Live Discussion with Dr Bryony Sheaves - 6th August

Dr Sheaves will be hosting a live online discussion here on Wednesday 6th August, 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.

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 1 Aug 2014 at 5:02 PM
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  • Sleepio Member

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    Graduate

    Thanks for your comments. I must say that I found them a little disappointing – they seem to be drawn from a 'one approach fits all' philosophy. And I have tried exactly what you suggest – reading somewhere else. But when I get sleepy I head to bed but don't sleep. Remember that over many years I've established a very strong reading-in-bed/sleep connection. Getting to sleep is rarely a problem for me. The problem is getting back to sleep after waking up during the night. Moreover, breaking the pattern of companionable reading in bed with my wife is a pretty drastic step (it's hard enough to be getting up and moving elsewhere; or setting an alarm for 5:30am). So since the reading pattern is working, doesn't it make sense to work on other aspects of the program? I would expect that I'm not that much of an outlier in this regard – it would be encouraging to see a little more flexibility and support in the program, especially as other aspects do seem to be helping me. Any further thoughts will be very welcome!

  • Sleepio Member

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    Expert

    Hi Lexis mum,

    That does sound like a frustrating difficulty, but remember little bumps in the road are normal and it sounds like your sleep is generally heading in the right direction.

    You are right, the light might play some role, so do check that you have good curtains/blinds or use an eye mask if you think that could be part of the problem.

    The other thing that springs to mind is that at 6am your sleep pressure is going to have dropped – because you have already had most of your night of sleep. Whilst it's tough because it sounds like you're really tired, I wonder if you could put things in place to help you get straight up out of bed at that time? The rationale would be that you will then build up your sleep pressure for the following night and hopefully get your sleep back in check again.

    Increasing your sleep window would do the opposite and decrease your sleep pressure so I might think about holding off that for the time being.

    See how you get on over the next week.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hi Dr Bryony,
    Thank you for your comments. I'm trying meditation/mindfullness, and know that this takes practise. I'm determined to work at it, though.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hi rvbseattle, it seems that you were asking Dr Sheaves for permission to continue reading in bed, when you have already made up your mind you are going to. In fairness, she can only go by the guidelines of the Sleepio course. It is up to you to apply more flexibility if you want to. I have seen other people on the course bending the rules to suit themselves, and then wondering why they weren't making any progress.

  • Sleepio Member

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    Expert

    Hi wridgy and thanks for posting.

    It sounds like it would be helpful to speak to your specialist for parkinsons about the impact that this might have on your sleep and also to let them know that you are trying the Sleepio course, if you haven't done already. They might have some helpful advice.

    I have to say I'm not so clued up on the research literature on treatment of insomnia for people with parkinsons. I've just found an article that says that CBT courses (like sleepio is) can be helpful for improving sleep, so probably worth keeping going, but do link in with your specialist to find out more about sleep and parkinsons.

  • Sleepio Member

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    Expert

    Hi rvbseattle,

    I'm sorry that my post was disappointing. You are right in the sense that the sleepio course is a package treatment. We know through research that the whole package is helpful for the treatment of insomnia and this is why we'd recommend sticking to it as closely as possible. But, you are also right that it is helpful to personalise it too, so that it works for you. It sounds like reading in bed is something that you are very keen to continue. If it feels too drastic to change, then try to stick to the other elements of the course as closely as possible, as you have been.

  • Sleepio Member

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    Expert

    Hi Lolita,

    Yes light therapy is often used for seasonal affective disorder. It is also used for people whose body clock has shifted – e.g. if they are an extreme morning person.

    There is an article in the library here:
    http://www.sleepio.com/library/article/what-is-bright-light-therapy/

    Did you have a specific question about it?

  • Sleepio Member

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    Hi Racing heart,

    I'm pleased you have made progress in your sleep and I think you are right in trying to use your knowledge of what has been helpful so far to try to improve your sleep when you are next to your partner.

    This is an exciting step that you are taking, because it is a mark of your success in improving your sleep so far. I wonder if your partner would mind a little disruption in the interim in order to sleep in the same bed again? I know you'd feel bad, it sounds like you are really considerate to his sleep. Has he said that he'd mind you quietly getting up or using other strategies that you know work? I wonder if you could work as a team to reach this next goal?

    I know there have been other posts about this same question before – it might be worth asking others who have completed the course for advice too.

  • Sleepio Member

    • 53 comments
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    Graduate

    Lolita – there is a light therapy gadget called Valkee which was developed at a university in Finland that looks like an iPod and puts light into the head through the ears….it did nothing for me though it comes with very respected research credentials.
    Kindest,
    Racing Heart

  • Sleepio Member

    • 11 comments
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    in reply to Sleepio Member
    Graduate

    That's a fair comment, Lindos, and thanks. Actually, I've been trying not reading in bed (along with following all the other guidelines) but that's the one behavior or action that doesn't seem – so far at least – to help. And while it's true I'm in a sense 'seeking permission' I guess that if NOT reading in bed was proving helpful then I'd be ready to give it up. But my experience so far is that I'm making real progress, with much improved sleep (though still short because of the schedule) and the nights when I stick to the old pre-sleep pattern seem to be the best. I should add that I certainly follow the advice to go elsewhere to read if I'm awake later in the night for more than 15 minutes, so I'm following almost every aspect of the program pretty faithfully.

  • Sleepio Member

    • 53 comments
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    Graduate

    Thanks Dr Sheaves. I am pleased to have got to this point. I need to talk it through with him more….he is very keen for us to share a bed but is a lark and gets in at 9pm and is up at 5am for his swim ….he is hard work. But we'll identify a low risk /stress time and go for it!
    Kindest,
    RH

  • Sleepio Member

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    Expert

    Hi Tai,

    This is in fact quite a common problem. There are a few things to consider if you are having unrestorative sleep. One is that I wonder whether there is an underlying medical condition that causes this (e.g fibromyalgia/chronic fatigue/chonic pain)? If you have other diagnoses it would be important to make sure the treatment of these is optimised. There is evidence that CBT strategies can be helpful for people who also experience these other difficulties.

    It could also be a factor of the timing of your sleep. Would you say that you are a definite morning person, or a definite evening person? If so you might find that adjusting your sleep times slightly might help. But be sure to move both bed time and rise time so your sleep window is the same.

    Lastly, it could just be that it is taking a while for your sleep quality to improve. Sleep duration can sometimes improve quicker than sleep quality, but it should improve with time.

  • Sleepio Member

    • 11 comments
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    in reply to Sleepio Member
    Graduate

    Thanks for your response, Dr Sheaves. You might see my reply to Lindos. Your point is a fair one. But I've tried the recommended approach (and certainly go to the living room during wakeful periods later in the night) and wanted to see what you thought of this – bearing in mind that I don't want to stick to reading in bed before sleep just because it's been our habit – but also because it enables me to fall asleep pretty reliably.

  • Sleepio Member

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    Hi fullnitesleep,

    I'd try to stick to you SR window if you can, even though I know it's tough! It's a key technique which we know is helpful, particularly for night time awakenings. The idea is that by going to bed later you will increase your sleep pressure. If your sleep pressure is higher you will be less likely to wake.

    Good luck and keep going with the course. If it's helpful do link in with others who are using the course through the forum, sometimes people find it helpful to have the peer support when doing the SR.

  • Sleepio Member

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    Expert

    Hi jas44 and welcome to the course!

    The course should build on the techniques you have learnt so far to help with these anxieties. Keep going, the course will offer new things to try each week and some will help you manage anxiety inducing thoughts. It sounds like this might be particularly helpful for the difficulty you describe.

  • Sleepio Member

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    Expert

    Hi everyone. We've reached the end of the session for tonight. Thank you all for your posts and interesting questions, it's been a good session!

    Good night,

    Bryony

  • Sleepio Member

    • 39 comments
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    in reply to Sleepio Member
    Graduate

    Thank you for replying.
    I would like to buy a lamp and feel clueless about what is best to purchase.
    Lolita.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hi! Racing Heart….haha! good to know.
    I'd like to take a look at it. Would love it if you told me where you got it. I'll try to Google it as well. Thanks so much. Lolita.

  • Sleepio Member

    • 107 comments
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    in reply to Sleepio Member
    Graduate

    Hi Racing heart,
    I'm wondering how helpful you found Dr Bryony's comments about how to overcome negative thoughts?

  • Sleepio Member

    • 107 comments
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    in reply to Sleepio Member
    Graduate

    Hi again RH,
    My last message disappeared before I had finished it – technology never has been my strong point!
    Anyway, as i was saying…..the difficulty I have with using the thought checker technique is that the thought I'm trying to get rid of is always much stronger than the thought I'm trying to replace it with. Dr B suggested writing it on a card, as visual cues can help to reinforce it. I'll try this, but I think it will take quite a lot of reinforcement. It's not always a quick, easy process to replace the thoughts we don't want with more helpful ones, because the unhelpful ones have become very established.
    I think the 'mindfulness' technique is good though – again, it takes practice.The key thing is consistent practice. I've found a book called 'Tired but Wired' by Dr Nerina Ramlakhan quite helpful with things like meditation, and being positive.
    One thing that has helped me, is my attitude towards bad nights. I'm now able to reason with myself when I'm unable to get to sleep, that I always manage to cope the following day.
    I hope things go well for you.

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