Midlife sleep complaints rarely present cleanly. Vasomotor symptoms, mood changes, alcohol, and years of accumulated sleep effort stack on top of one another, and the patient in front of you usually arrives asking for something to take — often after months of melatonin that did nothing.

Dr. Shelby Harris joins WNDG to work through the sorting problem. What's hormonally driven, what's primary insomnia, what's a circadian shift, and when a sleep-disordered breathing workup belongs in a perimenopausal patient who doesn't fit the classic phenotype. She'll cover where CBT-I sits as first-line treatment, how to introduce it to a patient who came in wanting a prescription, what to do with the patient already on nightly trazodone or zolpidem, and how wearable sleep data is reshaping the conversation in the exam room.

Shelby Harris, PsyD, DBSM, is a board-certified clinical psychologist specializing in behavioral sleep medicine and one of a few hundred Diplomates in the field nationally. She is Clinical Associate Professor in the Departments of Neurology and Psychiatry at Albert Einstein College of Medicine, and previously directed the Behavioral Sleep Medicine Program at Montefiore Medical Center for more than a decade. Her clinical work covers insomnia, circadian rhythm disorders, chronic nightmares, hypersomnia, and CPAP non-adherence, with CBT-I as the first-line approach. She is the author of The Women's Guide to Overcoming Insomnia and The Essential Guide to Children's Sleep.