Live discussion with Dr Bryony Sheaves - 20th January 2016

Dr Sheaves will be hosting a live online discussion here on Wednesday 20th January, 7:00-8:30pm (BST).

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.

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Posted 16 Jan 2016 at 3:20 PM
  • 17 comments
  • 1 helped

Comments

  • Sleepio Member

    • 1 comments
    • 0 helped
    Graduate

    I was referred to a sleep specialist, did a test with some equipment (not in the sleep lab) and have been diagnosed with this syndrome. The sleep MD is consulting with a respiratory specialist and promised to get back to me Tuesday. Anyone else been diagnosed with this? What are the options for treatment? I am a very healthy adult, so this is puzzling.

  • Sleepio Member

    • 6 comments
    • 0 helped
    Graduate

    Hello.
    I normally sleep well, but before BIG things I'm not able to sleep.
    It started out by not being able to sleep one night before tests, and it got worse and now I can't sleep a week before tests and not only tests but traveling, new job,etc makes me unable to sleep.
    I just finished sleepio course and it helped me(I especially liked the thought checker) but is there anything else I could try?
    I came up with an idea of doing Sleep Restriction some nights before tests.
    Is this a good idea?
    Anything other you would recommend?

  • Sleepio Member

    • 2 comments
    • 4 helped
    Session 5

    I don't have difficulty falling asleep, and my sleep efficiency is fine--about 80%. However, I don't feel rested after sleep, and I wake frequently for short periods throughout the night: usually 2-8 times for 5-10 mins each waking. This is confirmed by my Up3 sleep tracker, which tells me I usually spend 30-50 min in deep sleep and REM sleep per night, instead of the 2.5/1.5 deep/REM that is average for a woman my age.

    What can I do to encourage deep sleep? Is CBT even effective for sleep-maintenance insomnia like mine? I'm only on week 2 of the sleepio course, but I'm worried that it is not geared toward my particular brand of insomnia.

  • Sleepio Member

    • 6 comments
    • 0 helped
    Graduate

    Hi Dr. Bryony, I need advice around reducing anxiety when it comes to bed time. My heart races and head feels tight. Am familiar with progressive relaxation. I am not getting sleep. Thank you…..

  • Sleepio Member

    • 13 comments
    • 0 helped
    Graduate

    Hello Dr Sheaves. This is Week 2 for me and I've tried the Progressive Relaxation but found that I fall asleep during the audio and then wake up when it's finished as I'm not in my usual sleep position and still have the earphones in which is uncomfortable when I turn over. Last night I tried doing my own version of PR, fell asleep and was not disturbed. Is this an OK alternative? Overall, I'm sleeping better so far which is great!

  • Sleepio Member

    • 18 comments
    • 5 helped
    Graduate

    Hello, Dr. Sheaves! I feel like I am a very light sleeper, never fully entering deep sleep (hence a feeling of non-restorative sleep) and so I'm wondering what the science on this is (WHY can't the brain just go into deep sleep?) and if people can “train” or condition themselves to become a deep sleeper. Obviously, I'm hoping Sleepio will help with this (I'm in Week 2)! Also, I wake in the night several times and have the horrible “tired but wired” feeling – what accounts for this? I don't feel particularly stressed or worried or anxious, but it's like my brain won't just let me sleep despite being exhausted.
    Thank you for your time!

  • Sleepio Member

    • 478 comments
    • 81 helped
    Expert

    Good evening everyone and welcome to the live session!

    I'll be here for the next hour and a half to answer any questions you have about sleep or the sleepio course.

    Just a bit about me, I'm a clinical psychologist so am well placed to answer any questions about the psychological techniques covered in Sleepio. I fyou have particular medical queries it's best to speak to your GP / primary care physician.

    If you are logging in live, do say hello and I'll try to prioritise your post first. If not. I'll work from the top.

    Let's get started!

  • Sleepio Member

    • 478 comments
    • 81 helped
    in reply to Sleepio Member
    Expert

    Hi Jefferson,

    Not sure I'm clear about what the diagnosis is that you've been given. It sounds like it may be a respiratory difficulty during sleep, is that right?

  • Sleepio Member

    • 478 comments
    • 81 helped
    in reply to Sleepio Member
    Expert

    Hi,

    What you are describing is a really common difficulty – when we think would would value sleep the most (like before a test) this is just the time when it's more difficult to sleep. Quite frustrating!

    This is often related to the very usual anxiety that can be associated with life stressors – so it can be helpful to remember that even the very best sleepers have nights like these.

    One can also feel anxious about sleep itself. And it's easy on these nights to put a lot of pressure on sleep. Some people find it helpful to create a list of evidence of the times when these nights have occurred and the next day things have actually turned out ok. Other strategies that we may recommend are prioritising the wind down routine, putting the day to rest. Mindfulness can be helpful for distancing ourselves from thoughts (about sleep or life pressure etc) and relax the body. Heres more detail on it here:

    https://www.sleepio.com/library/article/mindfulness-putting-it-into-practice/

    I think in general any techniques that usually increase the chances of sleep are usually on these kinds of nights. So if going to bed slightly later is useful it may be one to consider.

    I'm really pleased to hear that you are usually sleeping well – this is good news and bodes well for you tackling these trickier nights.

  • Sleepio Member

    • 478 comments
    • 81 helped
    in reply to Sleepio Member
    Expert

    Hi,

    The course will certainly cover techniques which will help with anxiety at bed time. I think next week you'll cover sleep restriction and the quarter of an hour rule. The quarter of an hour rule in particular is helpful for interrupting anxious thoughts so do keep an eye out for that next week. And later in the course the thought checker will be a technique to look out for.

    The course works by introducing strategies one step at a time, each week, so I'd encourage you to take what you can from each session before building on it in the following session. It's great you're familiar with progressive muscle relaxation – has it been helpful? Are there any other evening routines that help with relaxation?

    Good luck with the rest of the course!

  • Sleepio Member

    • 478 comments
    • 81 helped
    in reply to Sleepio Member
    Expert

    Hi DaisyJuke,

    Thanks for your question. The recommended treatment for sleep maintenance difficulties is cognitive behavioural therapy for insomnia. This is the broad range of techniques which Sleepio will cover week by week.

    I think session 2 covers relaxation techniques – these can be helpful for decreasing arousal before it's time to go to sleep, which can increase the chances of staying asleep, and for that sleep being restful.

    Activity during the day and particularly exercise is associated with deep sleep. Some people find it helpful to plan in exercise and recruit some friends to help with motivation when lacking energy.

    If people think they are getting about the right amount of sleep, but that they wake feeling unrefreshed it is sometimes helpful to speak to a GP / primary care physician to check out that there isn't another reason for this.

    Lastly, whilst fitness trackers are helpful for providing an estimate of sleep onset and wake times, accurate sleep stages usually takes place with a more thorough sleep lab assessment. Some find this helpful to bear in mind when interpreting the results. The key goal for the course is to work on sleep efficiency so it's great to hear that it is 80%. I hope it keeps moving in the right direction or you.

  • Sleepio Member

    • 478 comments
    • 81 helped
    in reply to Sleepio Member
    Expert

    Hi Isabel123

    I'm so pleased to hear that your sleep is improving – excellent news. It sounds like you have found an alternative relaxation method which is working for you, which is great. Ideally we recommend that Sleepio users catch themselves before falling asleep to something (whether it be an audio or television etc) and head to bed. That way we catch ourselves when we feel sleepy tired and have the best chance of falling asleep when we are actually in bed. I think the course will cover this (the bed-sleep connection) in more detail next week.

    Good luck with the rest of the course, I hope you continue to see improvements.

  • Sleepio Member

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

    Thank you. That's helpful. Isabel

  • Sleepio Member

    • 44 comments
    • 4 helped
    Graduate

    Please explain autogenic training vs. progressive relaxation.

  • Sleepio Member

    • 478 comments
    • 81 helped
    in reply to Sleepio Member
    Expert

    Hi Silveraven,

    It sounds like what you are describing is sleep maintenance problems. The recommended help for this is cognitive behavioural therapy techniques which Sleepio will talk you through over the coming weeks.

    In terms of sleep architecture (ie. deep vs. light sleep) there are several things which can impact on it. Some medications, substances and alcohol can impact on how restorative our sleep is. There is some emerging evidence that bright light (e.g. from screens) can be associated with less restorative sleep and exercise can be helpful in the daytime (but not close to bedtime).

    In future sessions the course will talk through a technique called sleep restriction which helps people to build up sleep pressure throughout the day so that one feels very tired by bedtime and this can be particularly helpful for sleep maintenance problems.

    From the session you have just completed I think relaxation exercises were covered. These can help to decrease our arousal levels before sleep which can be helpful for reducing the chances of waking and increase the chances of a restful nights sleep.

    I wish you all the best for the rest of the course

  • Sleepio Member

    • 478 comments
    • 81 helped
    in reply to Sleepio Member
    Expert

    Hi Ronald,

    Thanks for logging in live!

    There are some library articles which I think may do a better job of explaining than me:

    This one is on autogenic training:

    https://www.sleepio.com/library/article/autogenic-training/

    And here is progressive muscle relaxation:

    https://www.sleepio.com/library/article/progressive-relaxation/

    The goal of each is the same, to help increase a feeling of calm. With this our heart rate and breathing rate often slows down and we are in a more relaxed state ready for sleep.

    With relaxation I encourage people to try out and find out which techniques they like. I don't think there are any that are particularly better or worse.

    You all probably realise this already, but just in case – you can download audios of relaxation techniques here:

    https://www.sleepio.com/casefile/downloads/

    I hope that's helpful in some way Ronald! All the best for the rest of the course.

  • Sleepio Member

    • 478 comments
    • 81 helped
    Expert

    Hi all, I think we'll end there for tonight. Wishing you all a restful night of sleep.

    Bryony

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