overall, job security, job satisfaction, relationship satisfaction. It’s important for our bodies, when it comes to cardiovascular health, metabolic health, balance and risk of accidents. It impacts every part of our body. It should be the thing that we think of as the bedrock.
What do you wish that you knew more of when it comes to sleep when you were younger?
It doesn't have to be always related to something else. Sometimes sleep gets thrown off from time to time and you can get back on track. People think of a lot of things, "I'm not sleeping. What's going on? I must be depressed. I must have anxiety." Sometimes we're human beings and we have a bad night here and there and it's okay. It's learning to be consistent with most of the stuff in your life.
It usually does come back around. If it doesn't, there are good treatments out there. It doesn't always have to be medication. You have to sleep perfectly every night. This is the norm. There's an individual variation for people from night to night. I wish I had learned that earlier on. A lot of people still have this rigid belief that you have to get eight hours every night or else it's not good.
What would you define as the perfect night’s sleep and how to get it?
I don't think perfect exists. You go to bed and you fall asleep within 5 to 20, 30 minutes. I don't want people to be like, "Thirty-one minutes wasn't good." You aren't bothered by how long it takes you to fall asleep. It's relatively quick. You wake up once or twice in the middle night because it's normal to wake up here and there. You get up in the morning around the time you need to.
It's more about how you feel overall most days. Do you feel well-rested and refreshed, maybe not right when you get up or an hour later? Do you feel okay? Do you have a little dip here and there during the day, which is normal like after lunch? Do you have enough energy? Do you feel cognitively pretty good? If that's going on and in your nighttime, you're not up for a long amount of time, then you're doing pretty well.
How hard is it for you as a sleep doctor to not dive into all of the different areas of health and wellness? My diet is either going to give me a productive afternoon or if I finish a car bloated lunch with two cookies after, I'm certainly going to feel that 2:00 PM crash. While you're working with your clients, are you also giving them information on diet and exercise?
Yes. It's all very much related. It's not you have to be completely vegan or whatever it might be that's going to help your sleep. It's finding what works for your body. Some people notice that carbs will make them sleepier. If you have something spicy, it will influence how much you wake up at night. I have bad heartburn sometimes. I can't eat chocolate or anything heavy because that's going to influence my sleep. I think about that stuff.
Exercise is something that I talk a lot about with patients. If you don't use your battery during the day, it doesn't need to recharge at night. We need to get people to move. It doesn't mean anything like going in all out. Movement, light exposure, and the timing of exercise for some people can influence their sleep at night. We do try and tailor it. That's why I do sleep diaries with patients because then I can see how they slept at night. I can look during the day and see, "You exercised at this time. These are the times when you do an exercise where your sleep is worse." We can see some patterns and make changes from there.
Do you wear a wearable?
I don't. I work with patients who struggle to sleep and are worried about their sleep. I tend to find wearables are great for people who are overall okay sleepers most nights but they don't get enough sleep because of choice or lifestyle. They are burning the candle at both ends and sleep-depriving themselves for that reason versus insomnia patients.
What time you wake up, try to keep it as consistent for bedtime as you can.
The wearables often make them more focused on their sleep and make it worse. There's been a lot of research on that. We call it Orthosomnia. I tend to not wear them because we were able to sleep for years and years before we ever had that stuff but it has its place. If you're someone who doesn't make time for sleep, it can bring that awareness to you more.
No. Some of them are better than others. The Oura Ring tends to have some of the best data behind it but they're not perfect. If you're looking at the stats of deep versus light sleep, try to take it with a grain of salt because it's good but it's not perfect. I like this stuff where the Oura Ring will tell you if you had alcohol.
You can see how it rustles your sleep. That stuff is wonderful. You can see how much sleep you're getting on average. That's still an estimate. It's great for that stuff but I wouldn't get too hyper-focused on REM sleep versus light sleep versus deep sleep. They're not perfect. If you're concerned, talk to your doctor. You can get a real sleep study to see.
I get a great night's sleep according to my Oura Ring. My husband wears a WHOOP. His numbers are a little different than mine. We like to do a morning side-by-side comparison. He'll be like, "What was your recovery from your sleep last night? How much REM did you get?" He envies my deep sleep. I get a lot of deep sleep.
Women get more deep sleep than men.
That's good to know. I can tell him that. The guys at the gym who are also wearing the WHOOP are like, "How do you get that much deep sleep?" Now I know that women get more deep sleep. I have a very low resting heart rate, which is almost equivalent to my sleep resting heart rate. When I'm sitting on the couch, watching TV, as long as it's not getting my heart rate up, my ring thought I went to bed at 9:20 because I sat down to watch TV. It started tracking my sleep, thinking I was asleep.
When I went upstairs to go to bed, it showed that I woke up and sleep again and then wake up. I ended up getting a good night's sleep. To your point, I love it for the reasons that I can say, "My ring is telling me this but I feel this." Some days will say, "Go easy," which I never do. I'll go to the gym and not go easy. I'll be like, "I feel fine."
What I like about it is after that workout, if my ring did tell me to go easy, I will be more in tune with how I'm feeling in the afternoon. If I went hard in the morning at a workout and my ring was telling me to take it easy and I didn't, how do I feel in the afternoon? I love it for those reasons. A lot of people will say, "Do you listen to your ring?" I say, "No, I listen to my body." That's important. I'm not going to let a device tell me what I should or shouldn't do or how I should or shouldn't feel.
That's where they get problematic for some people. Some people wake up and if they felt they slept well but then the ring or watch says they didn't, it changes their perception of the day. I try to have people use them mindfully. What is it that you're trying to get out of it if you're going to use it? With insomnia patients who struggle to get more sleep and it's not working, those things are a kiss of death for sleep for a lot of people.
You don't recommend them.
Not for insomnia patients but, in general, if you want to be interested in your sleep, go ahead. I have no problem with it.
My husband upgraded to the new WHOOP. We have a WHOOP laying around the house. We were talking about strapping it onto our kids for a couple of days so they could see what their numbers are because the statistics show how much sleep you're getting and how you're recovering in the morning. It's interesting to see when they're always arguing like, "Why do I have to go to bed at 10:00," in their teenage years, having something to back up the argument of, "You're not fully recovered if you go to bed at this hour versus this hour." We're using it as a game.
I have no issue with using them unless it's making your sleep worse or making you hyper-focused on it, then it becomes a problem.
Do you consider yourself to be an entrepreneur? I find this an interesting question to ask doctors. You are your own business in some way or another.
Never in a million years. It's nothing that they teach us in graduate school for Clinical Psychology. I would never have thought of myself as an entrepreneur until probably before the pandemic when I wrote my book. I started to do more on Instagram. I had more of a following and doing a lot more corporate stuff that I think now I’m much more of that than I ever would have thought of myself in the past.
It's funny because I work with a lot of doctors and a couple of clinical psychologists. I have some social workers. They want to build a business but they're not sure how. They’re focused on the whole doctoring thing.
Writing a book created a brand of women in sleep health for me, and that naturally fell into it from there.
Where do you see that going?
I love seeing patients and I have a nice balance of that, but I do a lot of corporate work. I love doing insomnia stuff, but I love doing more sleep wellness stuff like getting people thinking about their sleep a little more. I love working with women, moms especially, who can't find time in the day to make sleep a priority or whatever that looks like. I'd like to do more in the wellness space outside of just clinical treatment.
Have you ever thought about putting together an online course for people?
I've thought about it but in my area of specialty with insomnia, I find that a lot of the courses for insomnia can be too general. I wrote my book trying to be as special as possible, but I love to tailor treatment to people. I'm trying to figure out how I could do it.
We should have a side conversation outside of the show. My brain is going in a million different business directions for you. You should do that.
I try to only work with some people that I believe in and have products that I love. It's an interesting balance.
We talked a little bit about night owls versus morning person. Do you believe that there are more benefits to being one versus the other? Were you always a morning person? I switched from being a night owl to being a morning person and I feel so much better.
I wouldn't say I was ever a night owl. I was more of media. When I had kids, it forced me. I am a runner still. I've trained for marathons. Before I had my son, I was getting up a little later and then when I had him, I started to have to get up earlier to fit it in because I was never going to get it done otherwise. I find it works better to work out in the morning, get it done and then I'm more productive. I do go to bed early, which some people find that's not great.
Meditation is great as a placeholder if you really need something to quiet your mind down.
It is whatever fits in your life. Some research suggests that true night owls tend to have a little bit more risk of obesity and depression. I also find that true night owls also tend to be extremely creative and have a lot of other personality traits that are very welcomed by some people. It is what works for you in your life. If it becomes a problem, you can't get to work on time or you're having trouble staying up at night because you want to see your friends, then you seek treatment for it.
What time do you go to bed?
I'm usually in bed at about 9:30 PM or 10:00 PM at the very latest. I was up at 5:30 AM to get a run-in. I have a treadmill in my basement so I'm lucky in that respect. It doesn't matter what time of year, I just go down and workout. I still got a little child at home but I'm very lucky too that they are very good sleepers.
I have two kids. I'm at a point where I want to go to bed earlier than them. There's the trust factor like, “I'm going to go to sleep but you need to go to sleep.” Their bedtime is 10:30 PM to 10:45 PM. I want to be in bed by 10:15 PM. It's hard as a parent. My younger child still wants snuggle time but she also wants to stay up later. I don't want to stay up until 11:00 PM. It’s that balance for parents. This is a hard age for me and them. I need and want my sleep, but I also know that snuggle time is not going to last forever.
It's a challenge too for a lot of people because the school start times for that age range are still too early in many communities. You want your kids to go to bed earlier but their biology keeps them up later. It's a real challenge. I get the snuggle time. Even my child still wants a snuggle from time to time. I give in to it. It's short-lived. I have to go to bed around the same time but I foresee that getting very different in the near future.
They want to stay up at the same time. If I'm going to bed, there's nobody to tell my youngest after I go to bed that she needs to go to sleep.
My husband tends to stay up a lot later than I. He's usually the one doing that. They also have a sleep doc for a mom so they don't get as much. It has been pretty hard about it with them. It is what it is. I bend on the weekends. I want them to also enjoy it. I'm a big fan of consistency. Thinking about sleep is important but the more you become legit about it, it backfires. You start to resent sleep, which is what a lot of people do nowadays and why they stay up so late. Sleep isn't a good thing for them all the time.
What are your thoughts on a small dose of melatonin? I spent years taking 1 milligram because of fear. I became so dependent on it because I was scared if I didn't take it but I still get a good night's sleep. I learned that the melatonin gummies I was chewing had 2 grams of sugar in them. I was giving myself sugar before bed, which was also not good.
When I started intermittent fasting, I stopped eating the gummies. I was like, "Hopefully, the fasting will cure any of this anxiety I have about if I don't take the gummy, am I going to fall asleep?" My kids also would take melatonin. I have one ADHD child. She always has issues sleeping. The other one was like, “If she's taking it, can I take it because I want to get a good night's sleep?"
Melatonin is a loaded subject. It has gotten a lot of press. We've been talking about it for years in the sleep field. The thing to know about it is it's for adult insomnia. The data on it is very mixed. It's not the cure that a lot of people make it sound like it is. It can work for some people but it's not the cure that most people are like, "It's harmless. It's over the counter." It doesn't work as great as most people think. Next point is that 1 to 3 milligrams are enough, 5 milligrams are going to be a hefty dose. I see people whose docs are saying, "Take 10 or 15 milligrams."
There's no reason to be doing that. If 1 or 3 milligrams is not working for you, then it is not the treatment to be used. The other thing to keep in mind is in the US, it's not regulated by the FDA. It's considered a hormone and an appetite. It's a supplement. What you're getting from one brand might be different from what another brand has in their bottle. There's no governing agency looking at what's in the pills. It's a little bit of go with a trusted brand, but not everyone has that ability or knows what a trusted brand is. Melatonin has its place though in some people with insomnia. We use it a lot for people who are night owls but I use it very differently. I use 1/2 milligram many hours earlier than bedtime. It's very effective in that population.
We use it sometimes for shift work or jet lag but it has to be timed properly in the right dosing. No one is doing that stuff at all appropriately. We have research on the use of it in some kids with ADHD and autism, but we don't have a lot of research on it in most other child populations. People resort to it right off the bat and it's not based on anything. Keep in mind that there are other treatments to try but melatonin is not going to be what most people think it's going to do.
As soon as I realized I didn't need it, all of a sudden, I was like, "Maybe it's a placebo effect for some people." You need to take it because you think it's going to help you, and that’s going to calm you down and help you get to sleep.
That’s a big piece. The other thing I prefer to add is just because it's over the counter doesn't mean it doesn't have side effects either. I've had patients come to me who are taking melatonin and they're like, "I have a horrible nightmare problem and vivid dreams." It's probably melatonin. Melatonin can cause dreaming issues, dizziness, nausea and excessive sleepiness. Beware if you're going to use it.
My mom was here and she had gone through a very traumatic situation. We gave her melatonin to go to sleep. She woke up in the morning and said, "I slept awful. I had the worst nightmares." I remember that previously when I had taken melatonin, it was giving me nightmares. That was the last time we gave her melatonin.
It has its place. If you're going to try it, it's fine. Make sure your doctor says it's okay but don't assume that more is going to help. Don't go to the 5, 10-milligram stuff because it is not appropriate if you need to do that.
Is there an app that you love that you recommend for people, whether it's a sleep app or a meditation app?
I'm so old school but I do love some of the meditation apps. I've done some work for Headspace. I haven't recorded any of their actual meditation stuff, but I've recorded meditations for our company called Meditation Studio many years ago. I love them more so for people to listen to during the day to get into a meditation habit. The more you meditate during the day, it helps at night.
I love to get a tech out of the room for most people. Try not to meditate yourself to sleep with your phone because you're going to be tempted to wake up and look at your phone. I love all those apps. They're great to get people meditating. If you need to start with using it at bedtime, sure but eventually try to get it out of your room.
I sleep with my phone next to my bed. It's not a good thing. I try to shut down screen time 30 minutes before bedtime. It's very difficult for me. When I end up staying up a little bit later and help get the kids to bed, it's a great night’s sleep for me because I'm off my phone for 30 minutes while I'm helping get them down. I have the ring but I was listening to the calm sleep meditations, which I felt got me in the zone of relaxing and I would fall asleep five minutes in.
They are great as a placeholder if you need something to quiet your mind down. It's not like you're getting into a meditation habit. People are like, "I meditate every day. I used to fall asleep." You shouldn't be falling asleep to meditation. It will quiet your brain down. If you can do it also during the day, you might not need to rely on it as much at bedtime. It's about getting screens out of the room. If you have your phone next to your bed and you never look at it, then fine. I rarely find a person who never looks at their phone in the middle of the night. It's too tempting.
What's the weirdest question you get asked by people if you're at a party like, "I'm a sleep doctor?"
Sleep is the thing that people love to talk about more and more. Even pre-pandemic when there were cocktail parties, I go to them and people would come to me saying, "I take these pills." I know everyone's sleeping history and the medications for it. It’s hilarious because you don't go up and necessarily talk about whatever medical history you have otherwise but there's something about sleep.
The other thing I hear a lot is, "How am I going to sleep if your husband or someone else is snoring all night?" It’s usually their significant others next to them. I hear lots of these stories of sleepwalking issues and all this stuff that's happened on various medications. I have lots of stories that I cannot share.
My husband is a snorer. I said to him, "Maybe that's one of the reasons why you are not waking up fully rested and recovered." At what stage do you recommend people go get a sleep apnea test?
Night owl or morning person, it really is whatever fits in your life.
Even despite doing proper sleep hygiene as often as possible, you're not drinking lots of alcohol at night or caffeine, you're getting enough sleep 7 to 8 hours, and you still don't feel it's restorative, talk to your doctor. That's where the rings and all that stuff are great for not necessarily diagnosing, but catching that maybe it's not so great, so then you should see a doctor. If you genuinely feel routinely that it's not enough, that would be a good thing, especially if there's snoring going on.
He always says to me, "You snore, too. You were a lumberjack last night."
It's always something to bring up. A lot of people also have this assumption that you have to be a male, overweight, middle-aged or older to have sleep apnea. That couldn't be further from the truth. You're more at risk of it. I have patients with insomnia and people who didn't even know they snore lightly. In women, it's not as obvious either. Go by how you're feeling if there are other medical indications. Some people think they sleep fine but it turns out they are snoring. They have issues with high blood pressure that's not easily controlled or other diet issues that are like, "I eat healthily. Why am I gaining weight?" You might want to talk to your doctor because that could be a sign that something is going on in your sleep.
My husband has major jealousy because we checked our biological age. Have you done that?
No, I haven't.
I’m 49 and biologically, I'm 45. He’s 45 and biologically, he's 46. He's in great shape. He works out. He's like, "It's because you keep me off at night. I don't get a good night’s sleep." He was joking. He was not blaming it on me but he's very competitive. He was like, "I'm going to do all the things." The blood tests we use were a couple of months old and I've done major changes, supplements and diets since my last blood test because I had things that came back that were off. I'm curious to know what happens. I'm getting another blood test. I'm curious to see if I'm much younger.
You shave four years at least off your age so you're great. You got to go by how you feel. If you feel off or if your husband has noticed that you're pausing in your sleep, you're having pauses in your breathing or choking awake. A lot of people have no idea they have apnea. It's always good to bring this up with your doctor. Sleep studies at home are super easy to do nowadays, and they are great screeners for apnea.
I'm going to make sure that he gets one because he does do the pause in his breathing. Sometimes I'm like, "Is he okay?"
What's the worst thing that happens? You get a screener and find out it's nothing? That's great.
Is there any last tidbit you want to share?
We talked about a lot of the basic stuff about sleep. If anybody has any questions, you can always find me on my website, DrShelbyHarris.com. My book for insomnia, The Women's Guide to Overcoming Insomnia is very readily available online. People can find me on Instagram pretty easily too. I post a lot of stuff there.
Thank you so much for doing this with me. I truly appreciate you giving me the time. Thanks, everybody, for reading.
Important Links
Instagram - @SleepDocShelby
About Shelby Harris
Dr. Harris is in private practice in White Plains, NY where she specializes in the use of Cognitive Behavior Therapy (CBT) for anxiety and depression. She is board certified in Behavioral Sleep Medicine (BSM) by the American Academy of Sleep Medicine and treats a wide variety of sleep disorders (insomnia, nightmares, circadian rhythm disorders, narcolepsy, apnea treatment noncompliance) using evidence-based non-pharmacological treatments. Before going into private practice, Dr. Harris was the longstanding director of the Behavioral Sleep Medicine Program at the Sleep-Wake Disorders Center at Montefiore Medical Center.