Live discussion with Dr Bryony Sheaves - 9th March 2016

Dr Sheaves will be hosting a live online discussion here on Wednesday 9th March, 7.00 until 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 3 Mar 2016 at 1:23 PM
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  • 1 helped

Comments

  • Sleepio Member

    • 6 comments
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    Session 2

    Hi doctor,
    I went trough some stomach problems ( amebiasis) and took 2 cycles of antibiotics.
    After 1 st cycle I lost the ability to sleep and it is now 2 weeks. I am going to a neurologist who gave me Midazolam and xanax 0.25 before sleeping but this gave me only 4-5 h of sleep not all nights….
    My case is normal? People sleeping very well get stressed and completely unable to sleep @ any time of the day and night without pills….? I am getting anxious about it is not helping

  • Sleepio Member

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    Graduate

    Please can have some advice on shift work
    I am a mum and work 2 to 3 12 hr night shifts per week
    Then have to try to slot back to daytime life
    Any advice re restricted sleep , varying hours how best to manage ? Shifts are busy stressful on feet all time often no break ( midwife )
    Rely on meds a lot due to ever changing routine
    Days no better
    Start at 7 or finish at 10 whichever way no hope of routine !

  • Sleepio Member

    • 30 comments
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    in reply to Sleepio Member
    Graduate

    Ninja pug,
    Have you read the advice on the shift work under the library tab. You might find it useful.

  • Sleepio Member

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    Expert

    Evening all and welcome to tonight’s live session! I’ll be here for the next hour and half to answer any questions you have about sleep or the Sleepio course. Just a bit about me: I’m a clinical psychologist with a special interest in the treatment of sleep problems. I’m therefore well placed to answer any questions you have about the psychological aspects of the course. If however you have very specific medical queries or questions about medications your GP / Primary Care Physician would be best placed to answer these.

    Thanks to those who have already posted. If you’re logging in live please do post any burning question you may have.

  • Sleepio Member

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    Expert

    Just to note that my internet connection seems to be being a bit temperamental tonight but rest assured if my response is slow I will be back and answer the questions you post!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi, and thank you for your post. I’m afraid I’m not familiar with the stomach condition you mention. For people experiencing other conditions we would recommend speaking the doctor or clinician who has been in charge of treatment and check out that they are aware of the sleep problem and that help has been sought from Sleepio.

    Sleep problems are often triggered by a stressors, which can impact on sleep. Because of the difficulty with sleep at that time we can change the way we approach sleep. By this I mean for example, we can become understandably anxious about sleep, pay more attention to whether or not we are asleep, the effect of sleep on our day and may change our sleep schedule to catch up on lost hours. It is these factors that CBT courses (like Sleepio) are designed to help with.

    When we are feeling very anxious we have stress hormones racing around our bodies and are therefore more alert (looking for threat / danger). This of course decreases our changes of sleep, so if we are feeling very anxious, it is very common for sleep to suffer. There are sections in the course that are designed to target this very experience. So for example, look out for the relaxation audios that you can download, in future sessions look out the thought checker to target thoughts at night that may be fuelling the feelings of anxiety and the 15 minutes rule can help with breaking the cycle of anxiety that can keep us awake.

    There are lots of tools to help manage sleep and the associated anxiety. We usually advise Sleepio users to see what they can take away from each session and try it out before the next session. By the end of the course each graduate should have a toolbox of techniques to help manage sleep.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    There is indeed a library article on shift work – you can find it near the top of the library.

    In general people who work shifts are more prone to difficulties sleeping. This is because the two factors that drive our sleep can become out of sync. Let’s take each factor in turn and think through the things we’d recommend. The first factor is the body clock (circadian rhythm). The things that keep the body clock in sync are light exposure during the day, and keeping to a routine (for example exercise and eating). The thing with shift work is the routine changes frequently. So shift workers need to help their body clock adjust. This may include using bright light to help with alertness if light levels are low. Several manufacturers sell light boxes for these purposes as light emitted from light bulbs in offices / hospitals tends not to be as strong. Other ideas could be asking a shift co-ordinator to gradually change the shifts (e.g. do some earlies, some middle of the day, followed by some lates / nights) to give the clock time to slowly adjust. Or eating meals at times across the period you need to be awake, e.g breakfast, lunch and dinner, but scheduled at regular times throughout the night.

    I'll share this and then type the 2nd factor…

  • Sleepio Member

    • 44 comments
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    Graduate

    Using the QHR, on Monday night I couldn't fall asleep so I left the bedroom, intending to return when I was sleepy tired. However I never became sleepy tired so was up all night with a SE of 0. Any advice when you don't get sleepy tired?

  • Sleepio Member

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    Graduate

    Hello Bryony
    I have one question that I hope you could answer. I am doing the QHR, since I have problems waking middle of the night and not being able to return to sleep. However I find it very difficult to figure out when I am sleepytired, and ready to go to bed again. Just thinking about returning to bed wakes me up more. Suddenly I fall asleep on the sofa and find out that I was sleepytired after all. So would it be an idea to have a timer once I am up doing QHR, with the rule of trying to return to bed after 30 minutes? Or would that timer idea not work? I am just really tired of falling asleep on the sofa to be wide awake once I return to bed.
    Thank you
    Cotr

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi sorry for the delay, I think a problem with the wifi!

    So, the second factor is sleep pressure. Sleep pressure increases as a function of time – the longer we're awake the more likely it is we'll fall asleep. This is usually kept to a regular time period but of course can vary for shift workers. This may be helpful to bear in mind, for example the morning before a night shift some chose to sleep in so their sleep pressure is particularly low when they awake. Others who are 'morning people' may find it hard to sleep in but may be able to schedule an afternoon nap. This should help to keep arousal levels higher throughout the night and ensure that sleep pressure is high enough by morning.

    The techniques from the course may need a little adaptation and if you have any particular questions do check back in here.

    Is there anything from the earlier sessions that has been helpful? E.g. things about the bedroom environment that you may need to think carefully about for daytime sleeping?

  • Sleepio Member

    • 522 comments
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    in reply to Sleepio Member
    Expert

    Hi,

    Thought I'd jump down tot he posts which are live and then return to the earlier one.

    When someone describes not feeling sleepy-tired after using the QHR rule, it can be helpful to think through how time is spent when awake. E.g. doing something activating (like physical activity, or even housework) can increase arousal and decrease chances of sleep. Equally spending time thinking about the fact that sleep isn't coming can leave us feeling anxious or frustrated which can also be alerting. The trick is to find something that is calm, focuses the mind away from sleep and is relaxing, or even a little boring. How are you spending your QHR at the moment?

    The other thing that we may bear in mind, particularly for graduate, is whether the sleep window has recently been increased. If so, it may be a temporary difficulty, or the individual may chose to decrease their sleep window again to increase sleep pressure.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi,
    This quite a common difficulty, as soon as we focus our minds on 'am I feeling sleep tired?' then we feel more alert. The strategy of doing something relaxing for a time and then returning to sleep is one approach, and remember that sleep may not come when one returns to bed, but this is ok because the QHR can be used again.

    Have you covered sleep-restriction yet? This is the aspect of the course where people reconnect with the experience of being sleepy tired.

  • Sleepio Member

    • 522 comments
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    in reply to Sleepio Member
    Expert

    Thanks for the helpful suggestion!!

    Here's the link for anyone interested:

    https://www.sleepio.com/library/article/shift-work-and-sleep/

  • Sleepio Member

    • 44 comments
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    in reply to Sleepio Member
    Graduate

    Good points. I find that a stroll, music, techniques work. Watching YouTube, reading a book don't.
    I believe that the night I didn't get sleepy tired I just sat and did nothing. As you said, that is bad because you just spend time thinking about not sleeping. So this is probably the worst option.
    Also, I agree that expanding my sleep window has been problematic. Going back to sleep restriction can help me get back on track.
    Thanks.

  • Sleepio Member

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    Expert

    Hi all, if anyone has any burning questions about sleep in general or the sleepio course, please do post away!

  • Sleepio Member

    • 522 comments
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    in reply to Sleepio Member
    Expert

    Hi,

    Really pleased you've found out what is helpful and less helpful for the QHR – I'm sure this will also be helpful for others logging in as the QHR is one of the key techniques in the Sleepio course.

    There is also a community discussion on exactly this point which is one of the most popular threads so it's pertinent to many:

    https://www.sleepio.com/community/discussion/what-relaxing-things-can-we-do-when-we-wake-in-the/

  • Sleepio Member

    • 522 comments
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    Expert

    Hi all, any more questions at all?

  • Sleepio Member

    • 522 comments
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    Expert

    Thank you all for your questions this evening! I'm logging off now, but wish you all better sleep for tonight.

    Bryony

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