Self-pay telemedicine · California · Massachusetts · Michigan
Sleep and weight treated together by one physician
Many patients are told to use CPAP, lose weight, or start medication as if these are separate problems. Dr. Sangal brings Sleep and Obesity Medicine together in one self-pay telemedicine practice.
Direct physician care · No insurance maze · No handoff to a PA or NP
Self-pay telemedicine · California · Massachusetts · Michigan
Sleep and weight treated together by one physician
Many patients are told to use CPAP, lose weight, or start medication as if these are separate problems. Dr. Sangal brings Sleep and Obesity Medicine together in one self-pay telemedicine practice.
Direct physician care · No insurance maze · No handoff to a PA or NP
Board-certified in Sleep Medicine and Obesity Medicine
Leading expert with ~50 peer-reviewed publications
Professor, Oakland University William Beaumont School of Medicine
Every visit with Dr. Sangal, not a PA or NP
Sleep apnea & your health
Sleep and Obesity Medicine: treat sleep apnea and the risks that travel with it
CPAP is often the best treatment for snoring, breathing interruptions, and daytime sleepiness related to sleep apnea. But sleep apnea is frequently connected with excess weight, blood pressure, and cardiovascular risk. For many patients, the best plan is not CPAP or weight loss. At least initially, it may be both: treating sleep-disordered breathing while also addressing the excess weight. In the absence of related daytime sleepiness or high-risk sleep apnea, it could be weight loss without CPAP. It could even be medicines for sleep apnea along with weight loss. Dramatic and sustained weight loss may allow a subset of patients to get off other treatment for sleep apnea, such as CPAP.
The evidence increasingly shows that prescribing CPAP alone does not improve cardiometabolic risk or major adverse cardiovascular events (MACE).1–3 In fact, in patients without high-risk sleep apnea, CPAP may worsen the cardiometabolic risk.4 For many patients, addressing excess weight is also important, because sustained weight loss can improve sleep apnea severity and cardiometabolic risk. A physician who is board certified in both Sleep Medicine and in Obesity Medicine (such as Dr. Sangal) can help you with this.
- Yu J, et al. Association of Positive Airway Pressure with Cardiovascular Events and Death in Adults with Sleep Apnea: A Systematic Review and Meta-analysis. JAMA. 2017;318(2):156–166. PubMed
- Elbadawi A, et al. Impact of continuous positive airway pressure ventilation on cardiovascular outcomes among patients with obstructive sleep apnea: a meta-analysis of randomized trials. American Heart Journal Plus. 2021;11:100056. PubMed
- Feltner C, et al. Screening for Obstructive Sleep Apnea in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2022;328(19):1951–1971. PubMed
- Azarbarzin A, et al. Cardiovascular benefit of continuous positive airway pressure according to high-risk obstructive sleep apnoea: a multi-trial analysis. European Heart Journal. 2026;47(17):2077–2089. PubMed
Sleep and weight are connected
Excess weight and disrupted sleep can affect long-term health
Food and sleep sustain us. When our relationship with either falls out of balance, the consequences run deep, affecting both how long and how well we live. The goal when we treat sleep and weight together is, at its core, more healthy years.
Excess weight is associated with
High blood pressure Cardiovascular disorders Diabetes type 2Metabolic disordersCertain cancersSleep apnea
Obesity medicine practice available in California, Massachusetts and Michigan.
Sleep disorders we treat
No controlled substance prescriptions. No sleep lab or in-lab sleep testing. Home sleep testing available. Sleep medicine practice available in California and Massachusetts.
Care from a physician — not a sales funnel
Care from a physician with decades of experience
No crowded clinic, no insurance maze, no handoff to a midlevel provider, and none of the misalignment you experience with large telehealth platforms.
- You see Dr. Sangal himself — every visit, never a PA or NP.
- Medicine paired with real change — GLP-1s work best alongside intensive lifestyle management, built into your care.
- No upselling, ever — no unproven supplements; you’ll never be sold what you don’t need.
- Your time respected — appointments start on time and with the physician.
Is this practice right for you?
Who this is for — and who it isn’t
This practice is for
Adults and adolescents in California, Massachusetts, or Michigan who want direct physician care for sleep apnea, excess weight, weight-related health risk, insomnia, or restless legs syndrome (no controlled substances prescribed). Patients may have tried CPAP, weight-loss advice, commercial telehealth programs, or rushed specialist visits, and want a more complete plan. A physician who specializes in both Sleep Medicine and in Obesity Medicine (such as Dr. Sangal) is ideal for that.
This practice is not for
Medical emergencies, children younger than 10, unstable medical conditions, or problems that require an in-person exam or an in-lab sleep testing. If you are having chest pain, severe shortness of breath, sudden neurologic symptoms, thoughts of self-harm, or another emergency, call 911. It is also not for patients seeking controlled-substance prescriptions through telemedicine (such as stimulants, opioids, or sleeping pills).
Medical weight management
Results that last, not just results that start
How it works
Care in four simple steps
Book online
Choose a time, pay securely online — no insurance hurdles or hidden costs — and complete your forms to start care.
Evaluation by Dr. Sangal
A thorough telehealth evaluation with the physician himself, who reviews your history and builds a plan with you.
Your personalized plan
Medication where appropriate, paired with lifestyle change — and clear next steps you can act on.
Ongoing care
Follow-up visits are scheduled as needed and billed per visit. See full fees →
Transparent self-pay care
Fees and what to expect
Visit fees
(about 45 min)
$585
(about 15 min, no evaluation or management, no doctor-patient relationship established)
$195
(about 15 min)
$195
$585
$2,600
$130
$65 / 5 min
Payment is collected securely online at time of booking. 80% refund if cancelled at least 1 business week before the appointment; 50% refund if cancelled at least 1 business day before; no refund for cancellation less than 1 business day (24 h) before appointment or for no-show
What to expect at your first visit
Your first visit includes a review of your sleep history, weight history, medical conditions, medications, prior sleep studies or CPAP data if available, and your goals. Dr. Sangal will discuss whether medications, sleep testing, CPAP changes, lifestyle treatment, or additional lab work are appropriate.
Before your visit, complete your forms, send any pertinent prior medical records, and gather your insurance information (for labs, pharmacies, and device companies).
If you would rather have a brief introduction to Dr. Sangal before deciding on a new-patient evaluation, please choose “Introduction to Dr. Sangal” from the Visit fees panel.
What we treat
Focused, evidence-based care
Medical weight management
Evidence-based treatment for overweight and obesity — from GLP-1 and other medication pathways to lasting lifestyle change.
Sleep apnea & weight
Treating obstructive sleep apnea through maintained weight loss — easing symptoms while reducing cardiovascular risk.
Other sleep disorders
Diagnosis and management of other sleep disorders not requiring a sleep lab: insomnia, restless legs syndrome, bedwetting. We do not write prescriptions for controlled substances (such as opioids, sleeping pills, stimulants).
Where care is available
Serving California, Massachusetts & Michigan
Telemedicine visits are available for adults physically located anywhere in California, Massachusetts, or Michigan at the time of the visit (limited to obesity medicine in Michigan). You do not need to be in a specific metro area such as San Francisco, Los Angeles, San Diego, Boston, or Detroit.
Meet your physician
R. Bart Sangal, MD
Board-certified in both Sleep Medicine and Obesity Medicine, Dr. Sangal brings decades of clinical experience, an extensive research background, roughly 50 peer-reviewed publications, and a faculty appointment as Professor at Oakland University William Beaumont School of Medicine.
After building and selling a highly successful sleep medicine practice, he now devotes himself to a focused, self-pay telehealth practice — personally evaluating and treating every patient, with appointments that begin on time.
Dr. Sangal’s practice is intentionally small. He personally evaluates each patient and builds treatment plans that connect sleep, weight, medication decisions, and long-term health risk.
Common questions
Frequently asked questions
The new-patient evaluation (about 45 minutes) is $585. Follow-up visits are $195. A 15-minute “Introduction to Dr. Sangal” (no evaluation or management, no records kept, no physician–patient relationship established) is $195. Home sleep apnea testing is $585. See full fees above.
Yes, if reasonable — and only FDA-approved medicines. We do not prescribe compounded GLP-1 agonists.
Without an in-person sleep lab, Dr. Sangal treats sleep apnea, insomnia, and restless legs syndrome. The practice does not write prescriptions for controlled substances.
No. Home sleep apnea testing can be arranged if needed: the equipment and instructions are mailed to your home, you use it for three nights and send it back, and Dr. Sangal reviews and interprets the results himself.
You can usually be seen within a week, and the first evaluation visit is about 45 minutes.
Follow-up visits are scheduled as needed and billed per visit. Between visits, you can send questions through the HIPAA-compliant patient portal and usually get a response within one working day; portal review and response is billed at $65 per 5 minutes.
No. The practice is self-pay only, but can provide invoices you may submit to your insurer for possible reimbursement.
You complete your forms, send us pertinent prior medical records, and meet Dr. Sangal at the evaluation visit. Payment is collected when you book your appointment.
From the blog
Notes from the practice
Occasional, plain-spoken writing on sleep, weight, and the science behind real results.
Sleep better. Protect your long-term health.
Book a telehealth consultation with a board-certified physician — and pay securely online.
Self-pay · Telemedicine for residents of California, Massachusetts & Michigan