Live discussion with Dr Adrienne Heinz - 7th February 2018

Dr Heinz will be hosting a live online discussion here on Wednesday 7th February, from 8:00pm to 9:30pm British Standard Time or 3:00pm to 4:30pm US Eastern Standard 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 1 Feb 2018 at 12:42 PM
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  • Sleepio Member

    • 6 comments
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    Session 2

    Any tips for improving sleep quality? Even when I get 7-8 hours, I'm exhausted every day. Temperature, light, sound, exercise, sleeping medications, meditation, mattress and pillow… I've tried changing all of them to no avail in the last few months. I even bought a weighted blanket, tried taking valerian root and melatonin.

  • Sleepio Member

    • 1 comments
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    Graduate

    The problem I have with the program is when doing sleeprestriction I feel in sleep when sitting in the evening and watching TV. At that moment it's hard to stay awake. I supose this has a bad influence at my sleep during the night. Do you have any tips for dealing with this problem?

  • Sleepio Member

    • 4 comments
    • 1 helped
    Graduate

    I am sticking to the program, going to bed at the same time, getting up at the same time, not napping yet I still wake up at about the same time and am awake for up to 2 hours. I've tried the various techniques for drifting off and find when I use them just as I'm about to my mind says “ah, you are about to sleep” and it wakes me up. Do you have guidance on what to do…?

  • Sleepio Member

    • 5 comments
    • 1 helped
    Graduate

    Hello;
    I am a Sleepio graduate. My sleeping improved following the program but deteriorated in the last few months. I think menopausal symptoms play a major role in sleeplessness but I am also having trouble le getting out of bed when I can't sleep. I generally have an inability to fully relax and drift off to sleep. My body feels switched on. I think I will sleep again when menopause symptoms run their course but in the meantime it is discouraging. Any comments? Thanks!
    Joan

  • Sleepio Member

    • 20 comments
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    Graduate

    Only just started sleep restriction. I find it very very hard & had to adapt it to make it more bearable. Is doing this better than not doing it?

  • Sleepio Member

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

    It's sounds like you're working diligently to make changes and I applaud all your efforts. Non-restorative sleep is an issue with sleep quality, which CBT has been shown in clinical trials to help too. Although it is less clear with this type of sleep problem exactly which elements are important, I would work on the bedtime routine being consistent, the use of relaxation before bed, consistent bed and rise times and also making sure things such as caffeine are eliminated. Any underlying mental health struggles should also be considered (anxiety/low mood/high stress) as these can also affect sleep quality. Hope this helps. The more elements you test, the better sense you'll have of what works best for optimizing your sleep.

  • Sleepio Member

    • 139 comments
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    in reply to Sleepio Member
    Expert

    Hi Joan, Menopause is a time when our body rhythms can be disrupted leaving us feeling perplexed, frustrated, and anxious. Check out our library page for more information about the biological changes that occur in menopause, how they affect sleep, and helpful tips to address hormonally induced sleep problems. https://www.sleepio.com/library/article/menopause-and-sleep-problems/

    When lying in bed feeling keyed up – you might try to disconnect from your thoughts by using visual imagery of a place that comforts you or doing a non-stimulating activity that turns the volume down on your mind. Some individuals report that holding a pet or physically touching a bed partner can also be soothing – using tactile sensations to remove us from our mind. Hope this helps.

  • Sleepio Member

    • 139 comments
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    in reply to Sleepio Member
    Expert

    Sleep restriction requires changing entrenched behaviors. When changing these behaviors and patterns, it takes a variable length of time to be effective – it varies from person to person and can even vary within the same person at different times in their life. It is worth sticking with it, though, as it often takes longer than a couple of weeks to get used to a different pattern. Eventually your body will recalibrate. Hope this helps.

  • Sleepio Member

    • 139 comments
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    in reply to Sleepio Member
    Expert

    This is a very common struggle with sleep restriction, and especially in the beginning. Consider engaging in more active activities such as walking, cleaning, communicating with friends or family, completing puzzles, games, and trivia. Activities that keep you mind engaged (versus passive activities like watching TV) tend to be most helpful in this regard.

  • Sleepio Member

    • 139 comments
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    in reply to Sleepio Member
    Expert

    That sounds frustrating! It's clear you've put a lot of work into improving your sleep. We know that sleep cycles tend to last roughly about 90 mins, so it may be that this wakening is occurring at the end of one of these, when sleep gets a bit lighter. It is common to wake a few times a night (good sleepers do this). However, we recommend getting out of bed after 15 mins of not being able to sleep and only going back to bed once sleepy again. Sometimes it takes a while to get back to sleep and that's okay. But this is also why the activities we do during this time are important. Don't do things that keep you stimulated/too interested – do things that relax, calm, and comfort you.

    Another idea for turning the volume down on your mind is to try exercises that involve detaching from your thoughts. For example, you might try placing anxious thoughts on a leaf and then watching it float down an imaginary stream. Or placing it onto a train car and watching it leave the train depot. The goal is to notice and observe the thought rather than judge or react to it.

  • Sleepio Member

    • 139 comments
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    in reply to Sleepio Member
    Expert

    This is a really important and common concern. As you know, we are not able to provide individual medical advice so we always encourage you to speak with your doctor about changes to you medication.

    Some doctors will instruct patients to titrate/reduce the dose over the course of a few days. During that time, they may suggest using supplements such as melatonin to help facilitate the transition. https://www.sleepio.com/library/article/what-is-melatonin/
    After a prolonged period of sleep medication use, the psychological expectations one holds for the medication are useful to examine. Using the thought changer tool – consider exploring and testing thoughts about what will happen if you elect to stop using medication.

    Also visit our library for more information on sleep meds. https://www.sleepio.com/library/article/sleep-aids/

  • Sleepio Member

    • 20 comments
    • 5 helped
    in reply to Sleepio Member
    Graduate

    Thank you for your reply. I have allowed myself an extra hour in bed. I know it’s against the rules, but is it better than no sleep restriction?

  • Sleepio Member

    • 13 comments
    • 2 helped
    Graduate

    I’ve been a graduate to the programme for over 4 months. Unfortunately my sleep is not as I’d hoped at this stage. I’ve been wakening at 5am… after 5 hrs sleep using SR. I’ve been permitted 7hrs in bed following the programme. Occasionally I do fall over again… on the occasions I don’t the day ahead becomes very hard. Any tips to increase the 5 hr sleep would be very welcome

  • Sleepio Member

    • 139 comments
    • 25 helped
    Expert

    Hello Everyone,

    Dr Adrienne Heinz here. I'm looking forward to your questions today!

  • Sleepio Member

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

    Sticking to sleep restriction is challenging to say the least. Do your best to stay true to the commitment. Of course, if you are sick are find yourself so tired it jeopardizes safety (while driving or caring for children) certainly extend your window to accommodate your sleep needs. Many members of the community face the same struggle with the sleep restriction and I encourage you to visit threads on this matter for further ideas and support. If you think you need to shift your sleep window you can find instructions for doing so here: https://www.sleepio.com/library/article/how-to-shift-your-sleep-window/

  • Sleepio Member

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

    Congrats on finishing the program and sticking with the techniques. It’s quite common for our sleep to ebb and flow depending on a constellation of different factors. If you tend to be a morning “owl” chronotype (https://www.sleepio.com/library/article/do-you-really-get-people-who-are-owls-and-others-w/) perhaps shifting your bedtime earlier might help. If you are struggling with feeling sleepy in the day on those 5 hour nights, exercise can be beneficial. Specifically, it can help increase sleep pressure and improve mental health conditions (stress) that may exacerbate poor sleep. https://www.sleepio.com/library/article/i-feel-sleepy-during-the-day/

  • Sleepio Member

    • 13 comments
    • 2 helped
    Graduate

    thank you…. I've always been an active person so have continued to exercise as best i can. Tiredness stops me occasionally…. but i do try most days to do something . is it ok to exercise when sleep levels are as described (5hrs) or should i just listed to the body telling me when to take break

  • Sleepio Member

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

    That's great you're staying active. Of course always listen to your body first, but consistent sleep is often born of consistent routine. If exercise is part of your daily schedule – try your best to honor that. On days we're you're feeling lower energy, consider modifying your exercise and doing something lower impact.

  • Sleepio Member

    • 13 comments
    • 2 helped
    Graduate

    Thank you for the reassurance Dr

  • Sleepio Member

    • 139 comments
    • 25 helped
    Expert

    Thanks for all the great questions today folks! Take good care and we'll catch you back here next week.

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