The Problem with Sleep Medicine
Sleep disorders are consistently recognized as some of the most harmful and damaging range of conditions for longevity and quality of life yet there is little being done to facilitate quality of care. Insomnia sometimes requires difficult lifestyle changes, medications with variable responses in patients who have to wait months for modifications. Sleep Apnea sufferers are forced to sleep in uncomfortable sleep labs to get a diagnosis and when they are finally getting treatment months later, the CPAP machine comes with almost no support or instructions and the patient often receives low quality masks and settings that are not personalized to their needs.
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We understand that insomnia can have complex causes and deserves to be evaluated by a trained clinician in multiple disciplines. Dr. Hakim is a quadruple boarded specialist in Sleep Medicine, Pulmonary Medicine, Internal Medicine and Critical Care. He is able to take the time to evaluate complex cases, approach them from multiple angles, making him a leader in diagnostic sleep medicine. Furthermore, in the realm of Sleep Apnea, Dr. Hakim personalizes the treatment including mask fitting with the latest equipment, CPAP desensitization with ongoing setting adjustments and advanced, proprietary methods for maximizing CPAP use.
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How it Works
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The cornerstone of assessing sleep properly is collecting objective data. We believe that the best sleep study is performed in the patient's typical home setting using a device that is comfortable and allows the person to sleep in their normal way. Most patients find our test easy to perform and sleep with. Dr. Hakim exclusively makes house calls and during the first visit, the physician will come to the patient's home or appropriate designated meeting place and will teach the device, obtain a full history and physical, review medications and habits as well as teach important concepts pertaining to the patient's issues. Spouses or sleep partners are encouraged to be present.
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After the initial visit, the patient will perform a one night study and the results will be wirelessly transmitted to the doctor who insists on reviewing and scoring it himself. We don't believe in computer generated assessments, but rather a careful review of the data in the context of our client's main complaints. We make a careful review of Total Sleep, Deep Sleep and REM deficits and their potential causes contributing to daytime dysfunction. All sleep studies are encouraged to be fully reviewed between the physician and the patient, a process that our patients find illuminating.
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Unlike other sleep practices where waiting for the appointment can take many months, the sleep study another several months and treatment started months after that, Dr. Hakim believes in treating sleep disorders with timeliness and the same seriousness as high blood pressure and diabetes. It's not unusual for the doctor to consult, test and begin treatment within a one or two week timeframe. This is particularly true if a patient is getting minimal sleep or demonstrates significant oxygen compromise.
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Our practice is designed from the ground up for maximum efficacy. Patient's can be scheduled online or by phone. Once in our program, patients can text, email or call the doctor with ease. Dr. Hakim has a vast array of masks and devices available which he can have delivered to his patients' homes via a partnering DME company, quickly.
Frequently Asked Questions
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Q: Do I need a referral for your services?
A: No. We permit self referrals and even purchasing of our services to help loved ones.
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Q: I'm going to have a hard time doing sleep studies. What is it like?
A: We use perhaps the easiest device on the market. There is a wrist watch, a finger probe and a chest sensor. There is nothing on the face and it's easy for the patient to set up for themselves. Nobody else needs to be present for the study and all the steps are directed by an Android or Apple app. The doctor will help explain the steps on the first visit. Despite its simplicity, it holds unique patents regarding the assessment of sleep stages with far greater accuracy than consumer wearable technology. If a study needs to be repeated due to user error, the charge is only for the cost of the device.
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Q: I just need help using my CPAP. Do I need to perform a sleep study with you?
A: Most likely no.
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Q: If I'm diagnosed with Obstructive Sleep Apnea (OSA), can I get treatment that isn't CPAP?
A: There are certain things that could be relevant: large tonsils, large tongue for mouth size, central obesity, sleep apnea limited to certain body positions, low arousal threshold triggering accentuated nighttime sympathetic responses, disruptive body twitching, these are among the many things that could lead to non-CPAP therapies. However, CPAP is the Gold Standard treatment for OSA and most "gadgets" being sold to "cure" sleep apnea are attempting to capitalize on desperation. Most if not all non-CPAP therapies for OSA will have a disclaimer: "not intended for moderate or severe sleep apnea" or "we recommend attempting and failing CPAP first before considering our treatment." We recognize that CPAP has a bad reputation and high failure rate in traditional health care, however our practice proves that with attention to detail, close follow-up, CPAP can become a beloved therapy and something our patients look forward to each and every night.
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Q: Can your testing and services help me to qualify for GLP-1 inhibitors such as ZepBound for weight loss?
A: Absolutely. Such medications can be an important tool in dramatically improving sleep apnea. Dr. Hakim can prescribe and help monitor the progress of this intervention as well as obtain insurance coverage if the patient meets their specified criteria.
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Q: Do you test and manage children?
A: For sleep testing, the device being used is FDA certified for ages 12 and above. However, if we have a referral from a treating physician who will accept our off-label results to motivate a time sensitive intervention (such as tonsillectomy in a suffering child), we will arrange to have it done and appropriately prioritized. Often, a home study is the best way to comfortably and effectively obtain the necessary results in the pediatric population.
Q: Do you take insurance?
A: We are unable to provide the level of care and attention necessary under the conventional insurance model. We can provide the patient a superbill and help them get compensation to the best of our abilities. We can also help the patient get a CPAP machine using insurance.​ Our goal is to get you to become independent, with a fee for service model and the potential for lower cost virtual visits as needed. Prices are listed here.
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Q: What are reasons to not use insurance to obtain a CPAP device?
A: Many insurances don't accept Respiratory Disturbance Index (RDI) as an indication for CPAP and instead are fixated of Apnea Hypopnea Index (AHI) to define sleep apnea severity. We believe that many people who truly need CPAP are not being diagnosed or treated due to this paradigm. Furthermore, there are rigorous compliance regulations that can lead to the patient having to pay for the device or give it back if they don't reach a set threshold of use. Furthermore, some insurance based supply companies can give low quality devices or supplies.
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Q: Does Sleep Doc LA profit off the sales of CPAP equipment?
A: No, we are not a medical device supply company and don't want a conflict of interest with regards to the determination of sleep apnea.
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Q: Does Dr. Hakim come to my geographic area?
A: If the location is not among those listed on our homepage, please check with us at Info@SleepDocLA.com to see if a trip can be made. In some cases a long distance charge is requested.
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Q: How do you safeguard a patient’s privacy?
A: Sleep Doc LA is a medical practice that follows all the required rules for protecting personal medical information as dictated by HIPAA and the HITECH act. Maintaining your privacy is important to us and our full privacy statement can be read here.
Q: Is Dr. Alex Hakim a fully licensed physician in his location of practice and does he have board certifications by the American Board of Internal Medicine (ABIM) in his relevant field and associated training through the American Academy of Sleep Medicine (AASM)?
A: Dr. Hakim is fully certified and licensed through the ABIM and the State of California. He has been trained in the United States at top tiered institutions such as the University of Southern California (USC), University of California - Los Angeles (UCLA) and Cedars-Sinai Medical Center and has completed training courses hosted by the AASM. He is one of the few quadruple board certified physicians in the country. Click here for more information about him.
Pricining
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Initial Consultation | 1 hour physician consultation at home or designated meeting place. | $550 |
Follow-up Visit | 1 hour physician return visit for additional management. | $550 |
Home Sleep Study | Single night testing with careful, personalized assessment by the physician. | $350 |
Virtual Follow-up Visit | 30-minute video conference follow-up by the physician. | $300 |
Actigraphy | 2-week data collection on sleep-wake cycles, light exposure and sleep quality using a research grade device. | $300 |
We are unable to accept insurance to provide the highest quality of care for our patients.