Live Discussion with Dr Bryony Sheaves - 7th May

Dr Sheaves will be hosting a live online discussion here on Wednesday 7th May, 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 May 2014 at 9:35 AM
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  • Sleepio Member

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    Caliman,

    Thanks for your post. It's good to hear that you're keeping up some of the sleep tips from sleepio whilst also trying out something new.

    Your question was about sleep and bipolar disorder. There is nothing to indicate that CBT for insomnia shouldn't be used if someone has a bipolar disorder diagnosis – but it's important to monitor fluctuations in mood, particularly when doing SR.

    There is evidence that people with bipolar have circadian rhythm disruptions – this is the body's central clock, which keeps our sleep in line with our environment (ie. night). There is some evidence that this might be due to an enhanced sensitivity to light. So ensuring that you get light in the morning and reduce your light exposure (including screens/TV/laptop) during the wind down routine might be something to particularly pay attention to.

    The other factor to consider is that sleep can vary in line with mood. So for example when feeling more manic, one might feel a reduced need for sleep, whereas this might not be the case when ones mood is stable, or low. If feeling a reduced need for sleep it would be most important to give your body as many cues as possible that it's time to wind down.

    Keep going with the sleep techniques – Things like the wind down routine should be helpful for both mood and sleep.

  • Sleepio Member

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    Hi won052,

    It sounds like you have less of a difficulty getting to sleep, but it is staying asleep that's the problem, is that right?

    In terms of napping, I'd avoid adding naps into your day. You're right, you want your sleep pressure to be as high as possible when you go to bed and naps wont be helpful for this.

    When you do wake up, it sounds like you are staying in bed. Whilst this might feel like the kindest thing you can do it is unlikely to be helpful for your sleep. You want your mind to associate bed with sleep, rather than being awake. I wonder if you can leave a nice blanket in another room, or leave a heater on to find a way to make it more appealing to get out of bed? The 15 minute rule is a very helpful technique to help sleep so worth finding a way to make it work for you on the winter nights.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hi Mushmellowstar and hi Dr. Bryony!
    So good to hear you are sleeping better, M. It's been a long haul for you. Regarding sleeping in the same bed. I feel the same as you, that sleeping in the same bed is what I would prefer and we do have a king-size bed. However, I have been sleeping more times in the spare room and it is so much better. (Good that you will have a spare room too). It is cooler, there is no noise and the air in that room circulates better. My husband is okay so far with my nocturnal need to sleep somewhere else but I will sleep in the same bed as him if the temperature is okay and the room isn't stuffy, like last night. It's nice to have the option.
    anniem

  • Sleepio Member

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    Snoopmutley – great name!

    It's tricky when other factors impact on your sleep and shift work in particular can be tough for getting good sleep. Are the 3 nights in a block or spaced out across the week?

    Perhaps you could try to stick to your window as much as possible when you aren't at your work and make sure that when you have just had a shift that you sleep in the morning and wake yourself up in the afternoon so that your sleep pressure has time to build up before the following night,

    If you are already restricting sleep through work be careful not to over-restrict your sleep. If you are feeling dangerously sleepy, when for example driving, do take a short nap (preferably in the morning).

  • Sleepio Member

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    Hi Richmond,

    Non-restorative sleep refers to the experience of having a good quantity of sleep, yet waking up feeling like you had a poor quality of sleep, so much so that it impacts on your day to day functioning.

    There can be several reasons for this. For some, it might be an underlying condition such as chronic fatigue, fibromyalgia, chronic pain or depression. If this is the case, it's worth getting these conditions treated alongside the sleep problem. Another reason that some people experience non-restorative sleep is if they aren't sleeping at a time that suits their body clock (or circadian phase). If you find that you can get good sleep, but just not at the time that you'd like to, this could be the case.

    The good news is that treatments based on CBT methods, such as sleepio, have shown improvements in sleep.

    Good luck with the rest of the course.

  • Sleepio Member

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    Hi Racing heart,

    That's good that you've spotted that clock watching is unhelpful for your sleep. The 15 minute rule isn't intended to be a strict time limit on sleep. I think you're strategy of accepting that you might toss and turn a bit is great, but if you notice that you haven't got to sleep after a short while (around 15 minutes.. roughly), it's best to get up and do something relaxing in another room.

  • Sleepio Member

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    Hi won052,

    The duration of sleep that each individual needs varies so it would be difficult to judge the exact amount of hours. It is true that as we get older our sleep can become more fragmented, but there isn't anything to say we can't still work to improve it.

    Sleepio has a good evidence base for improving sleep quality. I see you are on session 2, good luck with the rest of the course.

  • Sleepio Member

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    Hi Naomi,

    I'd say just do your best.

    Perhaps you could have a larger lunch and a smaller dinner so that your body isn't working to digest a large dinner close to bedtime.

    Although it sounds tough to fit in, prioritising a wind down routine after a long days work and commute sounds like it might be worth it.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hi Won052, my pattern is exactly like you, I can hardly keep awake in the evening but then very often wake up much to early, especially if the previous day was busy. I've been like this, gradually getting worse in fact, 25 years and it's been very difficult to get through work days through feeling so tired, in fact I retired early in the end. I have just had to nap to get through on many occasions and I've concluded it's OK provided it is strictly time limited – used to be 20 mins, now only 10mins or even less – just briefly falling asleep seems to do it – and as you say before 3pm if poss , – I use the timer on my mobile to make sure it's quick, and I put the mobile somewhere out of reach to make sure I wake up completely and don't go back to snooze..
    I added a “nap” tag to my sleepio diary and found that actually my sleep quality and efficiency are slightly better on the nights when I had a nap the previous day, than the average.
    I have to say sleepio has made a big difference so far, though, I just hope it persists, but it is the most hopeful thing I've tried in the 25 years, I wish it had been there before, so keep at it!

  • Sleepio Member

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    Graduate

    Belated hello Dr. I have not had email facility for several
    days and have only now filled in my diary for the days'
    i was off line. I am doing ok. Sorry to community with
    no 'connection' to any of you. only NOW this minute can I use computer! Missed chat, sorry.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hi Racing heart,
    You can also check out yesterday's expert session on QHR for more information on handling the anxiety around it.
    anniem

  • Sleepio Member

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    Expert

    BeryIM – thank you so much for sharing your experiences. When looking at the link between sleep and mental health we often look at the daytime consequences of getting no sleep – it's a helpful reminder that we should also be thinking about the frustrating time in the middle of the night too.

    I'm so pleased to hear that your sleep has improved and I'm sure it's encouraging for others too. Thank you for sharing.

  • Sleepio Member

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    Won052 – I think there is a difference between herbal, green and black tea. The latter two have caffeine in, whereas most herbal teas, such as peppermint or camomile don't.

    In terms of melatonin – I'm not a medical doctor (doctor of clinical psychology) but if it was prescribed to aid your sleep I'd consider it a sleeping pill.

    Hope that's helpful

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hi won052,
    Herbal tea generally is caffeine-free as opposed to regular tea, so it's best to create a tag that distinguishes between the two. Caffeine can interfere with sleep if taken too close to bedtime and for some, even if it is taken much earlier, it can have an impact. Melatonin isn't a sleeping pill per se but a hormone that helps regulate sleep and wake cycles. I would create a tag for that too.
    anniem

  • Sleepio Member

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    Mushmellowstar – great to hear that your sleep has improved. Well done – I'm sure it must have taken lots of hard work.

    It's also lovely to hear that you are considering trying to share a bed with your husband again. It's good that you have some practical solutions in place to help – larger mattress and spare room.

    Perhaps try to think of it as the next exciting step towards better sleep. There might be some bumps in the road but you are heading in the right direction and have the tools at hand to get your sleep back on track if you do find a bump. Get your husband on board in helping you with the next step and see if there's anything he can do to support you so it feels less terrifying.

  • Sleepio Member

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    Hi Mckaydesign,

    I'd usually add time at the start of the sleep window rather than the end because it's easier to control and keep in a regular routine.

    If you are waking up naturally without an alarm clock it might be tricky to try to get yourself to sleep in longer. You'd obviously want to avoid being in bed for an extra 15 minutes in the morning without being asleep, so if you wake up, try to get up.

    If however you are finding that the alarm wakes you in the morning (ie you could sleep on…) then you could try adding 15 minutes to the morning and setting the alarm later.

  • Sleepio Member

    • 478 comments
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    Thank you for all your questions tonight and thanks for your helpful responses Anniem. I'm going to log off now, good night, Bryony.

  • Sleepio Member

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    Graduate

    Good night Dr Bryony.

  • Sleepio Member

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    in reply to Sleepio Member
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    Thank you Dr Bryony.

    It's been an interesting and varied session.

    Good to know we are not alone.

    One big question would be Why? (...is this such a problem for so many)

    Many thanks … Cheerio for now ….... BerylM

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Thanks for the reply! Unfortunately my shift extends till the early afternoon & then my next shift would be the following day..I will attempt to stick to it on the nights I am at home. I have 4 days off which started yesterday so I'm giving it a try!!

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