Live discussion with Dr Adrienne Heinz - 6th March 2019

Dr Heinz will be hosting a live online discussion here on Wednesday 6th March, from 7:00pm to 8:30pm BT or 3:00pm to 4:30pm US ET.

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 28 Feb 2019 at 9:09 PM
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  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Absolutely. Ironically, one of the most helpful techniques to fall asleep quickly is not to think about falling asleep. The more we fixate on falling asleep the more likely it is that we will struggle to do so. Instead, relaxing into a night time routine and thinking of other things will allow sleep to come naturally. We do not fall asleep on command and finding a creative way to distract the mind tends to be most effective.

    See this library article here as well for more information https://www.sleepio.com/library/article/how-to-get-to-sleep/

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Regarding listening to the radio, if it works for you and is not interfering with your sleep quality there is likely no need to make adjustments. I would encourage you pay attention to how ambient and radio noise may affect your sleep in the event it may be disruptive after you have fallen asleep (i.e., contributes to night time wakenings).

    Your concern about the bedroom environment is warranted. When possible, it is best to separate the bedroom from other aspects of our life – so that we can strengthen the bed sleep connection. Obviously there are times when this cannot be avoided – but it’s most optimal to find other places to work. This could include coffee shops, and if in your budget, a rented co-working space. I would encourage you to remain at your desk and never the bed when doing work. This includes emails and texts related to work on the phone.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    It can be quite frustrating to not feel rested after getting a full night of rest. Check out these resources for what factors may contribute to not feeling rested.

    https://www.sleepio.com/library/article/what-accounts-for-unrefreshing-sleep-/. and
    https://www.sleepio.com/library/article/sleepiness-fatigue-and-impaired-concentration/
    You might also consider what sources of stress may be affecting your energy level in the day and determine what modifications you can make to either remove sources of stress or learn to cope with them more optimally. https://www.sleepio.com/library/article/stressful-life-events-and-sleep-disturbance/

    With regard to the changing light patterns, you are already taking promising steps to address this. You might consider shifting your sleep window 30 minutes earlier to account for this change of seasons. You can also check out this community discussion on the topic and related Sleepio blog posts. https://www.sleepio.com/community/discussion/clock-change-and-its-impact-on-sleep/

  • Sleepio Member

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    Expert

    Early wakings are incredibly frustrating. Consider reconsolidating your sleep window and shortening it until the early wakings consistently subside. See this resource here for more information on staying asleep. https://www.sleepio.com/library/article/staying-asleep-during-the-night/

  • Sleepio Member

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    Expert

    Having a regression in sleep due to illness is so incredibly frustrating. In addition, it can put us in a vicious negative feedback loop that is difficult to break. When you are acutely ill the sleep restriction should be removed until your body heals. Coughing is especially disruptive to sleep and is a physical cause of sleep problems versus a psychological cause. When experiencing a relapse in sleep, it’s important to be self-compassionate and recognize that what not might be effective today could be helpful tomorrow. I encourage you to take it one day at a time. If certain techniques are not resonating, consider trying alternatives – aromatherapy (lavender pillow) – visualizing nature (ocean, forest) – focusing on ambient noise (sound machine). It’s so hard to appreciate when things are tough, but the worst of our sleep disruptions are intermittent and not chronic and do not last forever. https://www.sleepio.com/library/article/my-sleep-efficiency-is-slipping---should-i-be-worr/

  • Sleepio Member

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    Graduate

    Thanks for your reply, Dr. Heinz.

    I've read those articles, but I still don't see how Sleepio would help with sleep quality. Two nights ago, for example, I had 90% efficiency, but still felt unrested.

  • Sleepio Member

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    Graduate

    Also, you mention above that it's best to keep the bedroom for sleep only. Does that mean I have to go to another room to read before bed, rather than reading in a chair in my room?

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Great questions. If you want to manually change your sleep window – you can follow these instructions. https://www.sleepio.com/library/article/how-to-shift-your-sleep-window/ We aim to have consistency in sleep efficiency for at least one week before shifting the window as it takes time to recalibrate and reconsolidate our sleeping patterns. Our sleep does not get disrupted overnight, and likewise does not improve overnight.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    First of all, based on your description, you are doing a great job implementing “all the things.” You are correct that continuing with sleep restriction and adherence to the quarter hour rule following graduation can help with regard to maintaining gains. You might benefit from closer examination of the relationship between stress and sleep. Check out these below resources for more information. You might also consider introducing stress management techniques during the day, outside of the bedroom. Some of these tools are available in sleepio (progressive muscle relaxtion) while others are available externally, via yoga, meditation, and other forms of self-care. . Finally as you mentioned, short night time wakings are common and not harmful.

    https://www.sleepio.com/library/article/stressful-life-events-and-sleep-disturbance/

  • Sleepio Member

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    Expert

    We actually get this question quite a bit! Although there are outliers, the average human requires between 7-8 hours of sleep a night. To answer your question, we know from animal research that extreme sleep deprivation can cause death and that humans do need to sleep in order to survive. However, lack of sleep is not the cause of death but rather it is the impact of lack of sleep on our health. There are a number of published longitudinal studies (that follow participants over time) that demonstrate that lack of sleep is associated with increased risk of mortality. https://academic.oup.com/sleep/article/30/10/1245/2696836

    However, and perhaps most importantly, increased anxiety about this relationship may likely negatively impact sleep. Read here for more resources on addressing anxiety as it relates to sleep.

    https://www.sleepio.com/library/article/anxiety-introduction/

  • Sleepio Member

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    Expert

    You are correct, it is rarely effective to use scare tactics to influence behavior change. In addition, it can be rather invalidating to have prescriptive messages from media and others about what to do, when sleep is problematic for an individual.

    There is an established link in the literature between insomnia and dementia and you can evaluate the research here yourself https://www.sciencedirect.com/science/article/pii/S002239561630036X

  • Sleepio Member

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    Expert

    Great and timely question. See here for these resources and community discussions on the matter. https://www.sleepio.com/community/discussion/clock-change-and-its-impact-on-sleep/

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Congratulations on your progress. During sleep restriction the experience of day time sleepiness is quite common. You can expect this to improve with time and as you expand the sleep window. If you feel that your sleep has become more reliable and consistent, you can manually adjust your sleep window following these instructions. Read here for more information on daytime sleepiness and mental fatigue.

    https://www.sleepio.com/library/article/how-to-shift-your-sleep-window/

    https://www.sleepio.com/library/article/sleepiness-fatigue-and-impaired-concentration/

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    The feelings you describe are quite common and to be expected. It’s likely that your problems with sleep did not begin overnight nor will they be corrected overnight. While your SE isn’t the ideal 90% I gather it may have improved compared to the past? It’s important to practice self-compassion during sleep restriction and to celebrate and honor whatever progress you do make. Behavior change is incredibly difficult, and sometimes those with no sleep problems may take that for granted. Some users find comfort and support in the online discussion around sleep restriction.

    https://www.sleepio.com/community/discussion/dealing-with-the-new-sleep-regime/

    In addition, there will be a live discussion on the topic of sleep restriction with sleep expert Dr. Creanor on 3/17 https://www.sleepio.com/community/discussion/sleep-restriction---live-discussion-17th-march/

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Yes, sleep restriction is still effective in your type of insomnia. The early waking you describe is distinct subtype of insomnia and becomes more common as we age. Calling upon epidemiological studies, it is estimated that 17% of individuals with poor sleep experience this subtype of insomnia. See our Library page here for more information. https://www.sleepio.com/library/article/staying-asleep-during-the-night/

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    In addition, you might inventory how stress may be impacting your sleep. Are you experiencing ongoing or acutely stressful events? https://www.sleepio.com/library/article/stressful-life-events-and-sleep-disturbance/

    If you don't see stress as contributor to your poor sleep quality, perhaps consult a medical professional. You mentioned that were not at risk for obstructive sleep apnea but you might consider getting an evaluation/rule-out from a doctor.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    It is best practice to strengthen the bed sleep connection. For individuals who struggle with sleep, it is recommend that the bedroom be reserved for sleep and sex only. Once sleep improves consistently, it is possible to reintroduce other activities back into the bedroom.

  • Sleepio Member

    • 21 comments
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    Graduate

    Yes, I do experience stress regularly, as well as depression. I'm not sure that my insomnia will be helped with CBTi for that reason, but I will continue with it for now.

    It's good to know that I won't be banned from my room forever! My bedroom is actually my favourite room in the house. It is the most peaceful.

    Thanks again for all your help. Have a lovely afternoon!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    You too!

    Also a note of encouragement, we do find that CBTi is effective among individuals with co-occurring mental health conditions and that improvements in sleep mediate improvements in depression and anxiety.

  • Sleepio Member

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    Expert

    Thanks everyone for all of your great questions today! Catch us every Wednesday for the live expert session.

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