Live Discussion with Dr Gwen Keenan - 16th April

Dr Keenan will be hosting a live online discussion here on Wednesday 16th April 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 10 Apr 2014 at 12:34 PM
  • 65 comments
  • 30 helped

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  • Sleepio Member

    • 4 comments
    • 8 helped
    in reply to Sleepio Member
    Session 4

    Dear Dr Keenan,

    Thanks for your full and helpful reply to my posting on this forum. I'm writing because I've been a 'radio adict' (day & night) for just about all my adult life. I posted a question to Dr Sheaves last week about use of radio but got a rather equivocal reply. However 'RAYBIN' replied that I should give up my radio “at my peril”. As you can imagine, I rather liked that reply.

    For me, the radio works far better than any thought modification technique. I don't have anxious or fraught nights but it's not possible (even for 'normal' sleepers, I'd have thought) to prevent oneself from mulling over the happenings of the day or the moment. Listening to the radio undoubtedly helps temper that tendency. As you suggest, I have the volume as low as possible but one problem with the 'auto timer' is that it can awaken you when the sound stops!

    None the less, it's something I'm reluctant to give up and I think this is the same for many others.

    Thanks.

    Richard

  • Sleepio Member

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

    Hi there, I understand your point however I am afraid that the research indicates that time spent in bed awake (even when it is pleasant) reduces the strength of the bed-sleep connection. Also, by getting out of bed when you awaken and implementing the QHR will help build sleep pressure, reduce the time it takes to fall asleep (sleep-onset-latency) and improve sleep efficiency so you might find that you will sleep for the full sleep window rather than for only part of it. Having said that you might want to balance this with how much distress getting out of bed causes in the morning. If you are quite happy with your sleep as it is and you are having some relaxing time in bed in the morning then perhaps continue as you are. If however your sleep routine is still causing you distress then I would stick with the QHR rule.

  • Sleepio Member

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

    Hi there, that is a late one. The sleep window is adjusted as your sleep efficiency improves. Once you are achieving an average of 90% sleep efficiency for a week you can adjust your sleep window by 15 minutes. You can either choose a later rising time of an earlier sleep threshold time. It the current time feels unmanagable at the moment, you couold consider shifting it back- go to bed a little earlier but also rise a little earlier. Sleep restriction can be difficult however if it like a sharp nudge to jump start your sleep pattern- it won' t last forever. The online community can be very helpful during this time.

  • Sleepio Member

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

    Thank you! I am disciplined and get up at 8 am as
    prescribed. But keeping awake before going to bed is
    not easy. I have not yet reached the 90% part.
    But your reply is helpful.

  • Sleepio Member

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

    Good evening. It is very important that you stick to your allocated sleep window. This has been calculated by looking at how many hours sleep you get on average. Although it seems narrow, this is how much sleep you are getting only condensed into one sleep window. This will help you to develop a better, more routine and more efficient sleep. Do not adjust the sleep window until your sleep efficiency has reached 90% for one week. The Prof will advice you of this. You can however adjust when the sleep window takes place. Perhaps you are finding it is very difficult to stay awake until the threshold time? Is the rising time more difficult? You can move it back or forward but only increase the length when you are advised to by the Prof. I have pasted two links below that you might find helpful.

    https://www.sleepio.com/library/article/sleep-restriction-the-science/

    https://www.sleepio.com/library/article/how-to-shift-your-sleep-window/

    It is a small window that you have just now but this will help kick start a better sleep routine. Good luck!

  • Sleepio Member

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

    Thank you for the answer, I have read in one of the earniler replies to open the cutrtains and let the light come in to make you wake up easier. But the problem is that at 5.15 when I wake up, it is still very dark, so it makes it even harder.
    How long on the average does it take, if one follows the rules correctly, to acctuly start to improve the SE and the length and quality of the sleep within the sleep window?
    Thank you

  • Sleepio Member

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

    Good evening and welcome to sleepio! It sounds like you have a lot of things going on at once here with sleep problems, anxiety and depression plus some questions about medication. I would advise that you direct any questions about medication to your own medical doctor/GP. It is common for depression and anxiety to co-exist with sleep problems and I am sure many aspects of this course will be helpful for your sleep problems and might have the added benefit of helping some other difficulties you are having. In regards to the use of sleep medication, follow your docors advice about how to take them and how to come of them. Sleeping pills are an effective treatment for sleep problems however the effect does not last and some people develop a dependency. It is for this reason that they are not considered a long term treatment for chronic sleep difficulties. CBT for insomnia (which sleepio is) is the recommended treatment by National Institute of Clinical Excellence. This is because is has a number of high quality research trials that have been able to demonstrate its effectiveness. You are only on session one so just take each session as it comes and come back to me or the community if you have any other questions. Good luck!

  • Sleepio Member

    • 409 comments
    • 91 helped
    Graduate

    We are nearly out of time- I will keep going a little longer. Sorry if I have not got back to any follow-up questions!

  • Sleepio Member

    • 184 comments
    • 17 helped
    Graduate

    This was my first on-line discussion session. I valued it,
    thank you. Theresa

  • Sleepio Member

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

    I am sorry to hear about these difficult nights! I would follow the advice I have given and those in the community. Keep implementing the programme (including QHR) and give it time. I would keep the sleep window the same until you see improvements on thos other nights. Sometimes long standing problems do take some time to improve but you will get there.

  • Sleepio Member

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

    That's good to hear your personal experience- I think it is really helpful for others when they hear something like this. I am the same- cannot imagine having any noise when I sleep!

  • Sleepio Member

    • 435 comments
    • 248 helped
    in reply to Sleepio Member
    Graduate

    Thanks for the helpful response: it's as I feared! I often wake up about 15 – 30 minutes before my sleep window ends, and I feel cheated, (I know that's childish of me), so tend to chill out in bed for the rest of the time, but I can see what you are saying. No short cuts or easy options.

  • Sleepio Member

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

    The idea of banking sleep comes from the fact that we have a homeostatic drive when it comes to sleep. If you over sleep one day, you will need a little less that night (which is why we do not recommend napping). Similarly, if you undersleep, you accumulate a sleep dept and need more the next night. It is not hour for hour though- not quite as clear cut as that.

  • Sleepio Member

    • 10 comments
    • 1 helped
    Graduate

    Thank you again for your advice.

  • Sleepio Member

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

    I hope the lighter mornings help- they are coming! How long it takes can vary a lot between individuals depending on how well they are implementing all the aspects of the programme, how strict they are with sleep restriction, how long standing their difficulty is etc. For most people, they will see a difference within three weeks in terms of their improved sleep efficiency and day time functioning improves about a week later. Remember to come back to me or the community if you need any support with it. Alos, remember this a temporary solution and it will improve.

  • Sleepio Member

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

    I am glad it has been helpful!

  • Sleepio Member

    • 409 comments
    • 91 helped
    Graduate

    That's it for the night. Lots of great questions tonight- I enjoyed that! Good night.

  • Sleepio Member

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

    I am happy with the on line advice and have a better
    grasp of the programme now. Good night. Theresa.

  • Sleepio Member

    • 3 comments
    • 1 helped
    Graduate

    Dear Dr Keenan,

    Thanks for your message and wise words. I want to respond briefly.

    I live abroad but nevertheless have had sufficient help regards the kids' sleep habits. To be honest, on that front, I'm vaguely hopeful. We've moved around a lot, and now that we're finally settled, I'm seeing their sleep patterns slowly improve. But it goes in bouts and my youngest suffers from eczema that always flares at night.

    I feel strongly that – as long as I'm doing ok sleepwise – everything else falls into place. I've become, over the years, VERY dependent on having enough/quality sleep, which is becoming a bore – hence joining Sleepio and making some concrete steps towards better sleep hygiene. I'm seeing results already, but don't want to talk to soon.

    I'll take what I can from the course as, as you say, restricting sleep to a small window is not going help matters in my case.

    All the best, and thanks again,
    Helen

  • Sleepio Member

    • 6 comments
    • 0 helped
    Graduate

    Is there such a thing as seasonal insomnia? I ask because about 80% of my insomnia episodes happen during winter (over the past 25 years). When they happen, I follow a sleep restriction on my own and all of sudden the insomnia seems to resolve, but it seems to take forever--this time it has taken 4.5 months for the episode to clear although I've been following the same 5.5 hour restriction since Dec 7. Once it's gone, it's just gone, as if it never happened. I can have 1-2 years of no insomnia and then something inconsequential ( example hearing my daughter's alarm clock go off at 5 a.m. for a few nights, or allergic symptoms that go on for 3 nights), seems to trigger the insomnia pattern and once I'm in the pattern, it takes months and months to get out of it. I don't think I'm depressed as I feel normal during the isolated days when I've had a good night's sleep--however I have found when my hours of sleep dip below 4, I do have mood symptoms the next day (anxiety and negative feelings). I attribute this to the effects of sleep deprivation and not an actual depression.

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