Thanks, John. We will check out these resources. Regarding his ability to travel to a major teaching hospital, it would depend on where the facility is. I don't know what qualifies as a major teaching hospital so I can't say whether there's one nearby, but he's in Italy if that helps. There are so many contributing factors to his insomnia/misery that it's hard to know where to start, but the leads I'm most interested in are childhood trauma/neglect as they contribute to depression/anxiety, a high resting heart rate of 105bpm (OK'd by his cardiologist), and a couple spots in his brain that have been quiet and benign so far, but for which he has scheduled another MRI in December. I'm also really open to the idea that he's dealing with something rare that most physicians/psychiatrists wouldn't think to consider, but only good luck or systematic investigation will tell!

Is there more you can say about the approach, resources or methods of major teaching hospitals?

Thanks, a lot.