Live discussion with Dr Dimitri Gavriloff - 15th May 2019

Dr Gavriloff will be hosting a live online discussion here on Wednesday 15th May, from 5:00pm to 6:30pm British Summer Time or 12:00pm to 1:30pm US Eastern Daylight Time.

He will discuss as many topics as possible in the hour and a half and, as always, you are welcome to ask any questions at all about sleep or the Sleepio program. If there are a lot of questions, he may not be able to answer all in the time available, but will try to answer as many as she can.

Please do note that, as per our guidelines, Dr Gavriloff will not be able to give personal medical advice including those about medication. His 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 9 May 2019 at 1:02 PM
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Comments

  • Sleepio Member

    • 25 comments
    • 7 helped
    Graduate

    Hi Dr. Gavriloff. I had an incident on my 3rd day of sleep restriction that I don't know if I should be worried about or not. I have a 5.5 hour sleep window from 11:45 to 5:15 and on my 2nd night of SR, I had a 77% SE. The next morning I woke up feeling good but several hours into the day, I started feeling the side effects of insomnia again, which didn't surprise me as 4 and 1/4 hours of sleep isn't really that much sleep. However, as the day progressed, I started building up the Sleep Drive again and every time I sat down, I had to keep myself from dozing off I was so tired. I figured it was going to be another good sleep night that night. However, between 8:00pm and 9:00 pm, I was watching TV and out of the blue, my sleep drive just disappeared on me. It just quit. I didn't feel sleepy, I wasn't falling asleep in my chair and I didn't think I would be able to go to bed in the three hours when my SW started as I just wasn't sleepy anymore. I went from being exhausted to nothing in a matter of minutes. Is it normal for that to happen now and then? Can your sleep drive just disappear like that? That was my 3rd night of SR and normally at that time I would have been getting ready for bed if I wasn't on SR. Is it possible my anxiety over sleeping masked or eliminated my Sleep Drive so that I wouldn't have to go into the bedroom? I know a lot of people tell me they are exhausted from SR but except for the first two nights, I am really not that exhausted or sleepy. Should I be worried that SR may not be for me? I do want to continue with it. Thank you for reading my question.

  • Sleepio Member

    • 2 comments
    • 0 helped
    Session 2

    where and how can i watch this?

  • Sleepio Member

    • 32 comments
    • 12 helped
    Graduate

    I joined sleepio because I wanted to stop falling asleep during the day and evening. It not surprising that I feel dozy after a bad night or two but why should I feel sleepy after a good night sleeping right through to my waking time?

  • Sleepio Member

    • 10 comments
    • 6 helped
    in reply to Sleepio Member
    Graduate

    It’s live on this page in written format.

  • Sleepio Member

    • 129 comments
    • 46 helped
    Expert

    Good evening everyone and welcome to this week’s live session. I’m Dr Dimitri Gavriloff, a clinical psychologist specialising in sleep disorders and I work in both clinical practice and research. I’m here to answer as many questions as I can over the next hour and a half and will aim to make my answers as helpful as possible to the community in general.

  • Sleepio Member

    • 129 comments
    • 46 helped
    in reply to Sleepio Member
    Expert

    Hi Steve10,

    Thanks for the great question to start us off.

    In fact, what you describe (understandably worrying though it might feel) is common among people who describe poor sleep. It's also a phenomenon that we see in people who report good sleep too. It's likely to be what we colloquially term a “second wind” but a more jargony term might be entering a “wake maintenance zone”.

    Essentially, our sleep-wake cycles are regulated by two processes: 1) the homeostatic sleep drive [HSD] and 2) the circadian process [CP]. The “sleep drive” that you describe is related to the HSD and one of the principal mechanisms by which sleep restriction works is in priming the HSD such that mild sleep deprivation is induced (as you experienced!). The CP still has a role, however, and here, what you're describing is probably a second wind, where the SCN (the suprachiasmatic nucleus; the body's principal biological clock) sends out an arousal signal in the late afternoon – evening time. It's one reason why people who are zombies in the office at 5pm might be more coherent human beings at dinner only a couple of hours later! A somewhat similar and opposite effect can be seen in the “post-lunch/circadian dip”, where some people experience a dip in performance and alertness in the early afternoon.

    It sounds like, to some degree, this experience of a sudden “loss” of sleep pressure (which was still there by the way – just hiding behind the SCN/circadian process!) worried you (quite understandably) and then autonomic arousal kicked in and banished any feelings of sleepiness completely. The worry about how you might fare/whether anything was wrong then perpetuated this and compounded the issue.

    Sleep restriction is by far and away the part of the program with which most people associate challenge! Part of what people report experiencing in the first few days of sleep restriction is some “messy” patterns where the body's regulatory processes try and sort themselves out. This is, unfortunately, par for the course but we know that this element is one of the most effective parts of the treatment and so I'm really glad to hear that you're keen to carry on and have a go!

    Hope that helps explain things and keep up the great work!

  • Sleepio Member

    • 129 comments
    • 46 helped
    in reply to Sleepio Member
    Expert

    Hi Ruthie-fruity,

    It can be a little confusing for first timers! Essentially, people type questions and we answer them in real time.

  • Sleepio Member

    • 25 comments
    • 7 helped
    Graduate

    Thanks for the reply. I am on Evening 7 (end of first week) of SR tonight and over the past 6 days, my sleep has been real low except for that one 4 1/4 night but I've been warned that it could get worse before it gets better. Thanks again.

  • Sleepio Member

    • 129 comments
    • 46 helped
    in reply to Sleepio Member
    Expert

    Hi Peter99,

    This is a great question, thanks for asking.

    In truth, it's tricky to know why you as an individual wake feeling sleepy after a good night's sleep but there are a couple of things that might be worth considering.

    One possible explanation is that despite sleeping right up to your alarm/waking time, your circadian phase is a little delayed. This means that when you wake, you may still need a little more sleep (i.e. your sleep need hasn't been fully met) as your body clock has you down to get up a little later. Incidentally, this is often something that presents with difficulty _falling _ asleep but typically not with difficulty _staying _ asleep. The reason that this happens is generally because are getting into bed earlier than their body clock would like them to and therefore they are not “biologically” ready for sleep.

    Another reason might be that your sleep quality is being affected by something – possibly something that you've consumed (alcohol, caffeine and sugar are three usual suspects that may or may not be relevant to you), or another sleep disorder (perhaps periodic movements in sleep or a sleep-related breathing disorder). If you're concerned about the latter then a trip to the GP to discuss symptoms (e.g. headache, dry mouth, loud snoring) is a good idea so that a sleep study can be arranged to find out more. This is probably a good idea if you experience excessive daytime sleepiness (EDS), which might be summarised as falling asleep (or feeling severely sleepy) at inappropriate times and with little or no control.

    Another more simple explanation is that your sleep need isn't being met or is being over-catered for. If we sleep too little, we feel sleepy and sluggish because of sleep debt – the residual sleep pressure that our bodies really wanted to be rid of by the time we wake in the morning. If we sleep too much we can also feel sleepy and groggy. It's also worth remembering that we all need different amounts of nightly sleep to function optimally.

    Hope that helps to clarify a bit.

  • Sleepio Member

    • 129 comments
    • 46 helped
    in reply to Sleepio Member
    Expert

    Absolute pleasure Steve10. I think the honest truth is that sometimes it does have to go through a bit of a difficult patch before it improves. However, I always counsel people to trust in the science. The reason why we as clinicians recommend this treatment to people is because we know that it works for most people.

    Keep it up and feel free to keep checking in! :)

  • Sleepio Member

    • 129 comments
    • 46 helped
    Expert

    Well, that's all for this evening folks. Thanks so much for the feedback and the questions. Looking forward to another live discussion next week.

    Keep up the great work!

  • Sleepio Member

    • 1 comments
    • 0 helped
    Graduate

    Hi, I have been following the Sleepio program for several months, with a sleep restriction window from 11:15-5:15. When does sleep start to improve? I have an occasional night when sleep efficiency goes up, but most of the time it does not hit 75%. I am very, very drowsy in the daytime. In the afternoon, I find it very hard to work. Am I doing something wrong, or is it normal to have a long period of minimal improvement before my sleep gets better?
    Thanks.

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