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    Sleep & Circadian Care

    Sleep is not merely 'down-time'; it is an active neurological state essential for brain health, memory consolidation, and emotional regulation. When sleep is disrupted, every other aspect of your health suffers.

    Targeted Diagnosis: Identifying Your Sleep Architecture

    Dr. Karmazin looks beyond the simple symptom of "being tired" to identify the specific neurological or physiological disruption in your rest.

    Chronic Insomnia

    Difficulty falling or staying asleep, often driven by a hyper-aroused nervous system.

    Obstructive & Central Sleep Apnea

    Breathing disruptions that fragment sleep and deprive the brain of oxygen.

    Restless Leg Syndrome (RLS) & PLMD

    Neurological movement disorders that create an irresistible urge to move the limbs, typically worsening at night.

    Circadian Rhythm Disorders

    Misalignment between your internal biological clock and the external environment (common in shift workers or 'night owls').

    Narcolepsy & Hypersomnia

    Disorders of excessive daytime sleepiness and the brain's inability to regulate sleep-wake cycles.

    Precision Treatments: The Three-Pillar Sleep Roadmap

    Dr. Karmazin moves away from "one-size-fits-all" sedatives, focusing instead on restoring the brain's natural ability to regulate sleep.

    Advanced Pharmacological Management

    Respecting Natural Sleep Architecture

    • Dual Orexin Receptor Antagonists (DORAs): Advanced sleep aids that work with the brain's natural pathways
    • Dopaminergic Agents & Iron Therapy: Targeted treatments for RLS to calm the nervous system
    • Wake-Promoting Agents: Solutions for narcolepsy or shift-work disorder

    Physical & Interventional Therapy

    Addressing Mechanical Barriers

    • PAP Therapy & Alternative Interventions: Expert oversight for CPAP/BiPAP, oral appliances, and Inspire stimulator
    • CBT-I Coordination: Cognitive Behavioral Therapy for Insomnia—the gold standard for chronic sleep issues

    Lifestyle & Environmental Optimization

    The Sleep Environment

    • Chronotherapy: Aligning light exposure and activity levels with your natural circadian rhythm
    • Sleep Hygiene 2.0: Neurologically-backed routines that prepare the brain for sleep transition
    • Nutraceutical Support: Evidence-based use of Magnesium, Melatonin, and other supplements

    The Private Practice Advantage: Virtual Sleep Care

    The most accurate way to discuss your sleep is from the environment where you actually sleep. Our virtual model offers a direct line to a specialist without the stress of a commute.

    Personalized Attention

    Direct access to Dr. Karmazin to manage the nuances of your sleep-wake cycles.

    In-Home Assessment

    Discuss your sleep environment and triggers from the comfort of your own home.

    Rapid Coordination

    Digital orders for sleep studies and medications sent instantly to your local providers.

    Continuous Monitoring

    Integration of data from wearable sleep trackers to monitor your progress in real-time.

    Need Workplace Accommodations?

    Dr. Karmazin provides ADA accommodation letters, FMLA certification, and disability documentation for patients with this condition.

    Learn more

    Transparent Pricing

    Know exactly what you'll pay. No hidden fees, no insurance headaches, no referral needed.

    New Patient Visit

    $350

    50 minutes

    • Virtual neurological exam
    • Custom treatment plan

    Follow-up Visit

    $200

    25 minutes

    • Medication adjustments
    • Updated care plan

    Superbills provided for insurance reimbursement — many patients receive 60-80% back.

    View Full Pricing Details

    Ready to Take the First Step?

    Stop waiting months for answers. Request your virtual consultation today and experience compassionate, expert neurology care from home.