Live discussion with Dr Dimitri Gavriloff - 20th June 2018

Dr Gavriloff will be hosting a live online discussion here on Wednesday 20th June, from 7:30pm to 9:00pm British Summer Time or 2:30pm to 4:00pm 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 he 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 14 Jun 2018 at 11:12 PM
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  • Sleepio Member

    • 1 comments
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    Session 2

    HHi there, how do we join the online discussion?

  • Sleepio Member

    • 5 comments
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    Graduate

    Dear Dr Dimitri

    My SW is from 1am to 6am. At 12pm I am already very sleepy and noding off, but when I get to bed at 1am, I could not fall sleep quickly, and have to get up one or two times before falling sleep. This pattern has been for about a week, what is the problem here and what should should I do to fall sleep sooner? Thank you.

  • Sleepio Member

    • 53 comments
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    Graduate

    Hello Dr. Dimitri

    I seem to have already done all that Prof. has advised save for sleep restriction which shall commence today. Regards bedding while I am happy with my bed around 5years old, I bought a Dunlopillo which unlike previous feather pillows does not allow for fluffing up to make it comfortable to rest my head and fully support my neck.

    Therefore although John Lewis advisor suggested a towel to support for comfort I did not think this would help as I am side sleeper. I do not recall if did advise of my sleep posture but, cant think why I would not. Anyhow I have used a couple of old pillows one at a time with mixed results final wake up with some level of neck pain. What would you advice?

  • Sleepio Member

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    Graduate

    Additionally, another problem I encounter is a 'mind fight' to retain sleepy mind before I get to bed or when in my wakenings as the last two nights my switched to active and despite much reading did not get back to sleep.

    I should be grateful for your advice.

    Thank you in anticipation.

  • Sleepio Member

    • 129 comments
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    Expert

    Good evening everyone and welcome to this week’s live session. I’m Dr Dimitri Gavriloff, a clinical psychologist with a special interest in sleep 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
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    in reply to Sleepio Member
    Expert

    Hi there Sf5,

    You’ve joined it! The live discussions are done through this message board. All you’ve got to do is post your question here and I'll do my best to answer it during the time we have.

  • Sleepio Member

    • 129 comments
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    in reply to Sleepio Member
    Expert

    Dear Leo_L,

    Thanks for your question. It’s difficult to say exactly why it might be tricky to fall asleep at 1am, despite feeling tired at 12, but I have a couple of ideas. I suppose it’s worth saying up front that it does take some people (and their bodies) a bit of time to get used to sleep restriction – it can be a challenging element to CBT-I.

    One reason might be because of ‘sleep effort’ (i.e. the pressure we put on ourselves to get to sleep) – I’m not sure whether or not you notice a need to ‘try’ and get to sleep, once you do finally get into bed? Some people find paradoxical intention a useful strategy to try if this is the case.

    Another idea is that it might be to do with what happens between 12 and 1 (for instance, getting ready for bed/brushing teeth in a bright room, sorting out the phone before bed etc.). It may be worth making sure that everything’s ready to go well in advance of heading to bed so that as soon as your sleep window opens up you can just jump straight into bed.

    If you notice any particular cognitive arousal (e.g. racing mind, worries about not being able to nod off), another option might be to use some wind-down or relaxation techniques in the run up to bed.

    In any case, it sounds like you’re managing it really well by using the stimulus control instructions and making sure that you’re re-establishing that good bed-sleep association!

    Hope that helps and keep up the good work!

  • Sleepio Member

    • 129 comments
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    in reply to Sleepio Member
    Expert

    Hi there Sleepless in Ealing,

    Seems like you’ve got two questions here so I’ll answer them one by one, if I may.

    It’s probably worth saying that I’m not a physiotherapist and so don’t claim to be an expert in neck pain (!). However, neck pain can occur for all sorts of reasons that don’t necessarily mean that we’re sleeping in an unhelpful posture and it can be tricky to make sense of. For instance, I‘ve noticed that my posture during the day (particularly typing on a low table, which I’m doing now incidentally) can mean that I get quite tight shoulders and this can affect my neck and therefore my comfort when I lie down in bed. The remedy here for me has been to become more aware of what I’m doing and how it affects my neck and shoulders. When I notice it becoming tight I might give myself a moment to stand up and have a gentle stretch. This has really helped, and is something I often do before bed if I feel a bit tight in the neck or shoulders. I notice that you’ve also mentioned reading in the next question and that might be something that could be leading to stiffness in the neck before bed too.

    If the pain is disruptive and uncomfortable enough to cause you issues during the daytime, it’d be something I’d advise having a chat with your GP or a physiotherapist about. They’re best placed to advise on what kinds of stretches and exercises might be helpful.

    In terms of your question about the “mind fight” to stay in a sleepy mind-state, this sounds like a good opportunity to put some of the more cognitive elements of the treatment to use. Specifically, it might be helpful to see if you can identify what it is that you're dwelling on when you're mind-state switches to being “active” again. Acknowledging it and writing it down on a piece of paper next to your bed for tomorrow might help as a physical aid to mentally 'putting these thoughts away'. It does take some practice and perseverance though, so remember to be gentle with yourself. Additionally, when you notice that you're mind is active, see if you can see it as an opportunity to try out a relaxation or mindfulness exercise (perhaps something like a body-scan). My guess is that the sleep restriction that you're about to start will also be really helpful in consolidating the blocks of sleep that you're currently experiencing.

    I’m really glad to hear that you’ve taken what the Prof. has advised on board thus far. Sticking with the plan you've been following is a really good idea here – best of luck with the sleep restriction!

  • Sleepio Member

    • 129 comments
    • 46 helped
    Expert

    That's all for this evening folks! Thanks for the questions. It's been a bit of a quiet one here tonight but we'll be back for another live discussion next week.

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