Live Discussion with Dr Gwen Keenan - 11th June

Dr Keenan will be hosting a live online discussion here on Wednesday 11th June 7pm-8.30pm (BST).

She will discuss as many topics as possible, starting with the most popular questions with answers being given in a way to give the most benefit to the general Community.

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Posted 5 Jun 2014 at 2:30 PM
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  • Sleepio Member

    • 1 comments
    • 0 helped
    Graduate

    I have always had problems sleeping more than 2 hours at a time. After completing the course, I did find the regime helped me get to sleep better, but I still cannot get more than 2 hours of uninterupted sleep. Any suggestions? Thanks

  • Sleepio Member

    • 53 comments
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    Graduate

    Dear Dr Keenan,
    Do you have an opinion on the use of Melatonin supplements as a sleep aid. I took one 3mg recently, slept like a log and then suffered a terrible hangover for the entire following day. I understand these supplements are very popular in the states and Canada. Thanks RH

  • Sleepio Member

    • 409 comments
    • 91 helped
    in reply to Sleepio Member
    Graduate

    I see what you mean. So, your sleep window has improved however you still have a few night time awakenings- is that right? Please be reassured that even the good sleeper can experience these however for them, because they have not experienced the anxiety and distress of insomnia, they can just roll over and fall asleep. They may not even recall waking up. So, what you are experiencing is normal. However, if it becomes frequent and the awakenings lengthen then you might want to tweak your sleep window. You have done really well so you don't need to go back to the initial window however you could maybe take 15 minutes of and see how you go. It sounds like you are still at a stage where you should be sticking to having a set sleep threshold time and a rising time so stick with whatever you set. I hope that helps. The B is for doing bullet points and the I appears to be for doing an underscore (like this__ or this ****). I had never used them!

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Thank you Ever Hopeful! Welcome to Sleepio. I am really pleased to hear that you have found the live discussions helpful and that was very kind of you to say! I hope you continue to find all aspects of the sleepio programme helpful and please make use of the online community whenever you need to. Good luck with it!

  • Sleepio Member

    • 184 comments
    • 17 helped
    Graduate

    Thanks. Glad to be reassured that 'all is well' maybe I
    will try moving the window to a bit later to go to bed? The awakening times are not long, I'm only slightly aware of them, get up once to go to loo, as I don't watch clock don't know how long the 'awake' bit lasts.
    Thanks for explanation of the B & I … haven't progressed that far… delighted I can do as much as I do on the
    computer! thank you.

  • Sleepio Member

    • 409 comments
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    in reply to Sleepio Member
    Graduate

    Hi there, this is great news. Well-done for sticking with the programme and it is good to hear you are reaping the benefits. CBT-I stands for Cognitive Behavioural Therapy for Insomnia. Hopefully articles that have this in them will make more sense. Sleepio is CBT-I. I hope you continue to sleep well.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hi Kitty, again it is good to hear about the positive progress you have made and 7 hours sounds like a pretty good sleep window. I like your healthy approach to accepting that perhaps 7 hours is enough for you. Sorry to hear about that afternoon slump! This is a common phenomena that many experience (even good sleepers). It might be an idea to take a walk following your lunch- get out in the fresh air and exercise. Although you are expending energy, it is also energising to do some light exercise. It could also be that you need a bit of bright sunlight and if this is difficult to access, some people have found a lightbox to be helpful. Once you have taken some light exercise you could have a little caffiene- this will provide you with some energy. Contacting a friend at such times might also help- just having someone to chat too can distract you from the feelings of tiredness and let you then get on with the day. The feeling will pass so it is useful to keep in mind a number of stategies that you could employ when you feel it coming on. Also keeping in mind that it will adversly impact on your sleep might be enough to motivate you to keep going. Good luck!

  • Sleepio Member

    • 409 comments
    • 91 helped
    in reply to Sleepio Member
    Graduate

    Hi there, I am sorry to hear about this frustrating problem. Are you waking up for long periods of time or are you able to quickly fall back asleep? It could be that you are having mild awakenings between sleep cycles. Is there anything in the environment that could be causing this or making you vulnerable to waking up- is the bed comfortable, warm enough and are noise levels down? As I said to someone previously, night time awakenings are common and are experienced by good sleepers however the associated anxiety is worse in those who have had sleep problems (and no wonder when you know how difficult it can be to be awake much of the night!). If the awakenings are short, try to be reassured that this is a normal sleep phenomenon. However, if these last a while and are causing distress and you have ensured that it is nothing in the environment causing these awakenings then I would consider you implement the QHR and reduce your sleep window a little. How does that sound?

  • Sleepio Member

    • 409 comments
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    Graduate

    Sorry, I was having a problem with my internet connection there.

  • Sleepio Member

    • 409 comments
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    in reply to Sleepio Member
    Graduate

    Hi, thanks for this question. Some studies suggest that melatonin in tablet form, several hours before bedtime, can help people get to sleep more quickly. However, there are few long-term studies, so melatonin does not offer a solution for persistent poor sleep. Some people prefer the idea of a 'natural' product over a sleeping pill, but like sleeping pills, the benefits of melatonin seem to be lost almost immediately when people stop taking medication.

    Melatonin is a naturally occuring hormone and there may be things you can do to improve the production of melatonin. It is thought that light at night may inhibit the production of melatonin and lead to a delay in sleep onset and possibly sleep fragmentation. There is a growing concern that we are being exposed to light from phones and computers, for example, when in bed late at night, impacting on melatonin and sleep-onset. So, give up these devices and ensure you have a dark sleep environment. Perhaps start to darken the environment during your “wind-down” time.

    You might want to continue to implement the sleepio programme and see how that goes before introducing something else. That way you will be able to see what progress you have made at improving your sleep. This will help you develop an “internal locus of control” and help you see that you can improve your sleep. If you start with the melatonin it will be more difficult for you to know what was down to you and what was down to the melatonin. How does that sound?

  • Sleepio Member

    • 409 comments
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    Graduate

    Has anyone got any tips on what they do when they awaken in the night? That has come up a bit tonight. Or what about dealing with the afternoon slump- any tips? I find bright light, fresh air and a coffee helps me following my lunch!

  • Sleepio Member

    • 6 comments
    • 2 helped
    Graduate

    Hi. I.m in week 3 of Sleepio and really struggling. My original problem was nighttime wakings and not being able to get back to sleep. However, since introducing the sleep window and QHR things have got worse. If I get up in accordance with the QHR, I am up for hours and do not get any more sleep unless I take a sleeping tablet. I think knowing I'm chasing the close of the sleeping window is making me more anxious about this and making it harder to get back to sleep. Also, I am now so scared of waking and not being able to sleep again that I am struggling to get to sleep when I originally go to bed for fear of what the night will bring. maybe sleepio isn't for me?

  • Sleepio Member

    • 6 comments
    • 2 helped
    Graduate

    Also, despite doing my wind down routine I can fell myself getting more anxious as the evening approaches and bedtime gets near. In fact the wind down routine has really just become an anxiety trigger.

  • Sleepio Member

    • 184 comments
    • 17 helped
    Graduate

    I don't wake for long enough to be 'distressed' in the night thankfully, but with afternoon slumps, I'd suggest if one can, leave the 'work desk' for a brief walk up and down, and if not in employment, go out for a walk in the air, good or bad, thundery or whatever. Or have a coffee in a local cafe and meet others if that's a possibility. It has been particularly oppressive in the northern hemisphere in last few days.

  • Sleepio Member

    • 184 comments
    • 17 helped
    in reply to Sleepio Member
    Graduate

    see my comment, forgot to click reply!

  • Sleepio Member

    • 409 comments
    • 91 helped
    in reply to Sleepio Member
    Graduate

    Hi Becca, I am sorry to hear about this. It sounds like you are finding some aspects of the programme difficult just now. Please be reassured that this will get better- you are very new into implementing a whole new sleep routine and it can feel overwhelming to start with. I wonder if you have been experiencing sleep problems for a while- often when people have had sleep problems for a long time they then develop a range of coping strategies that actually make the problem worse (tossing and turning all night, napping through the day, TV/books in bed) and starting sleepio can be quite an overhaul! When you start the winddown routine can you try implementing a relaxation exercise or doing mindfulness. This will help reduce your anxiety. It might also be helpful to use the “thought checker” to identify thoughts that are causing anxiety and then reevaluate that thought. In terms of sleep restriction and the QHR stick with it- it is hard however it is temporary- this is a sharp quick start to a better sleep- it won't last forever. The first few weeks are the hardest. Basically what you are doing it consolidating all your sleep into one block. This helps to reduce time in bed awake. The more you are in bed awake, the weaker your bed-sleep connection. By reducing the time spent in bed awake and increasing the time in bed asleep, you develop a stronger bed-sleep connection. This means that your bed will come to be automatically associated with sleep and help sleep to come more naturally. By implementing the QHR and SR you also build sleep pressure and this reduces the time it takes to fall asleep and also helps to squeeze out any night time awakenings. Try and have a plan as to what you can do during the QHR. Have somewhere that is warm and comfortable. When you get anxious about being awake, try and use the thought checker to evaluate and change your thoughts or use mindfulness to help you feel less distressed. Please use this forum again so we know how you are getting on and so we can help you. It is a difficult time but usually works. Good luck.

  • Sleepio Member

    • 409 comments
    • 91 helped
    in reply to Sleepio Member
    Graduate

    If the QHR feels really unmanagable just now maybe try implementing SR without it. The last thing we want if to increase anxiety! However, the evidence is that the programme works best when all of the components are implemented. You mentioned that you have sleeping tablets. I wonder if you have spoken to your GP about being on this programme as they might be able to advise you further on the use of medication.

  • Sleepio Member

    • 409 comments
    • 91 helped
    Graduate

    That is all for tonight. Thanks for all your interesting questions and for joining me tonight. I am afraid this is my last evening on Sleepio. I have really enjoyed my time here and wish you all the very best with the programme.

  • Sleepio Member

    • 184 comments
    • 17 helped
    Graduate

    Ah thank you, sorry you won't be with us again, good luck in your next job.

  • Sleepio Member

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

    Thank you Dr. Keenan for your advice. I will identify when this occurs and find a way to 'break the cycle'

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