Live Discussion with Dr Dimitri Gavriloff - 9th January 2019

Dr Gavriloff will be hosting a live online discussion here on Wednesday 9th January, 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.

To keep up with new comments as they are posted you will need to refresh this discussion page.

To do this:

On PC hit CTRL and R keys or the F5 key
On Mac hit CMD and R

Posted 4 Jan 2019 at 12:23 PM
  • 12 comments
  • 2 helped

Comments

  • Sleepio Member

    • 2 comments
    • 0 helped
    Graduate

    I have linked my Fitbit with my Sleepio account. But Fitbit gives a totally inaccurate estimate of the time I spend asleep. Does Dr. Gavriloff see any value in Fitbit as a tool for measuring sleeping patterns?

  • Sleepio Member

    • 4 comments
    • 0 helped
    Graduate

    Face plant! I graduated Sleepio about 4 months ago with great success. I was no longer using sleep meds and handling any blips like a champ getting right back into a rythym. Then I hit the wall after a very stressful month and have had a couple bad weeks. I can’t seem to get back into a rythym, and it is really affecting my confidence I had toward bedtime. Any advice? Do I go back through the program again from the beginning? I’m frustrated and gaining back long gone anxiety by the day.

  • Sleepio Member

    • 3 comments
    • 0 helped
    Graduate

    Likewise. I graduated some time ago and was also off Nytol which I used regularly. I was sleeping up to 6 hours a night which I hadn't done for years. Over Christmas I had a bad cold and took Night Nurse for several consecutive nights. Since then I have barely slept. Sometimes I get an hour or up to 3 hours maximum. So same question as above really.

  • Sleepio Member

    • 121 comments
    • 45 helped
    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

    • 121 comments
    • 45 helped
    in reply to Sleepio Member
    Expert

    Hi Coleen,

    Thanks for your question. This happens to be a particularly interesting area for me and, in fact, some of my recent research has looked at the effects of feedback from these kinds of sleep tracking devices on people’s insomnia symptoms. In this age of the “quantified self”, more and more of us are using these kinds of devices to track our health data and we see a huge range of apps and trackers that purport to measure our sleep.

    Now, it's worth saying that we regularly use acti-watches (small actimetric devices that are typically worn on the wrist and that measure fine motor movement) in sleep medicine and sleep research. They are a low impact means of gathering data on how much people move around, particularly at night, and thereby give us some sense of for how long they are actually asleep and the times when this sleep takes place. However, these devices are generally very expensive and are specialist scientific instruments. Additionally, the data that they give us is also typically interpreted by a sleep specialist, someone who is trained to make sense of the (often quite complex) outputs. The commercial devices on the other hand are designed to be affordable (although some might still be quite pricey!) and to use automated algorithms to provide the output data that they present to the wearer. Suffice to say that there is, therefore, invariably going to be a bit of a difference in how the data is analysed and interpreted.

    I haven't used the FitBit myself and so I can't comment on it specifically or from an experiential perspective. However, if you feel that the device is giving you a completely inaccurate sense of your sleep then it may be that it isn't going to be of much use here. It might simply be better to rely on a good old fashioned sleep diary that you keep yourself. For those others who may read this and be very happy with their devices, there's no need to ditch the watch – the maxim, I suppose, is to use things only if you find they are helpful.

    Another point that it might be worth making, to go back to the research I mentioned earlier, is that people tend to pay attention to the feedback from their devices. This is particularly the case when people get negative feedback from their device, which may ironically actually make them feel worse and become part of the problem.

    Hope that helps!

  • Sleepio Member

    • 2 comments
    • 0 helped
    in reply to Sleepio Member
    Graduate

    thanks for that. I think I will have to disconnect since I am still experiencing significant sleep loss and if I leave my diary as it is now The Prof. is going to think I have made huge strides forward when sadly I know I haven't. When Fitbit records 'light sleep'what I am actually experiencing is no sleep

  • Sleepio Member

    • 3 comments
    • 0 helped
    Graduate

    Hi Doctor – I haven't been on one of these sessions before but I'm hoping you are going to answer the almost identical queries from myself Sleephopeful and someone before me Sleepio User. Thank you.

  • Sleepio Member

    • 121 comments
    • 45 helped
    in reply to Sleepio Member
    Expert

    Hi SleepioUser,

    Thanks for the question. First thing to say is … Bravo! Well done on doing so well going through the programme and making such progress!

    I'm sorry to hear things got complicated again after the stressful period you mentioned but rest assured that fluctuations like that aren't by any means uncommon. It might be worth remembering that in fact, these kinds of life stressors are often how people wind up struggling with their sleep in the first place.

    I suppose the key here is to focus on the two most important points: 1) that you have already gone from struggling with your sleep to doing brilliantly, simply by using your own effort and the techniques that are contained in the programme and 2) you've done it once so you can do it again!

    The great thing about CBT-I is that we can always go back to basics. That doesn't mean that we're starting from scratch! Remember, we're more experienced now and know what was helpful. At this stage it might just mean focusing on what elements of the course we could put back into place to help things get back on track. Take a moment to think about what things tricky at the moment?

    If your sleep is quite fragmented and you notice that you're waking up often throughout the night then it might be a good idea to try sleep restriction again to help consolidate the sleep.

    If you notice that you're struggling to fall asleep and that the “racing mind” is getting in the way, then it might be sensible to use some relaxation techniques as a means of helping yourself switch off.

    Either way, it will likely be helpful to keep up the stimulus control – using the bed only for sleep, not napping, getting out of bed after 15mins of sleeplessness or when you notice you're feeling frustrated and getting up at the same time each day. These last points (stimulus control) are really important to keen up with, even when sleep does improve again.

    Don't let the anxiety get you down SleepioUser – you're a lot more experienced than you were when you started and so even if it feels daunting, be heartened by your newfound knowledge and skills. You'll find all the sessions back in the Library.

    Wishing you well with the next steps and let us know how you get on, we're here for support!

  • Sleepio Member

    • 121 comments
    • 45 helped
    in reply to Sleepio Member
    Expert

    Hi SleepHopeful,

    Thanks for the question. As you mention, your query is similar to that of SleepioUser and so I hope the response to SleepioUser is helpful to you too.

    One thing that it's worth bearing in mind is that when our sleep starts to improve and we become more confident again, we might let go of some of the structure that we put into place when going through the programme. This makes total sense and why wouldn't we? Our sleep has improved and so why carry on with the things that got us there?

    One reason is that consistency is a good thing when it comes to sleep. For instance, maintaining a consistent daily rise time both on the weekends and the weekdays is very helpful for sleep regulation – remember, the notion of a weekday/weekend is completely arbitrary and so the body doesn't differentiate!

    When it comes to illnesses and holidays, in particular, our time in bed can start to fluctuate and so keeping an eye on the timings is important. As above, if in doubt, perhaps take an evening to go back through the library and find the session that you feel would be most helpful to start again with. There's no harm in going back to basics.

    Hoping that this helps and let us know how you get on. We're here for support.

  • Sleepio Member

    • 3 comments
    • 0 helped
    Graduate

    Thank you. You are correct in thinking I haven't been keeping to the rules as I was. Partly this was because as my sleeping deteriorated I became so exhausted that I just couldn't get up in the night when I should have done and in the morning I wasn't getting up at the prescribed time. When feeling so awful Sleepio is hard to do! However I will go back to the library and try again.

  • Sleepio Member

    • 121 comments
    • 45 helped
    in reply to Sleepio Member
    Expert

    No problem at all. These things happen and it's completely understandable that they do! I think many of us will agree that CBT-I isn't easy at the best of times (particularly the 15 minute rule and the sleep restriction!), but I hope we all feel it's worthwhile.

    Keep up the great work SleepHopeful! :)

  • Sleepio Member

    • 121 comments
    • 45 helped
    Expert

    Thanks for all the great questions this evening folks. That's it for this evening but we'll be back next week for another live discussion.

    Keep up the great work everyone! :)

Return to top