Live Discussion with Dr Bryony Sheaves - 25th March

Dr Sheaves will be hosting a live online discussion here on Wednesday 25th March, 7:00-8:30pm (GMT).

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.

She will discuss as many topics as possible in the hour and a half, starting with the most popular questions with answers being given in a way to give the most benefit to the general Community.

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Posted 20 Mar 2015 at 10:38 AM
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  • Sleepio Member

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    Expert

    Evening all and welcome to the session this evening. I'll be here to answer any questions over the next hour and a half. I tend to start at the top and work my way through but also check if people are posting live so we can keep the discussion interesting.

    Please do post away if you have a burning question. It might be worth bearing in mind that I'm a clinical psychologist. I'm not a medical doctor so if you have any medication queries it's best to speak to your GP / primary care physician.

    Let's get started….

  • Sleepio Member

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    Expert

    biddyp – what a good question!

    I think I'm right in saying that the clocks go forward so we lose an hour. It's difficult to say what everyone should do across the board.

    A 'good sleeper' would often take the hours sleep loss. This is totally fine and an option.

    You might want to try adding half an hour at the start of the evening an half an hour at the end of your usual sleep times. However, do remember, if you can't fall asleep within 15-20 mins do get up and wait until you feel sleepy tired to return to bed.

    If you wanted to keep your sleep drive high, to keep your chances of falling asleep as high as possible you might want to add on less time than this.

    Just remember, this is happening for everyone and it can take a little while to adjust so be patient.

  • Sleepio Member

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    Hi biddyp again!

    It sounds like it's tough getting up at 5:30 and you end up waking up earlier but then dozing past your wake up time. This is quite common!

    I think it's a question of quality over quantity, to start off with at least. It might be better to work really hard to get up at 5:30 (set 2 alarms, plan a nice rise routine – maybe a nice breakfast, opening the curtains). This will be tough the first day, but the idea is that you are building up sleep pressure so that the night after you will have more chance of sleeping slightly longer and getting into a good pattern.

    If you are consistently waking up at 5:00 you might want to start trying to get up at that time, until you feel like you are sleeping through and then gradually increase by perhaps 15 mins at a time.

    In terms of your sleep diary – you probably want to try and reflect the fact that you aren't asleep for the whole time by putting this into the 'how long did these awakenings last' question – add up the little chunks of time. Of course it'll be an estimate but will capture it in some way.

    Good luck with it!

  • Sleepio Member

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    Expert

    Hi Doonies – I think I've answered the sleep diary part in my previous post. You probably want to try and estimate it in some way for the sleep diary. The prof will then suggest a sleep window that takes this into account. Once you are getting more consolidated sleep you would gradually increase your sleep window.

    Hope that's helpful – it seems like dozing is something that many people are connecting with tonight.

  • Sleepio Member

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    Graduate

    Thanks for those helpful comments. I'm assuming you mean quality of sleep is more important than quantity of sleep – and sleep quality relates to how broken or uninterrupted the sleep is? I've been on the 11.30 – 5.30 SW for a couple of weeks now, and I assume that I shouldn't increase until I get 90% or more SE. Would you agree? Thanks again

  • Sleepio Member

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    Hi creakingbrain,

    Firstly it's great to hear that you are quelling the thoughts that come to mind – great progress!

    The 90 minute waking reflects the end of a sleep cycle, when you enter rapid eye movement sleep (REM – when most dreaming occurs) and many people wake – thought most aren't aware of it. Waking also becomes more frequent with age – so you aren't alone there.

    Are you trying the relaxation and putting the day to rest? They can be helpful for particularly intense dreams. In terms of acting out your dreams, if this is concerning to you, or is ever dangerous in any way, you might want to speak to your GP / primary care physician to see if there is anything more they could offer to treat this. Some medications for example can impact on REM sleep.

    Keep going with the sleepio techniques too as they go hand in hand. Good luck.

  • Sleepio Member

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    Hi biddyp,

    Yes sorry I probably wasn't being v clear – Ideally you'd want to aim for more consolidated sleep (rather than dozing) before increasing your sleep window. And you're right, the way we measure this is using the SE – which comes from the sleep diary info. This is why it might be helpful to capture the dozing in some way. I wouldn't worry that you have had the same sleep window for a few weeks, I always think it's better to consolidate each step well before taking the next one.

  • Sleepio Member

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    Graduate

    Thank you for your advice. It's quite difficult to do relaxation – or even sit in an armchair – in the evening because I have to guard against falling asleep accidentally. I do it in the night though. Maybe writing a diary would be a good idea to tidy up the day's events in my mind.

  • Sleepio Member

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    Hi SleepyLee,

    I'm going to answer both of your posts together. It sounds like in general you are monitoring your sleep quite a bit. Of course this is natural, when we aren't sleeping well we're concerned about it! However this concern tends to keep the problem going – it makes us feel anxious, which stops us sleeping. So in a way I'd suggest trying to be less aware of whether you are awake or asleep (rather than more). This might make the sleep diary tricky to fill in but it's just an estimate.

    Have you been trying the wind down routine? That might be particularly helpful to prioritise on those days before big events. And coming up in the course will be more techniques for managing those worries about sleep which can pop up, particularly before a big day.

    Sounds like you are making progress by limiting the time in bed. Keep going and you should see things continue to improve.

  • Sleepio Member

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    Expert

    Hi lew,

    Have you found anything for your wind down routine that helps with this? Some people say reading can be helpful to gradually wind the mind down ready for sleep for example, or writing a diary. I think it's about trying a few things out, give each a good chance and see what works for you.

    Session 4 also has many tips for dealing with thoughts (e.g mindfulness, imagery) so you might want to revisit this in the library. You might also be interested in this article by Professor Espie:

    https://www.sleepio.com/library/article/heightened-awareness-thoughts/

    Hope that's helpful in some way

  • Sleepio Member

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    Hi Tiffyshea,

    It sounds like you have some good strategies for dealing with any thoughts that pop up. It sounds like it isn't necessarily your thoughts keeping you awake, it's just that you aren't quite tired enough for sleep! So maybe the more behavioural tips might be best right now – making sure you follow a good wind down routine so your body slowly becomes less aroused ready for sleep, making sure you go to bed only when feeling sleepy tired and following the 15 minute rule for example. Have you tried these?

  • Sleepio Member

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    Hi SV,

    There are various questionnaires which can give you a gauge on this, for example the Munich chronotype question (available online).

    In general if this is a difficulty we would recommend very gradually shifting the clock, 15 minutes at a time and some people use timed light therapy, but you might want some more specialist advice so do speak to your doctor.

    It can be difficult to unpick insomnia and shifted body clocks so I'd recommend taking a scientific approach – try working through the course to improve the insomnia first. Hopefully your pattern will be helped too but if you continue to have difficulties speak to your doctor about your sleep timings.

  • Sleepio Member

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    Session 5

    Hi Dr Sheaves. At times when I'm generally worried or have low mood, I tend to fall asleep very easily, sleep in a block of 4 hours and then wake up totally alert and unable to fall back to sleep. Even if I try to wind down again at 4am, or do relaxation exercises, my body seems to be too wired to stick to anything. There are no worrysome thoughts in my mind, I just feel unable to calm down or relax physiologically. I end up unable to get drowsy again for a good 2-3 hours, if at all. (By then the alarm clock is about to go off.)
    Any tips for this?
    thank you

  • Sleepio Member

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    Hi FakeName228

    I'm pleased to hear that you are having some nights when you are sleeping through. On those nights when you are struggling to fall asleep, sleeping on the sofa (and within the times of your sleep window) is ok. But in general you want to be working towards improving your bed sleep connection, which does mean going back to bed. I'd keep the sofa as place where you are awake or winding down, and try to catch yourself where possible when you are just feeling like you might nod off, then head back to bed, if you can manage it.

  • Sleepio Member

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    Hi Paulav,

    I'm not entirely sure on the exact number of hours but we do sleep in cycles of 90 minutes. We get most of our deep sleep at the start of the night (in the first 90 mins) and then get less and less as the night goes on. We tend to get more REM sleep later in the night. Hope that's helpful in some way!

  • Sleepio Member

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    creakingbrain – what an excellent problem to have – a difficulty staying awake through relaxation! Think you've found yourself a good strategy there! :)

  • Sleepio Member

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    Hi Katsura

    I see you're on your first session so welcome to the course! The course will run through many strategies that will be helpful for early waking. Too many for me to do justice to here. What's great is that you already have a firm foundation with your relaxation and wind down strategies.

    I'd recommend taking a step by step approach, take what you can from each session and give it a go. Then you can build on it in the following weeks.

    Good luck!

  • Sleepio Member

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    Expert

    Hi all – time to say good bye for now. Thank you all for sharing your questions!

    Bryony

  • Sleepio Member

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    Graduate

    Thank you Dr Sheaves; I'll check out the article lew

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hello Katsura,
    Welcome to the Sleepio course. I just finished session 4 and already I have learned many things that are helping me sleep better. I hope as you go through each session, your sleep will improve also.
    One thing I noticed was that I was taking my multivitamin at dinner time. It has lots of B complex vitamins in it, which give you energy. I started taking it with lunch instead and found it boosted my energy mid-afternoon instead of the evening when I was trying to wind down. I slept more soundly after that. Just something to consider.
    KellyB

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