Live discussion with Dr Bryony Sheaves - 15th March 2017

Dr Sheaves will be hosting a live online discussion here on Wednesday 15th March, 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.

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Posted 9 Mar 2017 at 3:33 PM
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  • Sleepio Member

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    Expert

    Hi everyone,

    Firstly, I'm very sorry about us advertising the wrong time to the US Sleepio members. I'll feed this back to the team so we can ensure we're up to date with time zone changes in the future. I'll start a tiny bit early as I know you've been waiting.

    I'll work through the comments over the next hour and half, but if you're posting live – do post to say hello and I'll head to your post first.

    Let's get started!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi,

    I'm really sorry to hear that the progress has been slow and can appreciate the impact that this is having on how you feel when you have put hard work into the course.

    The changes in sleep following these techniques do vary from person to person. Usually in this situation, I'd be trying to work with the person to identify any differences between times when sleep did show some improvement versus the times when sleep has been more problematic. Essentially trying to integrate techniques which increase the chances of more better nights.

    I'd usually ask things like: did the sleep pattern differ? Was there anything happening in the daytime that could account for the difference? How were you feeling before heading to bed? Was it possible to stick to the recommended sleep window consistently? If not, what made that tough?

    I'm not sure if you're logging in live but if you are, and you feel comfortable, I wonder if you would mind considering answers to some of the above?

  • Sleepio Member

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    In reply to a deleted comment
    Expert

    Hi,

    Absolutely! By heading to bed when feeling sleepy tired (rather than before) this increases the chances of sleep. By sticking to the wake time, this ensures sleep pressure is consistently high each night.

    Thanks very much for clarifying!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi,

    Thanks for sharing your experience of this, I hope the previous reply clarifies the thinking behind the consistent morning rise time.

    I'm really pleased to hear that you found strategies that worked for you and I'm sure reassuring for others to read.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi,

    This is a really important question as I'm sure there will be many others who either prefer to stay in the same room (to avoid waking themselves further) or simply don't have access to another room to wind down in (e.g. studio apartments, hotel rooms).

    In these scenarios we recommend creating another comfy place in the bedroom (like your cushion) and doing the wind down routine there until feeling sleepy-tired, then heading back to bed. Essentially the aim is to create as much differentiation as possible between bed and wakefulness, even if in the same room.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi,

    Just looking into this further (got the sleep diary up on another tab) and not sure I'm totally understanding the question, sorry.

    Do you mean how do you calculate the answer to 'in total, how long do these awakenings last?'or is the question about how the course calculates the time spent asleep?

    If the former, the process is to add up all the awakenings that occurred throughout the night, even if in another room to wind down again (e.g. if woken 3x and the individual followed the 15 mins rule, and it took 30 mins to get back to sleep on each occasion, the answer to this question would be 90 mins).

    If the question is to do with the way the course calculates time asleep: it takes off the total time that the individual is awake for from the time spent asleep. So that the total sleep time accounts for night time awakening.

    Also just to clarify, questions 1 & 2 in the sleep diary (e.g. what time did you get into bed) are referring to the time that the person initially headed to bed at the start of the night (and not the time they returned to bed).

    I'm not sure if whether I've answered your question – if I haven't, please do let me know!

  • Sleepio Member

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    In reply to a deleted comment
    Expert

    Hi,

    Interesting question. Other people who report a similar experience often describe themselves as evening people (night owls). That means that the evening period is often when they feel at their best and is a preferred time for doing things. However the down side of getting stuck into an interesting project or reading social media is that it often leaves people feeling more awake and alert and pushes the sleep time back. And this can leave people feeling sleepy and not at their best the next day.

    I'm not sure whether the above is relevant to you as it's a bit of a leap from the information that you provided, but it just struck me that there's a chance it could be relevant.

    The good news is that the course is very well set up to help people work towards their own personal sleep goal. The techniques include thinking about the amount and timing of sleep, as well as the best activities to do before bed to promote good sleep. This includes for people who are night owls.

    On the issue of procrastination from sleep, having a clear sleep goal in mind can help. With this goal in mind, it can be easier to leave interesting or alerting activities to another time (e.g. the next day) and the investment in sleep can often make these activities more enjoyable in the daytime.

    Hope that helps

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi,

    The sleep diary is a helpful tool for the course to ensure that the sleep window is well matched to how sleep is for that individual right now. That said, we never want to be doing things which are getting in the way of good sleep!

    A general recommendation is to complete the sleep diary the following morning, and only put in estimates of times. Exact times aren't necessary for the course and as you say, watching the clock can be very unhelpful for promoting sleep!

  • Sleepio Member

    • 122 comments
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    Graduate

    Thanks for clarifying Dr Sheaves. I got the bit about changing the wake up time wrong-- but I'm sleeping very well in spite of this. Sleepio is working for me --still having the odd blips, more I'm confident that I can over come them- thanks
    Megwich

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi,

    Good question – deeper sleep typically occurs earlier on in the sleep period. So if the start of the sleep period is later, the deep sleep isn't skipped.

    In fact this deep sleep can change according to what our body needs, for example there is some evidence that very vigorous exercise in the daytime can increase the amount of deep sleep someone gets that night.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi,

    That's so great to hear and I'm sure a real product of the hard work you've put into improving your sleep. Congrats on the progress!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi,

    I'm not sure how common this specific issue is, however we do know that many (if not most) people with sleep difficulty describe differences in their sleep across nights. The reason for this can be different, for example for some it can be that they tend to feel more anxious on a particular day of the week, or it could be that they sleep in on a particular day of the week which knocks the sleep the following night.

    The course is designed to help overcome these. For example, it will help to promote a consistent sleep pattern across the week and target other factors which can increase the chances of waking early (for example worries about sleep before bed).

    I see you're on session 2 so have much of the course and these techniques still to come. If you have any further questions as you work your way through do feel free to post back here.

  • Sleepio Member

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    Graduate

    Thank you Dr Sheaves, That's very helpful and reassuring to know that my opportunity for deep sleep is not completely lost that night even if I don't fall asleep until later. It takes the pressure off a bit, Doodle.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi,

    Thanks for your question.

    I'm just wondering what you're using to complete the sleep diary – are you filling it in yourself or using your tracker? The Prof will use the sleep diary info to recommend any extension to the sleep window.

    In general we prioritise estimates of sleep times from what the client reports. Sleep trackers can be very helpful to supplement this info, but aren't 'objective' measures of sleep. This is because the accuracy of trackers vary- some are better than others. For example those that are worn on the wrist tend to be more accurate than an andriod/iOS app. But even wrist worn ones can make mistakes. This is because a key source of data they use to estimate sleep is movement. We know we can move in our sleep and also be very still when awake so they can only ever be an estimate.

    I'm not sure what happens if a Sleepio user sticks to the current sleep window (and continues to complete the sleep diary info) when the course recommends an extension, but I can message the other experts to see if I can get an answer for you.

    I'll do that now and post back when I have a reply. This may be a day or two.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi,

    Pleased to hear that. Good luck with the rest of the course and do post back if you have any further questions.

  • Sleepio Member

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    Expert

    We've come to the end of the session this evening. Thank you all for your questions and comments and good luck with the sleep tonight.

    Best wishes,

    Bryony

  • Sleepio Member

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    Graduate

    Thank you for your help. Night Night.

  • Sleepio Member

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    Graduate

    Thank you Dr Sheaves. My Fitbit syncs to Sleepio but I also fill the diary in myself because initially it did not seem accurate as it counted no movement as time asleep. However with SR its total sleep time,which takes account of restless periods, corresponds better to my estimate.

  • Sleepio Member

    • 7 comments
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    in reply to Sleepio Member
    Graduate

    Hi,

    Thanks for following up on this!

    I was under the impression that time spent outside the bed isn't counted towards the sleep efficiency number.

    If I spend an hour outside the bedroom in the middle of the night (because I woke up, couldn't fall back to sleep, and then left the bed), that this time should not be included in the efficiency calculation. If that's correct, how do we account in the diary for that hour?

    If I'm incorrect about this, then I think my question is moot. :)

    Thank you!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi,

    Just replying following an email to the other experts, as promised. The sleep restriction window is increased when a Sleepio user reaches 90% sleep efficiency (ie. the majority of time spent in bed is asleep). At the moment from the data you provided in your post, you are just shy of this so if this is taken from your sleep diary, the Prof shouldn't recommend an increase in sleep window just yet.

    That said, if and when he does, if you don't feel ready for the next step you should just be able to continue with the current window. The sleep diary is the key tool for keeping the course up to date with the current sleep pattern so if Sleepio users choose not to increase the window it can be helpful to keep going with the diary so that the course knows what is happening.

    Hope that helps

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