Live discussion with Dr Bryony Sheaves - 5th October 2016

Dr Sheaves will be hosting a live online discussion here on Wednesday 5th October, 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.

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Posted 29 Sep 2016 at 10:54 AM
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  • Sleepio Member

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    Graduate

    Hi
    This is covered in week 4 & 5 if I remember correctly! They suggest write down what you need to do for the next day and how you are going to acheive this and so if it enters your mind at night you can tell yourself you have already dealt with this so have no need to plan for it. Also think and mouth the word THE repeatedly for up to 5 minutes which helps to block out these thought because there is nothing for you to latch on to and get worried about.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi,

    Thanks for logging in live! My previous post may be of interest as it relates to earlier morning waking in general.

    Re: using the toilet in the morning, this is a tricky but common question. When people describe this we would usually consider problem solving as much as possible with timing of drinks (lessening intake in the evening) and avoiding tea/coffee (diuretics) in the afternoon and evening. Or if concerned about the need to use the toilet it may be helpful to liaise with a medical doctor.

  • Sleepio Member

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    Graduate

    I have 2 regimes- one for when I am at work the next day (I work shifts) since I have to be up at 5:30am and then a regime when I am off or starting late so I wake up at 7:30am (I am not naturally an early morning person!), so I don't like it when I wake up at 5am when I don't need to get up until 5:30am

  • Sleepio Member

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    Expert

    Hi,

    Just to mention that I've replied to your post in my two previous posts above. I hope this is OK, it seems like they are related.

    I'm pleased to hear that the course is going well so far. I imagine you are in the midst of sleep restriction and boosting the bed-sleep connection. Hope this is going OK and do post back if you have any further questions.

  • Sleepio Member

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    Graduate

    HI
    I agree with this I used to have problems with this especially when I had been at work and not got home until 8pm and used to have a pot of tea (2xmugs) and decaff coffe 1xmug. I still have that but I use decaf tea and either have a herbal tea which helps for sleeping and find I may get up once during the night rather than 2-3 times I used to, sometimes I sleep right through as llong as I remember to go as I am going to bed

  • Sleepio Member

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    Expert

    Hi,

    Many people find it tricky to adjust to the new sleep schedule that sleep restriction brings so feeling awake at the start of the sleep common is common to begin with. Laptops are an example of back lit screens which emit blue light (the wavelength that the body clock is most sensitive too). The intensity of the light that hits the eye decreases the further away the screen is so some find it helpful to push the laptop further away from them when watching. Others like to integrate other relaxing activities into the routine, for example relaxation audios which can be downloaded from Sleepio.

    A wind down routine is recommended for 60-90 minutes so another alternative is to integrate another activity earlier in the evening which isn't necessarily part of a wind down, but is just enjoyable. Then continue with the wind down activities afterwards.

    Good luck with the sleep restriction. It's one of the more powerful techniques so many find the problem solving like this is helpful in the longer term.

  • Sleepio Member

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    Expert

    That's really good to hear!

  • Sleepio Member

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    Expert

    Hi,

    If you're concerned do speak to your medical doctor. They are best placed to answer this from a medical perspective.

    From a sleep perspective, in the meantime, it may be worth taking a look through some of the ideas in previous posts re: needing to use the bathroom at night, and ways of problem solving this as it seems that a few other Sleepio users have had a similar difficulty.

  • Sleepio Member

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    Expert

    Hi,

    What you are saying about short term recommendation is right (for the US and UK). Here is an article with more info:

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

    Sleeping pills can help in the short term, but often people report what we call rebound insomnia when they come off of them. This is when the body has got used to the medication and when it is stopped sleep temporarily gets worse as the body readjusts to less medication. This is why it is helpful to follow a plan to gradually taper off the medication.

    There is of course a place for sleeping pills (they do help with sleep) and a medical doctor can provide more info re: the effects of individual medications and what may be suitable for each individual. It can be helpful to let the doctor know about other sources of sleep help, like Sleepio, so they can hold this in mind when thinking about other options.

  • Sleepio Member

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    Expert

    Hi,
    Thanks for your post. When people report food cravings in the middle of the night as a first step we would take a problem solving approach, looking at whether food during the day should be adequate to last through the night, and perhaps plan a healthy snack (not too big) late evening. If the wakenings are in the morning then I may consider whether this is a reflection of the body clock and that the body is ready for the day (dependent on the time of the wakening of course). If this is the case the individual may chose to move their sleep times earlier (go to bed earlier and rise earlier for breakfast).
    Or if this doesn't show a simple resolution then it may be worth sharing with a medical doctor to seek their opinion.

  • Sleepio Member

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    Expert

    Hi,

    In this situation I may consider the timing of the sleep window: if a morning person, shifting the time of the sleep window earlier may decrease the chance of wakening.

    It can also be helpful to bear in mind the concept of sleep pressure. Sleep pressure builds through the day and if it is high at night we increase the chance of sleeping through to our wake time. But napping at any time of day (including morning) decreases the amount of sleep pressure, so some people find it helpful to cut out the nap, as a means of improving sleep the following night and getting into a consistent and consolidated pattern.

    It is interesting that you describe dreaming sleep is your deep sleep as many describe the earlier part of their sleep window as their deep sleep (and this is what we see in sleep studies). I wonder what lets you know that this is your deepest sleep? That might be helpful info for finding a resolution.

  • Sleepio Member

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    Expert

    Hi,
    Finding a wind down routine that works for each individual is really important. It sounds like you are saying that audio books have worked well for you. The key with the wind down is i) finding things that leave one feeling sleepy and calm ii) doing the wind down routine for a good chunk of time (60-90 mins) and in a different room to the bedroom, so that the person can build up the bed-sleep connection (and hence increase the chances of sleep) and iii) heading to bed when the sleepy-tired feelings start. iv) Of course if unable to sleep there is always the 15 minute rule: getting up again and waiting for sleep pressure to build before returning to bed, when feeling sleepy tired (which will happen eventually).

    This is often a change of pattern and can take a few unsettled nights before the new routine takes hold but is helpful in the longer term.

    Good luck

  • Sleepio Member

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    Expert

    Hi,

    For people experiencing vivid dreams of nightmares, there are a few things we consider:

    -Could this be a side effect of medication? Some medications alter the architecture of sleep which increase the chance of dreams.
    -Similarly for alcohol use: alcohol use suppresses rapid eye movement (dreaming) sleep in the earlier part of the night which causes a rebound in the second part of the night.
    -How much sleep is the individual getting in total across the whole day (adding up any naps etc). If over sleeping, decreasing the total sleep time (e.g. by cutting naps) can reduce REM sleep and hence decrease the chance of them happening. Sleep restriction, which I think you are coming to, can therefore be helpful.
    -Strategies to decrease arousal and worry before sleep can reduce the chance of bad dreams happening.

    I hope these ideas are useful

  • Sleepio Member

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    Expert

    Hi,

    I notice you are just coming up to session 3 which includes some of the most powerful techniques for improving sleep (and sleep quality). I hope you see an improvement but do post back here is you need any additional help with these aspects of the course.

  • Sleepio Member

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    Expert

    Hi,

    I see you are on session 2. Sleepio has many techniques which users describe as helpful for this difficulty. Next week I think you will cover ways to boost your bed=sleep connection. This includes the 15 minute rule which is often helpful in this scenario. Later in the course (session 5 I think) you will also cover more strategies to calm thoughts which can get in the way of sleep. Do look out for these and good luck in the meantime

  • Sleepio Member

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    Expert

    That's all for tonight folks. Many thanks for the posts and I wish you all the best for sleep this evening.

  • Sleepio Member

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    Graduate

    Thank you for your response but no not really – I was not on any medication afore my night awakenings and hardly drink alcohol and try desperately not to catnap during the day;
    In principal though I do concur but my REM dreams are just too explicit and have been now for 3 years.

    Regards

  • Sleepio Member

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    Graduate

    Thankyou yes.
    Banning the laptop has after 7pm has had immediate effect. Now to work on the sleep through without medication…..

  • Sleepio Member

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    in reply to Sleepio Member
    Session 1

    @Dr Bryony Sheaves – Thanks for replying to my message!

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Yes thankyou for this reply. Ive now banned the device after 7pm and have got back to my normal drop off. I can now run it through the TV if I want to watch stuff.
    Regards
    D.B

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