Live Discussion with Dr Bryony Sheaves - 2nd December 2015

Dr Sheaves will be hosting a live online discussion here on Wednesday 2nd December, 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 26 Nov 2015 at 1:00 PM
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  • Sleepio Member

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

    I have posted twice, are you able to see them? My question has to do with my sleep restricted window.
    Thank-you

  • Sleepio Member

    • 478 comments
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    in reply to Sleepio Member
    Expert

    HI DebG – will get to your question now!

  • Sleepio Member

    • 11 comments
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    in reply to Sleepio Member
    Graduate

    ok, thanks. I have not posted before and wasn't seeing any responses to any posts, so not sure if there was a problem

  • Sleepio Member

    • 478 comments
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    in reply to Sleepio Member
    Expert

    Hi DebG

    Sorry for the slower response – if I've started writing a response I don't see others until I click 'add'.

    The Sleep Window is set up by the course based on the sleep times from the initial sleep test and from subsequent sleep diaries. It also takes into account some other information about health status, for example if someone rates their mental health low, then their sleep window is less restricted.

    For those who have an up to date sleep diary, sleep efficiency is currently still low and there are no other health concerns, lowering the sleep window may be beneficial. There is a library article here with more information:

    https://www.sleepio.com/library/article/how-to-shift-your-sleep-window/

    Good luck with the SR and do link in with the rest of the community for support during this part of the course if it would be helpful.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Thanks. I will check out the article.

  • Sleepio Member

    • 478 comments
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    in reply to Sleepio Member
    Expert

    Hi jevesha,

    Micro-sleeps refer to very brief periods of sleep which can be experienced during monotonous or relaxing activities and particularly when sleep deprived. The example of watching a film is very common, or whilst on public transport, and you are right that this can also occur during driving. People usually wake up with an awareness that they have had a brief sleep episode (e.g. by not remembering recent events or the plot of the film) so it would be unusual to not have any awareness that one has been asleep.

    Being vigilant to the effects of sleep deprivation whilst driving, as you describe, is sensible. This can be by taking regular breaks during a journey, avoiding driving at times when prone to feeling very tired (e.g. late at night, or very early in the morning) and pulling over when first notice the feeling of sleepiness (e.g. heavy eyes, yawning, weak / achy muscles).

    Or, if Sleepio users feel dangerously tired, particularly during sleep restriction, we would recommend taking a short nap (20 minutes) earlier in the day (before 3pm). This means that sleep pressure has time to build before bed so it shouldn't disrupt sleep later that night.

    Hope that answers the question in some way jevesha.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    thanks, that's very helpful. had been avoiding any napping during the day, but your tip about napping briefly before 3pm if really pushed is helpful. probably just knowing that I could do that as a last resort will see me through.

  • Sleepio Member

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    Graduate

    I'm going offline now; thanks again for your help

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi leo9,

    What you are describing is very common, even for the very best sleeper. There will always be times when our sleep is challenged so do bear in mind that it is really encouraging to hear that on the whole your sleep is better and this is very normal.

    The logical approach of CBT and the thought checker is a good approach – great to hear you've been giving this a go. For this it's important to be specific about the exact thought/fear that drives the 'sleep panic' – is it related to something happening the next day? Or the effects of not sleeping? Or related to a rule you have about your sleep? And then accumulate evidence for an alternative thought that is more helpful and balanced. Coming up with a new motto based on this, something catchy or even amusing, that one can remind themselves at night can be helpful.

    Another approach is mindfulness (in the library under session 4: https://www.sleepio.com/library/area/session4/).

    This is an approach within which we simply notice and accept where our mind has gone (and simply know that this is what the mind does), and gently bring it back to where we would prefer it to be. There are a couple of articles and a 'watch again' video in the library that may be helpful.

    There is evidence that adding mindfulness, or more of the 'thought checker' strategies can result in larger sleep gains, than relying on the other techniques alone.

    Hope that's helpful in some way – good luck with this and well done again on the gains you've already made!

  • Sleepio Member

    • 478 comments
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    in reply to Sleepio Member
    Expert

    Great – thanks for the question jevesha!

  • Sleepio Member

    • 24 comments
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    Graduate

    Hello. I'm at the end of week 5 and my window is 5hrs 15mins. However i'm worried that I filled my diary wrong during the first two weeks of the programme, because i struggled to recognise when i was sleeping and when i wasn't. And so i think i understated the amount of sleep i was getting in weeks 1 and 2, and as a result i have been given too small a window.
    I now know that I often sleep when I think I don't as I've been using a sleep relaxation app for the last couple of weeks and I realise that I never heard the end of it but I was sure I wasn't sleeping just a moment ago. Does it make sense? I was wearing fitbit in the first 2 weeks and didn't even believe the calculation made by fitbit so I still filled in the diary manually. I've looked at my fitbit records from the first two weeks today and realise that my average sleep was 6-6.5 hours. Should my sleep window be 5 hr 15 min? I'm not coping with the window, often oversleep and feel guilty when I do. I can fall asleep easily now, but i wake up 3-5 times a night, and i can still fall back to sleep within 5-10 mins.
    Thanks a lot

  • Sleepio Member

    • 478 comments
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    Expert

    Alicia,

    This all sounds like great progress – well done on the work you've been putting in to achieve this – I know SR can be hard going.

    You have highlighted an important point – it can be difficult to estimate sleep times! And sometimes using multiple sources can be helpful. Bear in mind that fitness trackers infer sleep using movement and sometimes combined with heart rate), so they too are an estimate, just as we are in our own judgements.

    The key bit of info that's helpful in determining the sleep window is the sleep efficiency calculation over the past week. Getting to sleep quickly, getting back to sleep quickly and getting up upon awakening all result in a better sleep efficiency. If sleep efficiency is good and one is struggling to stay awake to manage the window it may be helpful to increase the sleep window. In CBT courses (like Sleepio) we recommend doing this gradually, e.g. by 15 minutes at a time. It can be helpful to gauge what increase would be best by considering what can be managed consistently each night, without a large reduction in sleep efficiency.

    And here's the article I posted earlier about shifting the sleep window in Sleepio:

    https://www.sleepio.com/library/article/how-to-shift-your-sleep-window/

    Good luck with the rest of SR.

  • Sleepio Member

    • 9 comments
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    in reply to Sleepio Member
    Graduate

    Many thanks for the advice and encouragement – I had forgotten about mindfulness (ironically) so will give it another try.

    Re: the 'sleep panic', I can go from a minor worry about not sleeping to a major panic within 20 minutes or so. By that time, it's impossible to sleep for several hours, if at all, and leaves me in a pretty bad state. I will try being more specific about the thought/fear and hope that will help.

  • Sleepio Member

    • 24 comments
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    in reply to Sleepio Member
    Graduate

    Thank you so much. It looks like my sleep efficiency last night was 91% in 6 hour window and in the previous 3 nights also 91% in 6.5 hour window. Does it mean my window can be 6.5 hours?

  • Sleepio Member

    • 478 comments
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    in reply to Sleepio Member
    Expert

    Hi leo9

    It may be that what you are describing is a worry style of thinking, whereby one thought can lead to another more troubling thought and we can very quickly get to a very upsetting place. Worry is very often more challenging to manage at night because there is nothing else to stimulate the mind – so it stimulates itself with troubling thoughts.

    For people who find worry a difficulty at night, it can be helpful to 'put the day to rest', perhaps by giving the worries space earlier in the night – writing them down and putting them away so that they are 'dealt with'. And if worries come to mind, postponing them until the next day when the mind will be in a much better place to put good thought into them. Coming up with a phrase, e.g. “not now”, or coming up with an alternative thought or image to redirect to, so that the mind has something else to stimulate it can help with this.

    Good luck with this and do have a look through sessions 4 and 5 in the library for further ideas if you think it may help.

  • Sleepio Member

    • 478 comments
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    in reply to Sleepio Member
    Expert

    Hi AliciaT,

    Great to hear your sleep efficiency has been good the past few nights. I think this is your judgement call.

    Just remember, the main aim of SR at the beginning is to build the habit of going to bed, falling asleep and staying asleep – ie. having good sleep efficiency (like you have been the past 4 nights). So picking a window which wont compromise sleep efficiency is the way to go. Once good sleep efficiency is maintained regularly, then the window is increased to increase the duration of sleep.

    Sorry I can't be more direct with advice but hope that helps you weigh it up.

    Good luck!

  • Sleepio Member

    • 478 comments
    • 81 helped
    Expert

    That's all for tonight folks. Thanks for all your interesting questions and good luck with the rest of the course.

    All the best,

    Bryony

  • Sleepio Member

    • 24 comments
    • 1 helped
    Graduate

    Thank you!

  • Sleepio Member

    • 7 comments
    • 1 helped
    Graduate

    Hi

    My problem is that I am trying too hard to get to sleep. The fifteen minute rule is causing me immense frustration.

  • Sleepio Member

    • 7 comments
    • 1 helped
    Graduate

    Every time I go to sleep and then get up and then try to go to sleep again and then get up. Its really stressing me out. Please advise

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