We are pleased to offer a new sleep clinic with Dr Jonathan Tham. Jonathan offers comprehensive sleep assessments, as well as courses of cognitive behavioural therapy for insomnia (CBTi): the internationally recognised, gold-standard treatment for chronic insomnia.
In your first, 90 minute appointment, we explore your sleep in detail. We consider the nature of your problem, talk about the science of sleep and insomnia, and I recommend the next steps. After this, you receive a detailed report with your diagnosis and my recommendations. If you have a sleep problem other than insomnia, I’ll let you know where to go next.
I you have insomnia, this can be treated in follow-up sessions. These are 45 minutes long. As with all CBT, treatment has a defined end point which for most people is after five follow-up sessions. I’m happy to see clients ad-hoc after this if they so choose, but most don’t need regular follow-up after the treatment is complete.
Before your initial appointment, please fill in our patient registration form.
If you have trouble sleeping, you are not alone: sleep problems are common and have a devastating impact. Whether the problem started months or years ago, not being able to sleep can make you feel powerless, and leave you at your wits’ end, especially if you feel you’ve tried everything. However, rest assured, you are not powerless: with the right help, I truly believe anyone can achieve a good night’s sleep.
I developed an interest in neuroscience as an undergraduate at Cambridge University, focusing on sleep and insomnia whilst training to be a GP at St Thomas’ hospital. Since then, I have worked with some of the country’s leading experts in this field, including those at the Sleep and Circadian Neurosciences Institute at the University of Oxford.
I established my own insomnia clinic in London, where I delivered effective treatment to a diverse range of clients. I am very excited to bring this expertise to Wessex Private General Practice.
I have a collaborative and flexible approach, through which my clients achieve a better understanding of sleep, the factors that disrupt it, and the powerful cognitive and behavioural tools that can fix it.
What does a sleep clinic consultation involve?
In your initial consultation, you will complete a comprehensive sleep interview, at the end of which, I will produce a report with your diagnosis and my recommendations. If you suffer from chronic insomnia (the most common cause for long-term sleep problems), I will recommend Cognitive Behavioural Therapy for Insomnia (CBTi).
I offer this therapy, a full course of which is six, forty-five-minute sessions, which we can arrange at the end of your initial assessment if you so choose. I do not treat other sleep conditions (such as sleep apnoea or narcolepsy) and as such, if you have another medical condition affecting your sleep, I will refer you to a suitable private clinic or make recommendations to your NHS GP. Diagnosing chronic insomnia does not require access to a sleep lab or complex technical equipment, and as such, these do not form part of my assessment process.
What is CBTi?
Cognitive Behavioural Therapy for Insomnia is a talking therapy that is widely recognised as the most effective treatment for chronic insomnia. It is recommended internationally by many clinical guidelines, including the UK National Institute for Health and Care Excellence (NICE), the European Sleep Research Society, and the American Academy of Sleep Medicine. It uses powerful educational, behavioural, and thought based techniques to achieve reliable and long-lasting improvement in sleep.
Will it work for me?
As with any treatment, for any condition, there is no guarantee of success; however, so far, every client I have worked with has reported a subjective improvement in their sleep, with 92% showing improved ISI (insomnia severity index) scores after a course of treatment. If you have chronic insomnia, then CBTi is the best solution found to date.
How bad does my insomnia have to be?
CBTi is a specific treatment for a specific condition: it treats chronic insomnia. Chronic insomnia is defined as difficulty getting to sleep, staying asleep or waking early, occurring three or more nights a week, lasting three months or more, and affecting you during the day. This problem must not be caused by another independent condition, such as sleep apnoea or nocturia (the need to pass urine frequently at night) and is distinct from sleep deprivation (where someone is not given the opportunity to sleep, as can happen when caring for a loved one who has issues sleeping). If your insomnia ticks those boxes, CBTi is recommended.
How long will it take to work?
It depends. I have worked with clients who noticed a drastic improvement in their sleep after just two sessions; however, this is not the norm. Chronic insomnia develops over an extended period (three months at least by definition). It is fuelled by problematic behaviours and thought processes that have taken time to learn and need time to unlearn. A full course of treatment with me is at least six sessions, and everyone I have worked with has seen benefit by the end of this time. However, one of the wonderful things about CBTi is that this time-limited therapy teaches you the tools you need to become your own therapist. Most people who complete a course of CBTi will see further improvement in their sleep after the sessions have finished, as they continue the techniques they have learned.
I’ve tried everything before, how is this different?
It depends on what you have tried. If you haven’t tried CBTi, offered in-person by someone trained in this this treatment, then you haven’t tried the gold standard; and whilst you may be familiar with several of its techniques, a full course of CBTi with me may include many things you’re not aware of, and will certainly offer a level of explanation and personalisation that you are unlikely to have benefitted from previously. I have worked with clients who tell me they have ‘done CBTi before’. When they tell me this, my question is always, ‘what have you done?’ CBTi is a toolkit of techniques which needs to be tailored to you. Self-help books and apps are certainly effective, and provenly so for some people, but others need help to find what works for them.
What is sleep hygiene and how is CBTi different?
Sleep hygiene can be thought of as good advice that creates the foundations for good sleep. It is not a treatment for insomnia. If you have chronic insomnia, sleep hygiene advice will not cure it, no matter how exactly you follow it. CBTi offers a cure for chronic insomnia, sleep hygiene is part of its toolkit, but by no means the entire thing. I cover all common ‘sleep hygiene’ advice in one of my CBTi sessions.
What if I’m struggling with more than just my sleep?
Sleep is intertwined with many parts of your life and health. It is common for other medical issues to be related to, or even trigger chronic insomnia, which then takes on a life of its own. Two examples I see frequently are depression, and the menopause. As a GP, I am well positioned to advise on many medical issues; however chronic insomnia is complex, and we need to give it the time it deserves. If your sleep is being affected by another medical condition, we will identify this in your initial consultation, and explore steps to tackle it, but I will not consult on it specifically. My practice would be to advise on how insomnia interacts with the condition, to offer CBTi if chronic insomnia has indeed developed into an independent condition and advise your GP with my initial report.
Why can’t I do this on the NHS?
You can, but only in some areas, in some forms. Some parts of England (and all of Scotland) have access to CBTi through apps, and the NHS talking therapies program in your area may have practitioners who are trained in some of the principles of CBTi. However, as far as I am aware, there is nowhere you can get a full course of one-on-one, face-to-face CBTi on the NHS, which is the form of therapy on which most research has been done, and what is needed for some people.
How much do your sessions cost?
Initial assessment is £150: this is ninety minutes long, and includes a full report with diagnosis and recommendations, produced irrespective of whether you continue with CBTi. Subsequent sessions, in which CBTi is delivered, are £150 and are forty-five minutes.
What if I need more than a ‘full course’ of CBTi?
CBTi is a time-limited therapy, it has an end point, which for most people will be after around six sessions. Whilst I am not averse to seeing people who have completed a course of CBTi with me, this should not be necessary in most cases. If you work with me, you will receive a copy of my treatment manual: a book I have written to guide you through therapy. You will be able to refer to this as you progress, and after your sessions end, to remind you of what you learned.
I hope that this, along with your formulation (a formal summary of treatment, produced after your last session, which includes a plan in case of relapse) will make future sessions largely unnecessary. Nevertheless, if you feel you would benefit from seeing me again, I am happy to arrange these sessions ad-hoc. What I will not do is schedule routine, regular follow-ups. All forms of CBT are necessarily time-limited: this was one of the founding principles of this psychological therapy when it was created by Aaron Beck in the 1960s.
Do you offer virtual consultations?
Yes. These can be booked using the online booking form above, or by requesting them when you call.
Can I use my insurance to pay for sessions?
Not currently. However, this may change in future, so watch this space.
What is your cancellation policy?
Our cancellation policy for the Sleep Clinic, is to offer a full refund if you cancel 24 hours beforehand. No refund if you cancel less than 24 hours prior to your appointment.