Where are the Behavioral Sleep Medicine Providers and Where are They Needed? A Geographic Assessment

TLDR

There is a recognized shortage of clinicians trained in Behavioral Sleep Medicine and CBT‑I, but it is unclear whether the deficit varies by region. The study aimed to evaluate geographic disparities in BSM provider distribution. The authors mapped BSM providers nationwide using national directories and email listservs to assess distribution by city, state, and country. The analysis revealed that 88 % of 752 BSM providers are in the United States, with 58 % concentrated in 12 states and 19 % in just NY and CA, while 4 states lack any providers and 105 of 167 U.S.

Abstract

Although it is widely acknowledged that there are not enough clinicians trained in either Behavioral Sleep Medicine (BSM) in general or in Cognitive Behavioral Therapy for Insomnia (CBT-I) in specific, what is unclear is whether this problem is more acute in some regions relative to others. Accordingly, a geographic approach was taken to assess this issue. Using national directories as well as e-mail listservs (Behavioral Sleep Medicine group and Behavioral Treatment for Insomnia Roster), the present study evaluated geographic patterning of CBSM and BSM providers by city, state, and country. Overall, 88% of 752 BSM providers worldwide live in the United States (n = 659). Of these, 58% reside in 12 states with ≥ 20 providers (CA, NY, PA, IL, MA, TX, FL, OH, MI, MN, WA, and CO), and 19% reside in just 2 states (NY and CA). There were 4 states with no BSM providers (NH, HI, SD, and WY). Of the 167 U.S. cities with a population of > 150,000, 105 cities have no BSM providers. These results clearly suggest that a targeted effort is needed to train individuals in both the unserved and underserved areas.