Live discussion with Dr Adrienne Heinz - 9th May 2018

Dr Heinz will be hosting a live online discussion here on Wednesday 9th May, 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 3 May 2018 at 5:36 PM
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  • Sleepio Member

    • 139 comments
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    Graduate

    Hi Everyone, This is Dr. Adrienne Heinz here. I'm a clinical and research psychologist and I look forward to answering your questions today!

  • Sleepio Member

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    In reply to a deleted comment
    Graduate

    Poor and unrefreshing sleep can be very disruptive to quality of life and can make meeting role obligations quite difficult. Please see these library entries for tips on how to extend your window of quality sleep. Also CBTi strategies such as sleep restriction are well-suited to address the problem of excessive time awake at night.
    https://www.sleepio.com/articles/sleep-tips/how-to-get-a-good-nights-sleep/
    https://www.sleepio.com/articles/sleep-tips/staying-asleep-during-the-night/

    Finally, here is a community discussion on Tiredness Headaches: https://www.sleepio.com/community/discussion/dealing-with-tiredness-headaches/

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    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.
    Headaches and migraines are majorly disruptive and can impede on quality of life. It’s best to first consult with your doctor about treatment options. See also these community discussion for support and advice for peers who have struggled with similar issues. Tiredness Headaches: https://www.sleepio.com/community/discussion/dealing-with-tiredness-headaches/ Sleepio and Migraines: https://www.sleepio.com/community/discussion/migraine-and-sleepio/

  • Sleepio Member

    • 139 comments
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    in reply to Sleepio Member
    Graduate

    Our phones have become an extension of us and this habit is not uncommon! It is recommended that you stop using devices and hour before bed. As phone checking can be somewhat of an automatic behavior, a helpful strategy can be to plug the phone in on the opposite side of the room where it is out of reach.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    The short answer is yes. Although the urge to nap is powerful, resisting is critical for building sleep pressure (and especially during sleep restriction). Napping results in a reduction in the sleep drive which is necessary to facilitate the onset and maintenance of sleep. Here is a library entry that provides more information about behaviors that promote healthy sleep https://www.sleepio.com/library/article/what-should-i-be-doing-during-the-day-to-promote-h/

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    I just started that a few months ago and it's helped me a lot. I take 350mg about an hour before bed.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Struggling with sleep and nursing a baby through the night can be extremely HARD. Check out this community message board for support and advice from parents going through similar situations.. https://www.sleepio.com/community/discussion/new-parents-with-troubled-sleep/ also this guide has several pieces of relevant information about navigating sleep as a parent of young children. https://www.sleepio.com/articles/parent-sleep/ Regarding recording your sleep and wakings, the important thing is to be consistent. So if you record wakings and sleep one evening, record it the same way the next. You can also use tags on the night to note the awakening was due to feedings. Another modification you might entertain is to extend your normal sleep window to include or account for the time you would have been sleeping had you not been waking for your baby. Hang in there and note that it can be helpful to practice self-compassion when navigating transitions such as returning to work.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    That is super frustrating to hang out in bed but without escape to sleep. We recommend sticking to the quarter hour rule. If you find yourself fully awake for more than 15 minutes, get up, go do something non-stimulating/relaxing, and don’t return to bed until you feel sleepy. It’s tough but by doing this, you are breaking the conditioned association between the bed being a place that provokes and anxiety and frustration – and instead reconnecting it with the act of and satisfaction of sleep.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Really great question as sticking to the anchor time can be difficult. Perhaps consider finding an accountability partner to help you with the waking. This could be someone in your home, or a friend or family member who could call you, or you could offer to walk or care for a pet. Other options might be to have a reward waiting for when you wake up such as a desirable breakfast or enjoyable activity. Keep on aiming for the anchor time and as you say, the results of the sleep restriction may become more satisfying.

  • Sleepio Member

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

    If you suspect you’re deficient in magnesium or want to take magnesium supplements to support sleep, talk to your doctor first. Magnesium can adversely interact with other drugs, and taking excessive amounts in the form of supplements can cause stomach cramps, diarrhea and nausea. Magnesium deficiency has been associated with higher levels of stress, anxiety and difficulty relaxing, which are critical for sleep.

  • Sleepio Member

    • 139 comments
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    in reply to Sleepio Member
    Graduate

    Partner snoring can be incredibly anxiety-provoking and especially when one is already struggling with sleep. This technique is helpful for some individuals and less so for others. If the snoring is particularly disruptive it might be best to sleep separately from your partner during the program (if possible) and then returning the bed when sleep is more consistent and reliable. Check out these library entries for more guidance on bed-sharing. https://www.sleepio.com/library/article/poor-sleepers-impact-on-their-bed-partners/ and options to address snoring https://www.sleepio.com/library/article/snoring/
    and here is a community discussion about problems that arise when sleeping with a bed partner https://www.sleepio.com/community/discussion/sleeping-with-your-bed-partner/

  • Sleepio Member

    • 139 comments
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    in reply to Sleepio Member
    Graduate

    It can be incredibly frustrating to not feel refreshed after a night in bed. Keep in mind that stress can contribute to fatigue so consider how other lifestyle factors and circumstance may be affecting your stress level. Check out these library entries for more information and tips for managing daytime sleepiness. https://www.sleepio.com/library/article/i-feel-sleepy-during-the-day/
    https://www.sleepio.com/library/article/what-accounts-for-unrefreshing-sleep-/

  • Sleepio Member

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

    Great question. Although the urge to nap during sleep restriction is powerful, resisting is critical for building sleep pressure. Napping results in a reduction in the sleep drive which is necessary to facilitate the onset and maintenance of sleep. Here is a library entry that provides more information about behaviors that promote healthy sleep https://www.sleepio.com/library/article/what-should-i-be-doing-during-the-day-to-promote-h/

  • Sleepio Member

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

    Changes in temperature can be uncomfortable and disruptive to sleep. If you believe these temperature shifts to be hormonally its best to consult with doctor for treatment options. Check out our library entry for more tips on temperature regulation
    https://www.sleepio.com/library/article/getting-the-right-temperature-for-sleep/
    https://www.sleepio.com/library/article/the-importance-of-the-sleeping-environment/

  • Sleepio Member

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

    Thanks for reaching out about how best to customize the Sleepio program to your needs. The sleep restriction component can be difficult to incorporate however data from the literature suggests it is one of the most effective evidence-based means for improving sleep. It’s recommended that you stick to the routine with fidelity until you see reliable and consistent improvements in your sleep. Once that change is realized, you can then start to make gradual changes to your routine that feel right for you. It can be helpful to think of the sleep restriction as an experiment where you try something radically different, collect data over time, evaluate/analyze, and draw conclusions. However, if sleep restriction is potentially dangerous in your particular situation (falling asleep while driving, caring for young children, etc) – it is recommended you make adjustments accordingly.

  • Sleepio Member

    • 2 comments
    • 0 helped
    Graduate

    Hi, I've been recovering from a concussion for the past year and am finally up to about 6 hours per night of sleep. Recently, my last few hours of sleep have felt like I was wide awake (I swear I'm just lying there frustrated), even though I can prove I wasn't after looking at my clock or recalling a dream. It's the weirdest feeling and it leaves me exhausted when I do finally get up. Any idea what this is?

  • Sleepio Member

    • 139 comments
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    in reply to Sleepio Member
    Graduate

    Given your history of head injury it might also be helpful to consult with your doctor on this matter. Regarding your perception of sleeplessness, this is not uncommon and you can learn more in the library entry https://www.sleepio.com/library/article/can-you-think-youre-awake-when-actually-youre-asle/

  • Sleepio Member

    • 139 comments
    • 25 helped
    Graduate

    Thanks everyone for a great discussion – until next time!

  • Sleepio Member

    • 11 comments
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    in reply to Sleepio Member
    Graduate

    I've heard of studies indicating that short naps earlier in the day don't reduce sleep pressure. Is that the case?

  • Sleepio Member

    • 139 comments
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    Graduate

    Thanks for following up. It would depend on the population being studied (elderly adults, children, healthy sleepers, individuals with insomnia). Individuals who struggle with sleep likely do not benefit from naps when completing a sleep restriction intervention.

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