Live discussion with Dr Bryony Sheaves - 3rd June

Dr Sheaves will be hosting a live online discussion here on Wednesday 3rd June, 7pm-8.30pm BST.

She will discuss as many topics as possible in the hour and a half and, as always, you’re welcome to ask any questions at all about sleep or the Sleepio program. Please do note however that, as per our guidelines, Dr Sheaves won’t be able to give highly specific medical advice. She will however try to help as best as she can!

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Posted 1 Jun 2015 at 10:24 AM
  • 20 comments
  • 2 helped

Comments

  • Sleepio Member

    • 1 comments
    • 0 helped
    Session 5

    I can'tget beyond 6:00 am and can't go back to sleep?

  • Sleepio Member

    • 48 comments
    • 12 helped
    Graduate

    Hello Dr. Sheaves,

    I am a graduate who has had wonderful improvement in my sleep thanks to Sleepio and its community, going from 2 to 3 hours of hourly broken sleep per night to as long as 6 or 7 hours with only 2 or 3 awakenings.

    However, I've recently been quite ill with pneumonia with complicated bronchospasm and [thankfully temporary] reactive airway disease which forced me to doze off and on in a sitting position due to the incessant coughing and fluid in my lungs. I'm MUCH better now health-wise, but my sleep patterns seem to have reverted to their former nastiness and I'm awake once again within 45 minutes of falling asleep and wake up repeatedly during the night, usually for the final time at around 5:00 am despite now being able to lie down properly again.

    Do you have any tips for how to return to a better sleeping pattern after illness? Is it necessary to go right back to the beginning with a very tight SW? I had worked my way up to going to bed at 10:15 pm and getting up at 5:45 am, and dread going back to square one to have to re-set myself!

    Thank you for any insights or suggestions you may have.

    Flick
    xoxo

  • Sleepio Member

    • 1 comments
    • 0 helped
    Session 2

    Hi Doctor

    I've just started but excited to see how Sleepio can help me. My sleep isn't as bad as some others on here but has suffered greatly recently, especially since I'm spending a lot of time travelling right now. Would you recommend any way to quickly overcome jetlag?
    thank you

  • Sleepio Member

    • 4 comments
    • 0 helped
    Session 5

    Hi Doctor

    My sleep isn't as consistently bad as some of the other people here … What happens to me is that stressful thoughts catapult me into the bad sleeping patterns I experienced when I had a cancer scare. If I can control my emotions and anxiety, I sleep fine … However I can't always control them properly. Also, things like travelling or noise often interfere with my sleep patterns which is annoying. I slept just fine before the cancer scare, and am hoping that I can retrain my brain somehow not to associate stress with sleeplessness, and vice versa. That is, if for some reason ( say travel) I have trouble sleeping, my body responds by assuming I must be stressed. In your experience, is it possible to retrain the brain in this way?

  • Sleepio Member

    • 4 comments
    • 0 helped
    Session 5

    Also … Is it possible that thyroid issues contribute to sleep problems? My brother has just been diagnosed with an underactive thyroid and he says fatigue and problems with sleep were amongst his symptoms. Perhaps I should go for a blood test?

  • Sleepio Member

    • 1 comments
    • 0 helped
    Session 2

    Dr Sheaves

    On December 26, 2014, I took a vitamin b12 shot for weight-loss with the 3 amino acids at a clinic and since then have not been able to sleep. At first the shot caused high levels of energy which caused sleep disturbance. I have been on ambien for 6 months now and tried to get off the medication without success. At this point my doctor thinks it's a psychological association between getting the shot and thinking I won't be able to sleep since the vitamins are well out of my system.. I also believe that I have associated my bedroom with not being able to sleep due to the many restless nights I had. The 10 mg of ambien works for the most part but I still have wakeless nights. I have been to a cbt doctor in NYC and currently trying the sleep deprivation schedule of 1245am to 545am. Any help or suggestions is appreciated.

    Mk

  • Sleepio Member

    • 305 comments
    • 19 helped
    Administrator

    Hi all, thanks so much for adding your questions for tonight's session!

    Unfortunately, Dr Sheaves has been delayed by a bad bout of traffic so we're afraid the session will be starting about a half hour later than planned, at 7.30pm BST.

    Very sorry for the unexpected delay but please don't hesitate to continue to add your questions and Dr Sheaves will be online as soon as she can.

    Thanks!

  • Sleepio Member

    • 1 comments
    • 0 helped
    Graduate

    Hi Dr Sheaves,

    My Sleepio programme has generally gone well, particularly after a week or so of sleep restriction until around session 4/5 when things started to go wrong again. I was starting to wean myself off Zopiclone tablets (I was taking a few on weeknights), but now the fear seem to have returned that without them I will get literally no sleep that night. I've been keeping on top of my to do list more or less, but over the last week or so every time I listen to the audio downloads, for instance, all I focus on is how they're not going to work. I'm concerned I've now got negative associations with the programme, because it draws my attention to the elephant in the room when I'm trying to get to sleep, which appeared to be improving. It's yet another thought cycle – using the programme to improve my sleep, but at the same time engaging with it increasing anxiety which reduces the chances of sleep. Is this kind of setback normal and would you recommend anything in particular for coming to terms with setbacks like this?

    Many thanks in advance,

    Tom

  • Sleepio Member

    • 478 comments
    • 81 helped
    Expert

    Hi all,

    Sorry for the delay – I'll be starting in just over ten minutes!

    Bryony

  • Sleepio Member

    • 478 comments
    • 81 helped
    Expert

    Evening everyone!

    Firstly, I’m ever so sorry that I am late for the session. There were two bad accidents on the motorway which made me really delayed. I’ll do the hour and a half but if anyone has to dash off do let me know and I’ll make sure your question is prioritised!

    For those that are new to the session – welcome! I am here to answer any questions that you have about sleep or the sleepio course.

    Just to let you know a bit about me – I’m a clinical psychologist (and researcher), with a particular interest in sleep. I’m therefore best placed to answer questions about the psychological aspects of insomnia and the tools you’ll be picking up throughout the Sleepio course. If you have very specific questions about medications or other medical complaints your GP / primary care physician is best placed to answer these.

    I’ll head through the questions in order, but if you are attending the session live, do post away – it’d be good to get a discussion started if you have any thoughts / questions!

  • Sleepio Member

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

    Hi martyjennings,

    Firstly I see you are on session one so welcome to Sleepio and the live session! It sounds like you are having difficulty with early morning waking. This is a very common difficulty which people come with so you are not alone. The way the course works is by teaching you a range of techniques (too many for me to cover here) which can be helpful for improving your sleep (whether it is a difficulty getting to sleep, staying asleep or waking too early). I’d encourage you to try and take things away from each session and try them out. Then in the next session you can build on this by taking on something new. By the end you should then have a range of strategies which are all helpful for getting better sleep. Good luck and if you have a specific question do post back here.

  • Sleepio Member

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

    Hi Flick,

    Nice to hear from you and it’s so nice to hear you had previous success with Sleepio. I’m sure the new members will be pleased to read that!

    Sorry to hear you have been so unwell. That does certainly sound like a difficult situation for sleep so it’s not surprising that you’ve hit a bump in the road. The good news is, you have had success before, so it’s just about recreating those good sleeping habits again.

    There is the library of info, which has content from past sessions in – this could be a useful reminder. There might be things that you had tried out that are worth revisiting now. In terms of the sleep window, are you still entering your sleep diary? Your sleep window should follow on from your current sleep times, which won’t necessarily be the same as they were when you first started SR. Do you have an estimation?

    Good luck and remember, it’s common for even the best sleepers to have bouts of trickier sleep so keep faith that it'll improve.

  • Sleepio Member

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

    Hi Sleeppilot,

    Welcome to Sleepio and the live session! In terms of jetlag, travelling disrupts our sleep because our internal biological clock becomes out of sync with the environment. So the general advice is to try to take on the timings of the place you are travelling to and give your body as many cues as you can that the time has changed.

    Particularly important is natural light – this is the most important input to our body clock so try to get exposure to natural light through the day and ensure your bedroom is dark at night. Other strategies: see if you can keep active through the day – exercising, socialising and eat meals at the breakfast/lunch and dinner times of your new time zones. And of course, try and get your sleep window synced with the new time zone – this might mean staying up (where possible) when you're feeling pretty tired! If you do need to nap, try and do this as early in the day as possible and try to keep it short (ideally around 20 minutes).

    Good luck with it and I hope you find the other aspects of the course useful too.

  • Sleepio Member

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

    Hi Roberta42,

    …and welcome to you too! Lots of new sleepio members online tonight which is great!

    The difficulty you describe with anxious thoughts coming to mind is a very common difficulty when we aren’t sleeping well. The course has many techniques which will help you to manage these thoughts and emotions. In the coming sessions watch out for relaxation MP3s (next session), the wind down routine (session 3) and ways to check out and manage your thoughts in sessions 4 and 5. With each of these, try them across the week and see how they work for you. Then you can build on the techniques that you find most helpful in the sessions to come.

    You're right that stress and sleeplessness are often linked. The techniques above should help you to sleep better to break this pattern. And if you are sleeping better you should also see a knock on effect on how you are feeling in the day – you might find you are better able to manage stressors that crop up.

    In terms of travel – see my post above in response to sleeppilot – lots of pointers there.

    Good luck with the course and do check back in here if you have any further questions.

  • Sleepio Member

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

    Hi Roberta42 – sorry I didn't spot this question when I replied to the previous one.

    I'm not an expert in this area, but fatigue is a symptom of underactive thyroid and some people report problems sleeping if they have an overactive thyroid. If you have other symptoms, or are generally concerned that you might have thyroid problems it would be worth discussing this with your GP / primary care physician.

  • Sleepio Member

    • 478 comments
    • 81 helped
    Expert

    Hi everyone – is anyone logging in live tonight? If so I'll head to your question first!

  • Sleepio Member

    • 478 comments
    • 81 helped
    In reply to a deleted comment
    Expert

    Hi ncems14,

    Thanks for your questions. Welcome to Sleepio and the live session!

    In terms of sleeping medication – it sounds like you are keen to come off of them, but it's important to have a plan for this. Many people experience rebound insomnia, particularly if they come off of them quickly. Do speak to your prescriber for advice. Here are some articles / discussions that you might also find handy:

    https://www.sleepio.com/library/article/sleep-aids/

    Community discussion about weaning off medication:

    https://www.sleepio.com/community/discussion/zopilcone-depedance---how-to-ween-off-/

    Community discussion about taking medication while doing the program:

    https://www.sleepio.com/community/discussion/using-medication-while-doing-the-sleepio-course/

    Your second question was about light therapy. Here is an article written by Professor Espie:

    https://www.sleepio.com/library/article/what-is-bright-light-therapy/

    Light therapy is best used if you can sleep well, but need to sleep at the wrong times (e.g. you're an extreme morning person, or extreme evening person). The timing of the light is particularly important. Here is a questionnaire to help you find out the time that would work best for you:
    http://www.cet-hosting.com/limesurvey/index.php?sid=61524&lang=en

    Regarding use of melatonin – this can be used in addition to CBT type courses (like Sleepio) if you are an older adult (who can have lower levels of melatonin). It isn't the recommended first line treatment for insomnia.

    Calcium and magnesium supplements are not to my knowledge recommended for the treatment of insomnia.

    With all of the above I'd recommend taking a scientific approach. Try one technique and give it a fair go, and see if that's helpful before going on to the next. Otherwise it's difficult to know which to continue with.

    Good luck and do check back in here if you have further questions.

  • Sleepio Member

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

    Hi macklobell

    I think you have hit on a really important point with associating bed with not being able to sleep. Many of the techniques learnt through the course are focused on how to re-associate bed with sleep.

    There are also many triggers for sleep problems – it sounds like taking a supplement was a trigger for your sleep problems. The key to improving sleep is breaking the patterns which keep it going. This can be things we do, or things we think which inadvertently maintain the sleep problem. This is what the course is designed to do.

    When you say you are seeing a CBT therapist – you will likely see a lot of overlap in the content. The Sleepio program might have some additional content that you will find helpful – relaxation downloads, the library of info and community support but I thought I'd make you aware of the overlap. It might be helpful to talk this through with your therapist to decide the best way to use each source of support.

    As you will see from my previous post, there are many articles and community discussions on sleep medication which you might find useful. Here are a few:

    https://www.sleepio.com/library/article/sleep-aids/

    Community discussion about weaning off medication: https://www.sleepio.com/community/discussion/zopilcone-depedance---how-to-ween-off-/

    Community discussion about taking medication while doing the program: https://www.sleepio.com/community/discussion/using-medication-while-doing-the-sleepio-course/

    Community discussion about interactions of medication with sleep: https://www.sleepio.com/community/discussion/interaction-of-medications-with-sleep/

    Good luck with the rest of the course

  • Sleepio Member

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

    Hi Tom,

    What you are describing is the very normal difficulties that people have when coming off of sleeping pills. It's termed 'rebound insomnia'.

    The best solution is to come up with a plan for come off of the meds. This reduces the pattern of: coming off of meds, having a night of very bad sleep as a rebound and then going back on again and then trying to come off…

    It's best to speak to your prescriber about this. There's also a discussion in the community that might be of relevance:

    Community discussion about weaning off medication: https://www.sleepio.com/community/discussion/zopilcone-depedance---how-to-ween-off-/

    In terms of the associations with the course and the thoughts that are popping up – are there ways to check out how valid these thoughts are? For example, you mentioned that your sleep was improving before changing the medication – does that mean it could be again? The course has also been tried and tested by a randomised controlled trial and led to large improvements in sleep. CBT type approaches (like sleepio) are also the first line recommended treatment for persistent insomnia. All of these bits of information might be helpful to remind yourself when you are having doubts.

    Keep going, coming off sleep meds can be tough so you might want some support from the community – you wont be alone in doing this!

  • Sleepio Member

    • 478 comments
    • 81 helped
    Expert

    Looks like that's all the posts for tonight. Thank you for all your questions and apologies once again for the late start.

    It looks like there are lots of new members online tonight so very best of luck with the course and if you have any questions or just need a bit of extra support do check back in here. We're here each Wednesday.

    Best wishes

    Bryony

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