Live discussion with Dr Adrienne Heinz - 11th April 2018

Dr Heinz will be hosting a live online discussion here on Wednesday 11th April, from 8:00pm to 9:30pm British Summer Time or 3:00pm to 4:30pm US Eastern Daylight Time.

She will discuss as many topics as possible in the hour and a half and, as always, you are welcome to ask any questions at all about sleep or the Sleepio program. If there are a lot of questions, she may not be able to answer all in the time available, but will try to answer as many as she can.

Please do note that, as per our guidelines, Dr Heinz will not be able to give personal medical advice including those about medication. Her replies to questions will be made in such a way as to help as many people as possible who might have similar issues.

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Posted 5 Apr 2018 at 12:02 PM
  • 19 comments
  • 4 helped

Comments

  • Sleepio Member

    • 3 comments
    • 0 helped
    Graduate

    With the recommended sleep restriction, I find I am often waking up during a bad time of the sleep cycle. Does the program take sleep cycles into account? Is there any research on it?

  • Sleepio Member

    • 2 comments
    • 0 helped
    Graduate

    What role does lack of Estrogen play in insomnia. I had breast cancer and cannot have any estrogen. My insomnia started when my estrogen patch was taken away 9 years ago. Before that I slept great.

  • Sleepio Member

    • 2 comments
    • 0 helped
    Graduate

    What is the connection between poor sleep and chronic migraine? is sleep restriction an appropriate technique for these conditions as lack of sleep/rest is very likely to trigger increased migraines?

  • Sleepio Member

    • 1 comments
    • 0 helped
    Session 1

    I have struggle with what I believe to be restless leg syndrome, especially after injuring my knee in February, 2018. What are the causes and possible solutions. It is greatly disrupting my sleep.

    Thank you

  • Sleepio Member

    • 9 comments
    • 0 helped
    Graduate

    After suffering a panic attack in mid January, which lasted 3 days and meant I did not sleep, I have not slept more than 2-3 hrs since even though the panic went after the initial 3 day episode. How do I get some sleep without resorting to pills which I now take but don't really work.

  • Sleepio Member

    • 1 comments
    • 0 helped
    Session 3

    I tend to hit “snooze” in the morning. If it's a weekend and I have nothing urgent, I hear the alarm, snooze it in the bathroom (where I put my alarm clock), set the alarm for 20-40 minutes in the future, then go right back to bed.

    At worst, I might repeat this 5-6 times before actually getting out of bed for the day.

    What's happening here? I've always been really bad at getting out of bed, even when I was in high school. Am I just really tired in the mornings or something? Is there anything I can do to help with this?

    I've tried putting my snooze button somewhere far away. One time I had an alarm clock that rolled around on the floor.

  • Sleepio Member

    • 2 comments
    • 1 helped
    Session 4

    Are there any good tips- aside doing the CBT course!- for relentless awakening which only last a few seconds but nonetheless fragment my sleep? Have struggled with this more during perimenopause and not finding supplemental phytoestrogens (e.g. red clover) helping.

  • Sleepio Member

    • 1 comments
    • 0 helped
    Graduate

    I am on week 3 and doing sleep restriction. I am managing to fall asleep but wake every hour and a half or so – sweating profusely. My rota is 12 midnight until 6.30 but am finding that I wake at 5am and cannot get back to sleep – and lay in bed hot and sweaty. I suppose I should get up but am too tired/lazy to do so…. Is this to be expected?

  • Sleepio Member

    • 139 comments
    • 25 helped
    Expert

    Greetings Community! I'm Dr. Adrienne Heinz, a clinical and research psychologist. I'm here to take your sleep-related questions and I look forward to chatting with you for the next 90 minutes.

  • Sleepio Member

    • 139 comments
    • 25 helped
    in reply to Sleepio Member
    Expert

    Waking up during the middle of sleep cycle can leave us feeling unrefreshed and frustrated but sticking to the restriction formula in the short term will optimize your chances of having reliable and consistent sleep in the long term.

    Sleep cycles tend to last approximately 90 minutes and good sleepers generally go through 4-5 sleep cycles in a given night. The composition of sleep cycles change throughout the night, with the first third of the night tending to be characterized by greater amounts of slow-wave (deep) sleep (stages 3&4), whereas REM sleep tends to dominate in the latter third of the night, coinciding with a reduction in core-body temperature. Arousal threshold (the noise required to induce an awakening) also differs according to sleep stage. It is known, for example, that subjects are hardest to wake from slow-wave sleep, reflecting greater intensity and depth of sleep.

    The distribution of average time spent in specific sleep stages throughout the night is as follows:
    Wakefulness (5%)
    Stage 1 (2-5%)
    Stage 2 (45-55%)
    Stage 3 (3-8%) [SWS]
    Stage 4 (10-15%) [SWS]
    REM sleep (20-25%)

  • Sleepio Member

    • 139 comments
    • 25 helped
    in reply to Sleepio Member
    Expert

    Hormone fluctuations do indeed impact sleep. For more information on the relation between sleep and hormones see our library entry: https://www.sleepio.com/library/article/hormones-and-sleep-a-two-way-street/

    Ongoing research is beginning to assess what treatments may be effective for sleep disturbance in menopausal women (who are experiencing reductions in estrogen); with recent controlled studies looking at the effects of hormone replacement therapy (HRT), anti-depressants, hypnotic sleeping pills, valerian, and non-pharmacological interventions, like yoga, on measures of sleep quality.

    I hope this helps – we are honored to be serving a cancer survivor.

  • Sleepio Member

    • 139 comments
    • 25 helped
    in reply to Sleepio Member
    Expert

    Great question. There is indeed a correlation between poor sleep and migraines and insomnia is a common condition among individuals with chronic migraines. However, most of this data is correlational (does not establish causation) as there are a host of other factors that contribute to migraine. In many cases, insomnia may arise from other medical problems which cause chronic pain and make it difficult to sleep comfortably, and in turn disrupts normal sleeping patterns. Migraines disrupt sleep as they force us to go to bed in the middle of the day and can cause mid-night wakings – a recipe for a vicious cycle. There is an ongoing community discussion thread on managing migraines while using the Sleepio program https://www.sleepio.com/community/discussion/migraine-and-sleepio/ . It is also recommended that you speak with your doctor if you want to learn more about treatment options for migraine.

  • Sleepio Member

    • 139 comments
    • 25 helped
    in reply to Sleepio Member
    Expert

    RLS can most definitely negatively impact your sleep as the urge to move is most present when resting. If you believe you might be experiencing RLS it is recommended that you consult your doctor for treatment options. For more information on RLS and sleep please see our library https://www.sleepio.com/library/article/what-is-restless-legs-syndrome-rls/

  • Sleepio Member

    • 139 comments
    • 25 helped
    in reply to Sleepio Member
    Expert

    Panic attacks are incredibly difficult, frightening, and disruptive to our ability to function. It is unlikely for the acute phase of a panic attack to last 3 days as the body cannot sustain that level of physiological arousal. However, the residual effects of anxiety and panic can and do negatively impact sleep. Please read here for more information about managing co-occurring panic and sleep struggles. https://www.sleepio.com/library/topic/panic-disorder/

  • Sleepio Member

    • 139 comments
    • 25 helped
    in reply to Sleepio Member
    Expert

    This is a very common habit! When the alarm goes off our impulse it hit snooze and languish in bed. The illusion is that those extra few minutes will help fuel us for the day. Unfortunately that belief is erroneous and repeated snoozing affords a worse quality of sleep than if we just set the alarm for a later time. What happens is that the snoozing interrupts the onset and completion of a new sleep cycle – and leaves us feeling more tired and disoriented than if we were to just go ahead and start the day.

  • Sleepio Member

    • 139 comments
    • 25 helped
    in reply to Sleepio Member
    Expert

    Those frequent awakenings can be incredibly frustrating. Please see our library course on how to address frequent awakenings https://www.sleepio.com/library/article/staying-asleep-during-the-night/ and on menopause and sleep https://www.sleepio.com/library/article/menopause-and-sleep-problems/

  • Sleepio Member

    • 139 comments
    • 25 helped
    in reply to Sleepio Member
    Expert

    You are undoubtedly entering the most challenging part of the course. Ensuring that your sleep environment remains at a comfortable temperature will better optimize your sleep. Please see our library on sleep and temperature for more information.

    https://www.sleepio.com/library/article/getting-the-right-temperature-for-sleep/

    See also this community thread on experiencing excessive night time heat fluctuations. https://www.sleepio.com/community/discussion/night-heats-dont-help-trying-to-sleep/

  • Sleepio Member

    • 139 comments
    • 25 helped
    Expert

    Thanks everyone for all your great questions today – until next time, take good care!

  • Sleepio Member

    • 2 comments
    • 0 helped
    in reply to Sleepio Member
    Graduate

    Thank you! I assume then you still think SR is appropriate for chronic migraineurs.
    Best wishes.

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