Live discussion with Dr Bryony Sheaves - 15th February 2017

Dr Sheaves will be hosting a live online discussion here on Wednesday 15th February, 7.00 to 8.30pm British Standard Time or 2.00 to 3.30pm US Eastern Standard Time.

Dr Sheaves is a Research Clinical Psychologist working within the Sleep and Circadian Neuroscience Institute at the University of Oxford. Her work focuses on the association between sleep and mental health difficulties, particularly symptoms of psychosis.

Please do note that, as per our guidelines, Dr Sheaves won't be able to give personal medical advice. Her replies to questions will be made in such a way as to help as many people as possible who might have similar issues. 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.

To keep up with new comments as they are posted you will need to refresh this discussion page.

To do this

On PC hit CTRL and R keys or the F5 key
On Mac hit CMD and R

Posted 9 Feb 2017 at 1:33 PM
  • 43 comments
  • 8 helped

Comments

Show older comments
  • Sleepio Member

    • 843 comments
    • 143 helped
    in reply to Sleepio Member
    Expert

    Hi,

    It's common for the start of SR to be associated with a blip in sleep rather than immediate improvement. I think this is often related to the anxiety or a tighter sleep window.

    I tend to recommend aiming for a sleep window that is manageable to do each night consistently rather than aim for a tighter window that results in naps.

    The other aspect of this which can help to boost the effectiveness of SR is following the sleepy-tired rule and the 15 minute rule. Sleepy-tired rule means that when heading to bed there is a greater chance of sleep. The 15 min rule tends to help wind down again and actually get to sleep more quickly than lying in bed. So we usually recommend these strategies in tandem with SR.

    Good luck with this, really hope you start to see your hard work pay off soon and do check back in here if you continue to have difficulties.

  • Sleepio Member

    • 843 comments
    • 143 helped
    in reply to Sleepio Member
    Expert

    Hi,

    Good question. Many people with sleep difficulties describe the challenges of sleeping next to a bed partner.

    The Sleepio course will run through strategies for taking attention away from things that we perceive are threatening our sleep (e.g. bed partner breathing / snoring / moving). Look out for imagery and mindfulness techniques in particular in session 4.

    The other techniques in the meantime are also all aimed at increasing the chances of sleep. E.g. next week you'll run through sleep restriction and this is one of the more powerful techniques for improving sleep.

    Some find it helpful to talk through the sleep techniques with their bed partner so they understand the rationale for some of the changes that are made as part of the course. Sharing successes with the bed partner can also be helpful, so that they can celebrate those and not feel too much like the source of the sleep problem.

    Good luck with the remainder of the course.

  • Sleepio Member

    • 843 comments
    • 143 helped
    in reply to Sleepio Member
    Expert

    Hi -The broad content is available to all but the details are personalised based on information from the initial sleep test and sleep diary info.

  • Sleepio Member

    • 843 comments
    • 143 helped
    in reply to Sleepio Member
    Expert

    Hi,

    I'm afraid I'm not clear on anaesthetic as a particular trigger. Your GP would have more knowledge than me in this area.

    In general whilst there are an array of different triggers for insomnia, the sleep problem can persist even when this trigger has stopped. At this point it can be helpful to focus on what might be keeping the sleep problem going. These tend to be the patterns of thinking and the changes in the things we do. It is these that the course focuses on, to learn ways of thinking and behaving that increase the chances of sleep.

  • Sleepio Member

    • 843 comments
    • 143 helped
    in reply to Sleepio Member
    Expert

    Good question!

    Yes, light exposure decreases the further away that you are from the device. Smartphones for example are held close to the face as you mention so best avoided before bed.

    The other part of electronic devices is the content which is viewed. Whilst some content can be sleep inducing, if something makes you feel more alert (for example, for me, watching a scary film!) then this is best planned for a time other than just before bed.

  • Sleepio Member

    • 95 comments
    • 54 helped
    Graduate

    Hello Dr. Sheaves, I'm just joining in…
    I'm curious to know what criteria a person should use to rate their sleep quality. I realize this is probably entirely subjective from one person to the next. Sometimes it's hard to ascertain the difference between a “fair” or a “good” quality of sleep since SR regularly leaves one at varying degrees of “tired”, no matter how well their Sleep Efficiency pans out. Thanks for your perspective.

  • Sleepio Member

    • 843 comments
    • 143 helped
    in reply to Sleepio Member
    Expert

    Hi,

    I'm sorry to hear you've having a tough time with the sleep. I'm sure it's even more frustrating when you recall a time when you were a super sleeper.

    It sounds like you're trying to make sense of the change. I wonder if there was a particular trigger for the start of the sleep problems? Many say a period of stress / worry or some other big change. These triggers can often start a different pattern of thinking and behaving which is focused much more on sleep. This sleep focus often inadvertently decreases the chances of sleep.

    The good thing about this scenario is having a model of really good sleep to aim for. In this situation I often encourage clients to ask themselves: What were you focusing your attention on when you were sleeping well? What was your sleep pattern like? What were you doing in the day? What were you thinking about at night?

    These are often helpful pointers for things to do to get back there. And things that the course will focus on.

  • Sleepio Member

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

    Hi Ohforsomesleep,
    I've just graduated from the programme and am continuing to strive to stick to the suggested SR window. The one thing I have noticed is that I feel more in control because I now have a range of strategies to adopt in different situations. My main hurdle to a full nights sleep [-I wake 2, 3 or 4 times every night which means I rarely sleep more than 2 hours in one go] is the menopause and night sweats which has lasted for years. Just try to stick as close to the window as you feel is manageable, and try not to worry. What is good for you is what is important and the fact that others may sleep more is just a difference between you and them. I hope this helps. After all, sleep is just a deeper form of relaxation?.....

  • Sleepio Member

    • 843 comments
    • 143 helped
    in reply to Sleepio Member
    Expert

    What a good question!

    I agree the sleep quality question is very much subjective, but focused on the quality of the sleep itself rather than too much on daytime tiredness. I.e. one can sleep very well (good quality), but not for long enough (as can be the case in SR) and conversely, one can sleep poorly, but for a very long time.

    Does that make sense?

  • Sleepio Member

    • 843 comments
    • 143 helped
    in reply to Sleepio Member
    Expert

    Thanks so much for that – really helpful perspective!

  • Sleepio Member

    • 11 comments
    • 0 helped
    Graduate

    Its thanks to you and your programme. I'm really very grateful to you all.

  • Sleepio Member

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

    It was a change in career- a big mistake that I have since corrected. I used to be a lazy student who would sleep in until 11am and be back asleep by 11pm no problem. Never in my wildest dreams did I think my insomnia would last this long. It's heartbreaking but I also understand that it took 14months to get to this point and will take longer than 3 weeks to correct it. I just hope that this is not something that I will have to deal with for the rest of my life.

  • Sleepio Member

    • 153 comments
    • 67 helped
    in reply to Sleepio Member
    Graduate

    Thanks for your advice and insights, Ozzie. It is heartening to hear from someone who has gone through the course and has acquired strategies for dealing better with sleep problems

  • Sleepio Member

    • 843 comments
    • 143 helped
    in reply to Sleepio Member
    Expert

    Hi,

    As we get older our body clock gradually shifts a little earlier so this may be a natural tendency. One approach can be to shift the whole sleep window later, but very gradually. E.g. if current sleep window is 11-6 (for example) try 11:30 sleep time and see if this results in a later wake time. If it does, maintain this for a week and then try to shift the sleep onset time earlier again (don't change the wake time). If this isn't possible to bring the sleep time earlier again, it may well indicate that the optimum sleep length is reached and to sleep later it's best just to shift the whole window.

    Bit complicated but hope that makes some sense!

  • Sleepio Member

    • 843 comments
    • 143 helped
    in reply to Sleepio Member
    Expert

    The good news is that courses like Sleepio, based on CBT principles are the recommended treatment for persistent insomnia. It has helped very many people get their sleep back on track so I remain hopeful for you too. Good luck

  • Sleepio Member

    • 95 comments
    • 54 helped
    Graduate

    Yes, your reply makes sense, and I've had the experience you describe.
    Generally, I consider sleep quality 'good' if my thought processes awhile after getting up for the day are at least somewhat clear and focused, as opposed to some days where I feel mentally or emotionally muddled, sluggish, dull, etc.
    “Poor” is typically a result of feelings of restlessness and frequent awakenings, or sleeping very little or not at all. Thanks again for your input.

  • Sleepio Member

    • 843 comments
    • 143 helped
    in reply to Sleepio Member
    Expert

    Hi,

    Snoring is a really tricky problem for sleep isn't it? Have they tried practical solutions like changing sleep position? (e.g. side is often better than sleeping on back).

    Whilst the course can't change some of the environmental challenges for sleep, it can help people to return to sleep more quickly by building up a range of strategies week by week.

    Good luck and do check back in here if we can be of help with any aspects of the course

  • Sleepio Member

    • 843 comments
    • 143 helped
    in reply to Sleepio Member
    Expert

    Hi,

    Was the medication prescribed PRN (taken only when needed) by the doctor or was it for each night? I ask because some find it helpful to find out the best way medication can be optimised for sleep. I.e. best time to take it and how frequently. Many medications have effects on sleep (good or bad) so often helpful to have this conversation.

  • Sleepio Member

    • 843 comments
    • 143 helped
    in reply to Sleepio Member
    Expert

    Hi,

    I'm sorry I'm getting to this post at the end of the session as it would be helpful to hear more about what you mean by restless spells. For some this can be restless legs, jerky movements, for others it can be restlessness through anxiety about sleep and for others it can be what is detected on a health tracker device.

    If restless legs / jerks some find it worth discussing with a medical doctor or referral to a sleep clinic. If anxiety related, it may be worth recapping some of the Sleepio techniques in the library. If a sleep tracker, we usually recommend working off how you feel and perceive sleep and use these devices as a guide.

    The good news is that you have seen improvements in sleep so you have clearly been doing the right things. It's very usual to have a blip in sleep, even the very best sleepers have bad nights and it can be helpful to hold this in mind.

    I hope things get back on track for you soon.

  • Sleepio Member

    • 843 comments
    • 143 helped
    Expert

    We've reached the end for tonight. Thanks so much for your questions and comments and good luck with the Sleepio techniques tonight.

Return to top