Live Discussion with Dr Gwen Keenan - 19th March

Dr Keenan will be hosting a live online discussion here on Wednesday 19th March 7:00pm-8:30pm (GMT).

She will discuss as many topics as possible in the hour, 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 13 Mar 2014 at 4:23 PM
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  • Sleepio Member

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    That is fantastic to hear! The online support is crucial as I am sure you have noticed so thanks for coming along tonight. I always find the insights provided from the sleepio community so helpful. A statement providing empathy and understanding can go a long way to helping someone going through sleep problems.

  • Sleepio Member

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    HI there… regarding you earlier answer to poor sleep quality and sleep maintenance … since before joining sleepio i was doing everything you listed regarding daytime and night time…everything that has been suggested to me .. I've had a really good sleep hygiene (except SR and qhr) yet my sleep quality still feels really bad. Im not even having a stressful time as so many others are…. I'm a bit lost ?

  • Sleepio Member

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    Hi Raybin, I am glad to hear that your sleep related anxiety has improved; often that is one of the most distressing aspects of not sleeping well and also one of the factors that contribute to the maintenance of sleep problems; poor sleep leads to anxiety about sleep and possible consequences of poor sleep and then this in turn disrupts sleep further. Am I right in saying that you are getting 3-4 hours sleep a night and then you have a longer sleep every few days? I would like to think you could get a longer sleep window however if this is comfortable for you and not causing any distress then this is great progress. It certainly sounds like the QHR is difficult for you as you fully awaken however I would caution against spending long periods of time in bed awake as this will cause the bed to become associated with being awake rather than asleep. What might help you is to try to build sleep pressure throughout the day by staying active. As I have said a couple of times tonight, caffeine and alcohol should be avoided as this can cause a disrupted sleep. The power nap you describe might also inhibit a good sleep at night time however because you are sounding quite accepting of your sleep pattern I do not want to tell you to cut it out. It sounds as though you have developed a more regulated homeostasis. This is a natural system that keeps things like appetite, thirst, and indeed sleep in perfect balance. The idea of a homeostat is that it regulates what we require. So, from the moment we wake up in the morning, we gradually accumulate debt in the sleep bank until we repay it the following night. Daytime builds up sleep debt, and night time pays off the debt, daytime builds up the sleep debt again, and night time once again pays it off. This is a well balanced homeostatic system. This is the kind of homeostatic balance that CBT helps re-establish in a clearly organised sleep schedule.

  • Sleepio Member

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    It sounds as though you have been addressing your sleep difficulties for some time? I wonder if you have been to the GP just to rule out any medical causes for disrupted sleep such as sleep apnea? For many people though it is about the bed-sleep connection. As people struggle to sleep in their beds, anxiously tossing and turning, it becomes a place associated with anxiety. Rather than waking up and falling straight back asleep, a feeling of dread can set in and sleep becomes more difficult. This is where implementation of the QHR and SR can be very helpful (in addition to the other strategies you are using). Remember, it doesn't last forever but is a method of kick starting a better sleep routine. In addition to this, think of ways to build sleep pressure by expending energy throughout the day- physical activity can help sleep quality.

  • Sleepio Member

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    Hi Dr Gwen,

    Thanks for your very detailed answer. Just to clarify, I am regularly getting 5 hrs but every now and then I bomb out. This morning, however, I felt tired when I awoke but could not return to sleep. I have worked for 6 hours in the garden today and should be tired but feel weary….not tired. It seems as though my brain is ready to go when I wake up even though I feel tired. It is not racing…..just wide awake and ready for the day. I feel so much better if I have 6 hours but I just don't seem to be able to get there. Any ideas?

  • Sleepio Member

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    This sounds more like resting if you are aware of your surrounding. As we fall asleep we go into a transitional phase between wakefulness and sleep known as stage 1 sleep. During this phase the muscles relax more than they would during wakefulness. This phase of sleep can be identified using sleep recording devices (EEG, EMG and EOG). Phase 1 tends to be a very brief period of sleep before transitioning into phase 2. It is possible that you are beginning to lapse into stage 1 however not fully as you are in a stimulating environment. Are you worried about napping throughout the day?

  • Sleepio Member

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    Sorry to butt in Raybin, It just occurred to me that maybe you need something to make your brain weary rather than your body….? Maybe an intellectually challenging project of some kind…?

  • Sleepio Member

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    Wow, that is a lot of gardening! How is it looking? That sounds like a great way to stay active and build sleep pressure. It sounds like the body gets tired but the mind stays alert? You say that nothing is worrying you though? Have you tried mindfulness meditation? That can be a good way of training the mind to stay in the present moment and might help relax it somewhat. Another technique for taking control of a the mind is thought blocking- I discussed this earlier. This is when you repeat the word “the” over and over. Perhaps it might be helpful to avoid the nap but if the body feels tired just take a rest and read a book? The nap will impact on night time sleeping.

  • Sleepio Member

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    Great thinking!

  • Sleepio Member

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    Hi Jaqs99, thanks for your comment. Honestly, I have a few intellectual challenging projects also. Not quite like being at work but, for example, I am currently negotiating with a receiver to buy an asset from a defunct company and my genealogy is very mentally challenging as there is no low hanging fruit. I have just told my wife, who is sitting next to me what you have said. She thinks I have too much on my plate…..:-)

  • Sleepio Member

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    We have about 10 minutes left. Any more questions? There have been some great ones tonight. A lot of people describing sleep maintanance difficulties and I hope the advice I have given is helpful. Remember to make use of the library resources. They go into quite a lot of detail regarding many of the issues discussed tonight.

  • Sleepio Member

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    That does sound a lot. Before going to bed are you taking time to switch off mentally? Winding down, putting the day to rest?

  • Sleepio Member

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    One last reminder to complete the survey regarding sleepio. Please follow this link:

    https://www.survey.bris.ac.uk/nottingham/sleepiosurvey

  • Sleepio Member

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    I have tried both thought blocking and the “the” technique. My mind wanders as I get bored. I have concluded. That my mind I'd jus awkward…...and my wife agrees! I did find brain entrainment was useful for about 10 days…then it stopped working for me. I think, again, I was bored with it. Unfortunately, in my job as a Chief Exec of a medium sized company, I was used to things happening a
    Most instantly. Now that they don't…...as I have to do everything myself(!) I seem to get bored very easily. Does that make sense to you?

  • Sleepio Member

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    Ah, Please apologise to your wife :)
    Still going with the brain tiring idea though, maybe something creative ,like writing a book, or oil painting(!), not something that feels like a job of work on your plate, but that comes from a different part of your brain than the problem solving type of activity.

  • Sleepio Member

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    I must admit that I used to meditate before going to bed but I have dropped that off…..yes, I got bored!.......perhaps, I should re-start that?

  • Sleepio Member

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    Jaqs99, you may have hit on something, which I can try. I had not thought about the brain separation….left and right. I need to look into that. Thanks!

  • Sleepio Member

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    Yes it does! That sounds like a major life transition and it can take some time to adjust. I like that you are feeling less anxious about your sleep and this is what we should probably focus on. Keep going with the various components of the course that have worked and if you feel things deteriorating then I would recommend revisiting sleep restriction and not napping throughout the day. I am reluctant to offer too many strategies as this may increase your anxiety rather than be helpful!

  • Sleepio Member

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    Meditation can be very helpful. If you aim to just be aware of what is arising inside you without judgement, this can be very calming. You may find that thoughts creep in such as “this is boring” and that is okay, just let the thought pass as you reconnect with what is going on in the present moment: your breathing and bodily sensations. Here are a couple of links regarding mindfulness.

    https://www.sleepio.com/library/article/mindfulness-putting-it-into-practice/

    https://www.sleepio.com/library/article/mindfulness/

  • Sleepio Member

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    Thanks everyone for your questions and helpful comments. That's us for tonight. Goodnight.

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