Are Sleep Consultants A Scam?

A mom gives her 8-month-old baby a warm bath, towels him dry, and wriggles him into soft pajamas. As instructed, she reads him a story, lays him down in his crib, steps into the hall and pulls the door closed. She heads downstairs where her husband and their sleep consultant wait. The strange woman’s presence at this hour, and the fact that she was paid $2,600 to be there, might be jarring to previous generations, who learned all they knew about babies and sleep from their families.

For three days, the sleep consultant observes the family, each time for up to 12 hours. She watches how they handle meals with the baby — solids and breastfeeding — and calmly guides the couple through nap times and a soothing bedtime routine. After her sit-ins, she makes herself available to the parents via text at all hours. Whenever her baby wakes up screaming, the mom taps a frantic message to the coach asking what to do, feeling like whatever she chooses, it will be wrong. (Trust me.)

Baby sleep, or the lack of it, has spawned a desperate market of parents who spend $325 million per year on products that claim to help infants sleep better, deeper, or longer. With that kind of money on the table, and a health care industry that is stretched thin, it’s no surprise a new type of wellness entrepreneur — the sleep consultant — has popped up to fill in the gap. Sleep consultants are now part of many new parents’ experiences (and expenses). But who exactly are the people we’re letting into our babies’ circadian rhythms, and what are they really qualified to be doing there?

Dr. Craig Canapari, M.D., board-certified pediatric sleep specialist and director of the Yale Pediatric Sleep Center, finished his training in 2007 and says sleep consultants weren’t on anyone’s radar then. He attributes their recent rise into the collective consciousness of parents to two things: social media, and a very real, unmet need for exhausted new parents. Sleep has always been a necessity, of course, but the isolated way we parent today, with both parents working and fewer grandparents nearby, makes it harder to come by.

“Nationwide, there just aren’t enough pediatric sleep doctors,” Canapari says. “Pediatricians do not get a lot of training in sleep medicine. I probably had one hour, in my four years of medical school, on sleep medicine. I’m not even exaggerating here. As parents who don’t have a village anymore, and we’re all working and we have all of life’s challenges on our shoulders in addition to parenting, we need sleep.”

Sleep providers’ wait lists are long — Canapari says his new patients usually wait four to five months before being seen. For parents desperate enough to turn to a sleep psychologist for help, that’s a lifetime (and for the infant, it is their lifetime). “That’s not acceptable, right, if your life is falling apart?” he says.

Sleep consultants, on the other hand, can help families much sooner (and in doing so, they enable children with medical sleep issues, like obstructive sleep apnea, to move up the waitlist for a physician faster).

When you’re a parent running on little sleep, just having someone listen to all the nuances of trying to put your baby down for naps and bedtimes can feel invaluable. It all sounds like a happy little ecosystem that results in well-rested families, until you start picking at the edges.

Sleep consulting, in a way, has always existed within the advice from our mothers, grandmothers, and friends. It’s hard to discern exactly when it sprang up as an industry.

Arielle Greenleaf is a certified sleep consultant and co-founder and chief coaching officer of Restfully. She was certified in 2016 (though she is the first to admit it’s a shaky qualification) after using a sleep consultant herself in 2015. She’s aware of other consultants who practiced as early as 2008 or 2009, but says in recent years, the industry has “just kind of exploded,” with new consultants being certified every day.

Sleep consultant certifications are not government-issued or conferred by a recognized medical body. They’re granted by small businesses, mostly online courses, written by other sleep consultants.

“I always say my dog could create a certification program and people could go through it and become certified pediatric sleep consultants.”

“It's kind of like life coaching, right?” says Greenleaf. “You can Google life coaching, and you can go on there, and it can be like, ‘Oh, this [course] is accredited by some random place that no one’s ever heard of.’ But you go through the program, and then you’re a life coach. You can make a career out of it. [Sleep consulting] is the same thing, and it shouldn’t be because we’re dealing with children.” Having hired one myself, I know how it bolsters your confidence to see “certified sleep consultant” behind the name of the person you’ve chosen to help your family. It’s formatted just like other health care providers’ credentials: So-and-so, speech-language pathologist, RN, or whatever else. It’s meant to convey expertise, but it’s mostly a prop.

When Greenleaf was certified, there weren’t as many options for sleep consulting certification programs as there are today. Her choices were a $10,000 certification earned over one weekend in Jupiter, Florida, or another $6,000 option. She was certified through an online course that cost $1,500, but hesitated to name it because “it’s so poorly done.” Greenleaf completed her own certification in 10 days “with very little thought required,” while underscoring that certification should take much longer. “I always say my dog could create a certification program and people could go through it and become certified pediatric sleep consultants,” she says. The training isn’t uniform from one program to the next, nor are the programs required to cover child development or signs of medical sleep problems. Some programs do include modules on those very topics, but Greenleaf says they’re not always based in scientific literature or written by those with medical expertise. What online schools do offer are MLM-sounding promises, emphasizing that sleep consulting will let them work from anywhere, and help them finally achieve the perfect work-life balance.

Dr. Melisa Moore, Ph.D., is a pediatric sleep psychologist at Children’s Hospital of Philadelphia. She says the average sleep psychologist has seven to eight years of clinical training and, in her case, has passed special board exams in behavioral sleep medicine. There’s nothing wrong with having a sleep coach, she says, that is if you’re in “a very straightforward situation with a healthy baby that responds exactly like you would expect them to.” But the lack of standardized training for consultants can lead to a few issues. Without knowing the latest science and theory behind infant sleep, Moore worries consultants may not be able to tailor their advice to an individual baby’s needs. Coaches can wind up prescribing the same plan to all babies based solely on their age, and parents can feel beholden to it, creating a new source of anxiety should they be even a few minutes late laying their child down for a nap.

But her second concern is the one that unsettles her most. “Sleep is an early marker for some medical concerns, developmental concerns, [and] medical sleep disorders. And I think if you don’t have a serious grounding in that, things can be missed. That really is a big deal.”

Without thorough medical education, Moore doesn’t know how a consultant would distinguish between when sleep training is hard just because it’s hard or because the baby has an underlying medical condition preventing them from sleeping like they should. Most sleep consultants’ websites say they were inspired to join the profession after dealing with their own babies sleeping poorly, an experience Moore says can make a great and empathetic coach, but not an expert.

When a family brings a baby to Moore, she assesses them for sleep issues that fall into one of three categories:

1. Medical sleep problems like obstructive sleep apnea, restless legs syndrome, or insomnia.
2. Behavioral sleep problems like negative sleep associations (needing a bottle to fall asleep or a parent in the room). This is where sleep consultants “should and can” help families, Moore says.
3. Other conditions that can impact sleep, like reflux, eczema, or autism. This group is the one Moore worries about. Missing the sleep-related signs of these conditions can and does cause delays in getting care for them, in her experience.

Both Moore and Greenleaf point to the lack of sleep consultancy oversight as a problem in the nascent industry that needs to be addressed. It’s the missing piece that would legitimize the profession, perhaps enough to encourage doctors and hospitals to partner with sleep consultants and for their services to one day be covered by insurance. Why? Because it has worked before for doulas and lactation consultants.

The letters behind a lactation consultant’s name, IBCLC, denote that they’ve taken and passed an exam through the International Board of Lactation Consultant Examiners (IBCLE). The IBCLE is the official organization dedicated to credentialing lactation consultants and ensuring they receive a standardized, evidence-based education. It was founded in response to the need for standardization in the profession after more and more parents sought breastfeeding support between the 1970s and 1980s. It also provides ethical oversight for IBCLCs and can take disciplinary action against their certified lactation consultants if necessary. Similarly, doulas have DONA International, the world’s largest doula certifying organization. While there are other doula certification programs, DONA’s is considered the gold standard, offering conferences and continuing education opportunities and overseeing its graduates’ professional behavior after they receive their certification. For sleep psychologists, there’s the Board of Behavioral Sleep Medicine. Their diplomates, according to Dr. Jennifer S. Kazmerski, Ph.D, a pediatric sleep psychologist at Texas Children’s Hospital (who is one), have to renew their certifications every five years, which requires that they complete academic research, attend educational seminars, or take classes and earn credits.

Sleep consultants offer advice on infant sleep, a key aspect of babies’ health, but have none of this same oversight. Getting all sleep consultant training programs to standardize their coursework would require an authoritative body to regulate the countless online and in-person programs around the world (or for one to become preeminent and basically invalidate all the others, like DONA). Ideally, sleep consultants would also need to complete continuing education to remain certified, to ensure their medical knowledge, and the advice they pass on to vulnerable parents, is current.

There are organizations trying, like the Association of Professional Sleep Consultants and the International Association of Child Sleep Consultants, which hold members to a code of ethics and offer continuing education. However, joining them is completely voluntary, and they don’t have formal complaints processes to investigate members available online.

“It’s problematic that there isn’t a general oversight,” Moore says. “I think the field of lactation consulting, the doulas, they all emerged similarly, but they have these bodies of oversight. Each of these sleep consultant training programs is different. There needs to be consistent guidelines about what training you need to have before you even become a sleep coach or a sleep consultant.”

If sleep consultants could organize behind one authority, Canapari and Greenleaf feel it would be one big step toward getting sleep coaching covered by insurance, the same way lactation consultants are. Currently, Greenleaf says, some health savings and flexible spending accounts can be used for sleep consultant services if you provide the proper documentation. Most parents pay out of pocket.

“There’s a hell of an equity layer because these services aren’t free and they’re not covered by insurance, right?” Canapari says. “I don’t know how the industry starts policing itself because there are a bunch of bodies, but none of them really have any authority. I think the real problem is what is probably driving success in the world of sleep consultants is more the Instagram algorithm than perhaps real measures of quality.”

For parents in distress, it feels like getting answers immediately. Just open the PDF and begin your new, well-rested life.

Instagram and TikTok are where sleep consultants thrive and draw in many of their customers. When the algorithm learns you’re pregnant, you’ll be fed their posts on five sleep habits to start when you get home from the hospital and a full breakdown of wake windows (a concept Canapari traced the origins of only to discover it was invented by sleep consultants but is not based on any scientific literature). Coaches on social media offer free PDFs on all aspects of sleep training, and of course, paid courses for more in-depth information.

“Parents want answers, right? And if someone’s going to be like, ‘I have a system. This is going to answer your problems,’ well, they’re going to get a lot of traction, and they’re potentially going to make a lot of money. But it’s not necessarily based on science,” says Canapari.

Instagram-sold, downloadable programs (and bundles, e-books, et cetera) have a special draw — they’re lower in cost compared to working with a sleep consultant one on one, and for parents in distress, it feels like getting answers immediately. Just open the PDF and begin your new, well-rested life. But Greenleaf has one piece of advice for parents who want to purchase any sleep coaching programs like this: don’t. Or do but keep your expectations low.

“Go into it remembering that your baby is an individual and any sort of templated advice or generic age-based advice may not work. And that if it doesn’t work, it doesn’t mean that there’s something wrong with you or your baby; it just means that they don’t fall within a specific norm that that particular course is calling normal,” she says, noting the many “Taking Cara Babies dropouts” who come to her distraught.

All of the experts Romper spoke with agree that sleep consultants can absolutely help parents who think their child’s sleep issues are behavioral. You just need to put in a little effort to sniff out a good one. When you’re interviewing sleep consultants, Canapari, Greenleaf, and Moore recommend:

• Working with a consultant who confirms that you’ve talked to your pediatrician about your baby’s sleep issues, and done so recently. This can help rule out underlying medical conditions causing your child’s sleep disturbances, and your sleep consultant should know your child’s weight is normal before wanting to cut out any overnight feedings.
• Choosing a consultant who offers a money-back guarantee. Canapari says, “You really should give people their money back if this doesn’t work.”
• Finding a consultant who aligns with your parenting philosophy. For example, are you OK with crying it out or not?
• Avoiding any coaches whose recommendations aren’t in line with the American Academy of Pediatrics’ safe sleep guidelines.
• Discussing your individual goals and concerns with the sleep consultant, and gut-checking with yourself that you feel heard and understood.

It’s also OK to quit on your sleep consultant if their program isn’t working. “If you don’t turn that corner in a reasonable time and you feel like you’re a bad parent, you need to stop and take a fresh look,” says Dr. Suzanne Beck, M.D., medical director of the Children’s Hospital of Philadelphia’s Sleep Center. “If you feel that you’re not making progress or you feel like the plan’s getting a little contorted or you’re too locked in, then I think it’s time to take a step away.”

If you’ve already worked with a sleep consultant and your baby is still having difficulty sleeping, you might need help from a specialist. If your baby is snoring, didn’t respond well to sleep coaching, or has developmental concerns along with poor sleep, Moore recommends taking them to a sleep psychologist.

In most cases, Moore notes, these providers are covered by insurance.

Experts:

Arielle Greenleaf, certified sleep consultant and co-founder and chief coaching officer of Restfully

Dr. Craig Canapari, M.D., board-certified pediatric sleep specialist, director of the Yale Pediatric Sleep Center, and author of It’s Never Too Late To Sleep Train

Dr. Melisa Moore, Ph.D., pediatric sleep psychologist at Children’s Hospital of Philadelphia

Dr. Jennifer S. Kazmerski, Ph.D, BCBA-D, DBSM, pediatric sleep psychologist and board-certified behavior analyst at Texas Children’s Hospital

Dr. Suzanne Beck, M.D., board-certified pediatric pulmonologist and sleep medicine physician, medical director of the Children’s Hospital of Philadelphia’s Sleep Center, and co-editor of a sleep medicine textbook for providers