About

Coaching, your doctor and CBT-I

What NEOS does, what it doesn’t, and when to see a doctor first.

When to see a doctor first

The short answer

Is sleep coaching a replacement for a doctor or for CBT-I? No. NEOS Performance offers sleep coaching and education, led by Dr. Glenn J. Landry, PhD, a sleep and circadian rhythms scientist. Dr. Landry is a PhD, not an MD, and NEOS does not provide medical advice. We read your own wearable data and help you with the timing of light, meals, movement and sleep. We don’t diagnose, treat or prescribe, and we don’t change medication. If you have signs of a sleep disorder, see your doctor first. If you have insomnia, ask your doctor about CBT-I (cognitive behavioural therapy for insomnia), the standard first treatment. Coaching can work alongside both.

What NEOS does

  • Sleep coaching and education. Dr. Landry is a scientist with a PhD and 30 years in sleep science. He is a PhD, not an MD, and he doesn’t act as a therapist.
  • We start with your own data. With an Oura Ring, Fitbit or Apple Watch, we look at your nights over time and work out what to change. Consumer devices estimate sleep stages; night after night they are reliable enough to see patterns, and we say where they aren’t.
  • We focus on circadian rhythms (your body clock). It’s not just what you do. It’s when you do it: light, meals, movement, bedtime and wake-up, shift schedules and time zones.
  • We change one thing at a time. Every two weeks, Elite Sleep® Coach gives you one clear focus. In one-to-one coaching, Dr. Landry works with your history and goals.
  • A person when it matters. AI tools help prepare Elite Sleep® Coach reports, following Dr. Landry’s method. While the service starts, he reviews every report before it’s released. You can ask to speak to a person at any time.
  • We screen, and we refer. The Free Sleep Assessment includes a sleep-apnea screen (STOP-Bang). If anything in your questionnaire or data suggests a possible medical issue, we tell you and refer you to your primary care provider.

What NEOS doesn’t do

  • We don’t diagnose any sleep disorder, and nothing we give you is a diagnosis, a treatment or medical advice.
  • We don’t prescribe or change medication, and we don’t recommend melatonin or sleep medications as a fix. Never start, stop or change a prescribed medication because of anything we tell you. Talk to the professional who prescribed it.
  • We aren’t a CBT-I program or a sleep clinic. We don’t run overnight sleep studies (polysomnography) or home sleep apnea tests.
  • We don’t promise results. Results may vary depending on the changes you’re ready to make.
  • We aren’t an emergency service.

When to see a doctor first

See your doctor, or a sleep clinic, before or alongside coaching if you notice any of these:

  1. Loud snoring with gasping or choking, or someone has seen you stop breathing in your sleep.
  2. Sleepiness while driving or at other times when it’s dangerous, such as at work with machinery. Don’t drive when you’re drowsy; get help before coaching.
  3. Falling asleep without meaning to during the day, or exhaustion that won’t budge however long you sleep.
  4. Trouble sleeping most nights for three months or more (insomnia).
  5. Waking up with a headache, a very dry mouth, or chest pain, or waking at night with a racing heart or shortness of breath.
  6. An uncontrollable urge to move your legs at night, or acting out your dreams (shouting, punching, kicking).
  7. Low mood or anxiety that is getting in the way of your life, or feeling hopeless. If you are in crisis or thinking about harming yourself, call or text 9-8-8 in Canada, call 988 in the US, or your local emergency number right away.
  8. A score of 3 or more on the sleep-apnea screen (STOP-Bang) in our Free Sleep Assessment. We recommend you get screened for sleep apnea: ask your doctor about a sleep test.
  9. You take sleep medication, or a medication that could affect sleep. Keep seeing the person who prescribes it. Don’t change it without them.
  10. You are pregnant, or you have a heart, lung, neurological or mental health condition and your sleep has changed.

Shift workers: shift work disorder is a real diagnosis, found in roughly 1 in 10 to 1 in 4 shift workers depending on how it’s measured. Loud snoring, gasping awake or exhaustion that won’t budge are reasons to talk to your physician.

What to bring to your doctor. Your last few weeks of sleep data (your Oura Ring, Fitbit or Apple Watch app), and your Free Sleep Assessment scores if you’ve taken it. Tell them when you work, when you sleep and what you take.

How NEOS and CBT-I fit together

What CBT-I is

CBT-I is cognitive behavioural therapy for insomnia: a structured program, usually delivered by a trained therapist, in person or online, that changes the habits and thoughts that keep insomnia going. Major guidelines recommend it as the first treatment for chronic insomnia in adults (see References).

How NEOS differs from CBT-I

NEOS is a lifestyle and behavioural approach focused on circadian rhythms (your body clock) and sleep health. Dr. Landry trained in CBT-I in a full-day Canadian Sleep Society workshop for psychologists (Calgary, 2017). Our approach uses many of the same tools, with a much greater emphasis on circadian regulation.

The core difference is sleep restriction. CBT-I usually begins by restricting time in bed. We don’t. Instead we:

  1. build a sleep window that fits your circadian rhythms and your life;
  2. protect that window with what you do during the day, and at night when you can’t sleep;
  3. let your sleep accountant fill the window with the sleep architecture you need: the right balance of light, deep and REM sleep, not just hours.

Our evidence is real-world, not a controlled trial. Dr. Landry has coached hundreds of people since 2015, paid and unpaid, and interpreted thousands of sleep assessments. Results are before-and-after measurements of each person’s own sleep data, not a comparison against a control group.

You’re at the centre of your care team

Whoever you work with, whether that’s your physician, a CBT-I therapist, a psychologist, a nutritionist or a coach, NEOS is one part of that team. We give you your sleep data and reports, and you decide what to share with your health practitioners. If you have chronic insomnia, talk to your doctor: CBT-I is the guideline-recommended first treatment, and you can do CBT-I and coaching at the same time.

What we ask of you: tell us about any diagnoses and medications at the start. Your reports are yours: share them with your doctor or anyone on your care team whenever you choose.

Questions

Is NEOS medical care?
No. NEOS provides sleep coaching and education. Nothing we provide is a diagnosis, a treatment or medical advice, and we are not your physician.
Is Dr. Landry a doctor?
Dr. Glenn J. Landry, PhD, is a sleep and circadian rhythms scientist. He is a PhD, not an MD, and NEOS does not provide medical advice. He doesn’t diagnose or prescribe.
Is this CBT-I?
No. NEOS is a lifestyle and behavioural approach that uses many CBT-I tools, with a greater emphasis on circadian rhythms and without sleep restriction.
Can I do coaching and CBT-I at the same time?
Yes. You’re at the centre of your care team: we give you your sleep data and reports, and you choose what to share with your therapist.
Should I see a doctor before I start?
If you have loud snoring with gasping, sleepiness while driving, insomnia most nights for three months or more, or any other sign in “When to see a doctor first”, yes. If you’re unsure, take the Free Sleep Assessment: it takes under 10 minutes and includes a sleep-apnea screen. It is a screening tool, not a diagnosis.
I take sleep medication. Can I work with you?
You can, but we won’t advise on it. Keep your prescriber involved and don’t start, stop or change a medication because of anything we say.
What if my data shows something worrying?
We’ll tell you and recommend you speak to your doctor. A wearable can’t diagnose; it can show patterns worth asking about.
Do you work with sleep clinics?
We refer you to your primary care provider, who can refer you to a sleep clinic. For example, if you score 3 or more on the sleep-apnea screen (STOP-Bang, moderate to high risk) in our Free Sleep Assessment, we refer you to your primary care provider right away. We don’t have a partner clinic.
Is there research behind what you do?
Dr. Landry has published research on sleep, circadian rhythms and aging (see his profile). Our own evidence is real-world: before-and-after measurements of each client’s own sleep data, not a controlled trial. CBT-I has the larger research base; we say so on purpose.

References

Show the 4 references
  1. Edinger JD, Arnedt JT, Bertisch SM, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 2021. doi:10.5664/jcsm.8986
  2. Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD. Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 2016. doi:10.7326/M15-2175
  3. Hall AL, Smit AN, Mistlberger RE, Landry GJ, Koehoorn M. Organisational characteristics associated with shift work practices. Occupational and Environmental Medicine, 2016. doi:10.1136/oemed-2016-103664
  4. Shift work disorder prevalence: sources 23 and 24 in our article “The Best Sleep Schedule for Night Shift Workers”. Read the article’s sources