Live Discussion with Dr Bryony Sheaves - 7th October 2015

Dr Sheaves will be hosting a live online discussion here on Wednesday 7th October, 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 1 Oct 2015 at 3:24 PM
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  • Sleepio Member

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    Expert

    Dear Icecream – great name by the way!

    Great work in implementing the wind down routine – I wonder if you found it helpful in these first few weeks?

    For SR, the idea is to increase sleep pressure so that when in bed, the chances of sleep are much higher. Then when the habit of going to bed and falling asleep is beginning to be established, the sleep window is increased.

    This technique is designed to be implemented in addition to the other techniques so should follow on from doing the wind down routine. E.g. if doing a 2 hour wind down and the start of the sleep window is 1am, then the wind down would start at 11. We would tend to avoid activities which increase wakefulness in the evening as in the long term, this is unlikely to be helpful for sleep.

    The timing of the sleep window should relate in some way to sleep time preferences. So for those who tend to be more of an 'evening' person (an owl) then the sleep window may start later. And for those who are 'morning' people (a lark), they will find that they are more sleepy in the evening, so may have a sleep window that's a bit earlier.

    We would usually recommend starting the sleep window at the time when sleep is most likely and then once this pattern is established, very gradually extending the sleep window.

    Does that help to answer your questions? Do let me know if I've not been clear.

  • Sleepio Member

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    Expert

    Hi all, is anyone logging in live and got a burning question? It's pretty quiet on here tonight so if anything comes to mind, please feel free to post away!

  • Sleepio Member

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    Graduate

    Hello Dr Bryony just logged in to see your live feed and the questions of fellow sleepio users .
    I have just enrolled for another months session as it has helped me so much and meeting the nice folks in the community with their help.
    Thanking yourself and everybody.
    Trevor.

  • Sleepio Member

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    Hi Dr. Sheaves. What are your thoughts about FitBit or other devices for monitoring sleep for the sleep diary. I find myself looking at the clock when I wake up in the middle of the night so I can have an accurate sleep diary. However, I think this causing me not to be able to fall back asleep. I thought I might try the FitBit instead.

  • Sleepio Member

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    Hi Trevor – that is so nice to hear! Congrats on things improving, I know that will have taken a lot of work. Best of luck with the rest of the course, Bryony

  • Sleepio Member

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    Thanks for your response.
    I've never had a problem getting to sleep at night. I struggle to stay awake until 10pm anyway. I've used a wind down for bed routine for a long time, not to go to sleep, but to try to help me stay asleep a bit longer. Even during my wind down hour my husband has to wake me cos I'm nodding off.
    My problem has been staying asleep past 2.30am on a regular basis. There's no way I could do passive activities and stay awake until my sleep window of 1am, I'm exhausted by 9pm and can only stay awake by Asda 24hour shopping, press-ups, washing the kitchen floor, baking, etc. This has been my routine since starting the SR on week 3. From what you've said, I think it sounds like it would be ok for me to go back to a wind down routine and bed at 10.30, have my sleep window and get up at 3.30am??
    That would seem much more natural to me, but because all that would have shown in my Weeks 1 and 2 diaries, I thought it would have been taken into consideration and a 1-5am sleep window was what was necessary for me. I thought it must be required to break former sleep patterns or something.

    Are you telling me I can go to bed in a couple of hours??!! Yay!

  • Sleepio Member

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    Graduate

    I have another question Dr. Sheaves. I just did Session 5 of Sleepio today. I have been doing the sleep restriction for over three weeks now and my sleep efficiency is still in the 70's. Do I just need to give the Sleepio program more time, or is it just not working for me? Thanks.

  • Sleepio Member

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    Hi DougieG,
    That's an interesting question. There are many fitness trackers on the market which measure sleep – one of which is Fitbit. I have to confess I have not tried this particular device so can only answer in general.

    All of these devices use an algorithm to estimate when someone is asleep based primarily on actigraphy (movement of the wrist on which the device is worn). Actigraphy is a widely used measure in sleep research. Some of the wearable devices also combine this data with other data, e.g. heart rate and report having increased accuracy for measuring sleep. So these devices in general provide an estimate of sleep and they may vary in their accuracy. It might be worth posting this same question to other Sleepio users too to get their experiences.

    The experience you describe with watching the clock is common and often gets in the way of sleep. We tend to advice just getting an estimate for your sleep diary. A good sleeper isn't going to be 100% accurate with the sleep diary so we don't need to aim for this; an estimate will be good enough info for the course.

    Hope that's helpful in some way

  • Sleepio Member

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    Expert

    Hi Icecream,

    In general I think we don't want to alter sleep strategies that have been effective. Do you mind if I ask some of the other experts exactly the info that the course uses to suggest the sleep window and get back to you?

  • Sleepio Member

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    Of course. Thanks

  • Sleepio Member

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    Expert

    Hi DougieG,

    Sleep can indeed take a little while to get into a consolidated pattern. Would you feel ok sharing a little more info on what pattern your sleep is currently following so we can think about it a bit more?

  • Sleepio Member

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    Expert

    Great, I'll get back to you!

  • Sleepio Member

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    That's interesting. I'd wondered about getting one of these, but as they seemed to be based on movement I couldn't understand how it would know whether you were awake but still or asleep but moving. I'd always spent hours lying still at night just thinking. (not now with the Quarter Hour Rule)

  • Sleepio Member

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    Expert

    Hey icecream – have just asked out other experts. Not sure if anyone's online this evening but I can get back to you after the session when I hear.

    The wearable devices are interesting. They do pick up very inactive periods and think it's sleep, so they aren't a definitive measure of sleep, but can be a useful estimate. Personally I find them great as a motivational tool to encourage more activity during the day – which is of course helpful for sleep and wellbeing more broadly.

  • Sleepio Member

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    Would it be possible for you to tell us something about 'Sleep cycles' ? I'd read that it was natural to start the night with a couple of cycles going into deep sleep, covering about the first 4 hours and for the rest of the night the sleep cycles tended to be less deep sleep. My own personal thought was that I got so exhausted that my 'busy brain' was overcome and I slept, but as soon as I'd had about 4 hours sleep my silly brain started buzzing again and I then wasn't tired enough to stop it. What do you think?

  • Sleepio Member

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    Expert

    Hi Icecream,

    Of course! You're right we do sleep in cycles. Sleep is characterised into rapid eye movement sleep (REM – where most dreaming occurs) and non rapid eye movement sleep (NREM). NREM is further broken up into sleep stages 1-4 (4 is the deepest, referred to as 'slow wave'). We have a cycle of NREM sleep going down from stages 1-4 and then back up again, and have a brief period of REM sleep. This lasts around 90 minutes.

    The interesting thing is, these cycles change across the night, so we get more deep sleep at the start (in our first 90 mins) and later in the night we get less. But, later in the night, we get more REM sleep. So if people describe intense dreams or nightmares, these are often in the second part of the night.

    This does mean that our sleep is cleverly adapted to get our deepest most restorative sleep at the start.

    If this is a bit confusing, then type 'hypnogram' into google images and you should see several visual depictions of what I'm referring to.

  • Sleepio Member

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    Expert

    Hi everyone, we've now reached the end of this evenings session. Thanks all very much for your interesting questions! Wishing you all the best with the rest of the course.

    Good night,

    Bryony

  • Sleepio Member

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    Graduate

    Thank you

  • Sleepio Member

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    Hi Icecream,

    Just responding to your post from last night. Thanks for your patience whilst I checked this out.

    Whilst I haven't found out exactly which info the course uses to determine the start and end of the sleep window just yet (it's either the sleep diary or the initial sleep test you took) it is possible to adjust the sleep window to a time that is more achievable for you. We'd also recommend the wind down routine prior to the sleep time and using all the tips to build up a strong bed-sleep connection.

    There is further info on how to alter your sleep time in the course here:

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

    After establishing a good sleep efficiency, some Sleepio users try and move the whole window, for example to slightly later (ie. same sleep window length, but later in the night). This may be for example, to be awake/asleep at the same time as others. We recommend to all users that doing this very gradually, e.g. by 15 mins per week, is most likely to lead to most success.

    Hope that's useful Icecream and do check back in if you have further questions.

    Bryony

  • Sleepio Member

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    Hi DougieG
    I have had a Fitbit since February and started using it when I embarked on the course. I find it very useful.
    Lands

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