Live Discussion with Dr Gwen Keenan - 23rd October

Dr Keenan will be hosting a live online discussion here on Wednesday 23rd October 7pm-8pm BST.

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 18 Oct 2013 at 10:06 AM
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  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    I am glad that was helpful. I often find that when I am busy in the afternoon I don't realise the time going past so I am hoping that by putting the clocks back at this time, it will feel easier to deal with. How are you getting on with SR?

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hi Megan,

    Sorry to hear that- it sounds as though this is a frustrating problem for you! I am not sure what the cause of this is for you however you might want to consider if you can identify potential external or internal triggers. External triggers could be noises outside, comfort levels, heating etc. Internal triggers could be that you need the toilet or you feel thirsty. Try to limit these potential triggers. Night time awakenings are a common phenomenon even in people who consider themselves to be good sleepers! The difference is however that the good sleeper can turn over and go back to sleep. For you, it sounds as though you cannot get back to sleep for several hours. There are several things you can do to try and overcome this (as well as dealing with external and internal triggers). Let’s think about the range of tools you have acquired from the Sleepio programme that might be helpful. Have you put in place a good wind down routine? Have you put the day to rest? Are you going to bed when you feel “sleepy tired” rather than just tired? Are you ensuring that bed is for sleep only? It sounds as though you continue to use the QHR which is good to hear as we need to continue to develop your bed-sleep connection. I am wondering if you get fairly anxious when you wake up- perhaps you feel annoyed and frustrated. What are the thoughts that you have at this time that drive such feelings and can these be replaced with less anxiety provoking thoughts? Can you reframe getting up at this time as an opportunity to do some relaxation before returning to bed once you are sleepy tired? Have you got a nice environment to go to during your night time awakenings?

    Research indicates that Sleep Restriction often works well to overcome night-time awakenings by helping to increase sleep pressure and consolidate sleep. Continuing with this part of the program should continue to reduce and eliminate night time awakenings. I hope some of these ideas are helpful to you.

  • Sleepio Member

    • 54 comments
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    in reply to Sleepio Member
    Graduate

    Thank you for you helpful comments. My day sleepiness started at the time I started SR.
    I do yoga mindful meditation and the evening relaxation.
    Yes I am anxious about sleep/insomnia and this is difficult to tackle . I am trying to remain positive. How how long do I have to stay with SR?

  • Sleepio Member

    • 20 comments
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    Graduate

    Mmm, its been a bit of challenge on SR. My initial SW was 12-6 and did that for a week and a bit rashly changed it to 10.30 -4.30 the second week because I could not face staying up so late – real early bird. Anyway after much support and encouragement from various people in the community am at 11.45 – 6 (somehow managed a 15min bonus this week)! Yesterday I swam for the first time in ages and slept like a baby for over 5.5 hours -this is the first time I got more than 3.5 hours since week 3. So am quite chuffed and feel like I have bottomed out and on the up. Now I understand more my fears re sleep and how the program can address them.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hi there, your question is very similar to Megan's and you will find my reply above helpful. As I have said to her once you have ruled out potential external or internal triggers it is best to revisit the tools you have learned over the course of this programme. I see you are in session 4 so you are quite new to this and the impact of sleep restriction tends to take effect after a couple of weeks. As you continue to build sleep pressure through sleep restriction and by expending energy througout the day, and as you continue to implement the QHR you will start to experience more consolidated sleep that should last throughout your sleep window. Please read my answer to Megan for additional advice. Remember though, you are fairly new to the sleep restriction component so give it a few weeks and you should see improvements. Keep in touch for advice and support.

  • Sleepio Member

    • 409 comments
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    in reply to Sleepio Member
    Graduate

    Sounds like you are making great progress. Swimming is a great way to expend energy and promote sleep in the evening. I like that you have been a little flexible with your sleep window rather than getting preoccupied and stressed by it- that is an excellent approach! It is also really good to hear that the online community has been a good support. Well-done!

  • Sleepio Member

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    Graduate

    Hi Dr. Keenan,
    I see you've answered all the posted questions so I have one for you. What causes someone to fully wake up during the nighttime awakenings and other people don't really wake up – just roll over and sleep? This is what I am working on now by reducing my SW to try and consolidate my sleep and reduce those pesky awakenings, where I am fully awake.
    Thanks, Angie.

  • Sleepio Member

    • 409 comments
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    in reply to Sleepio Member
    Graduate

    I can hear that you are anxious but it sounds as if you are very motivated to get better which is great. You are also looking into lots of remedies for your difficulties- just remember you do not have to tackle everything with every potential solution at one time- that can be overwhelming. Please do use the online community for support also.

    Sleep restriction is possibly the most challenging part of the Sleepio course however it is also the most effective. It is difficult and in some published research it was found that the harder people found it in the first few weeks, then the better their subsequent improvements in sleep were (pain = gain!). Sleep restriction is not forever though, it is just the kick-start you need to get your sleep pattern reset. You should stick with it until you have improved your sleep efficiency and sleep window to a point that you can feel satisfied and refreshed. This differs for everyone. Early days for you so stick with it and all the other advice you have been given and you should see improvements.

  • Sleepio Member

    • 409 comments
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    in reply to Sleepio Member
    Graduate

    PS I like the sound of yoga mindfulness meditation. Do you do that in a group? It sounds like a good way to be active yet deal with anxiety at the same time!

  • Sleepio Member

    • 20 comments
    • 2 helped
    Graduate

    Thanks Dr Keenan. That is encouraging as I was feeling a bit annoyed for having toyed with the window, but can see that I had to find a balance. It now seems to be working. Swam again today – Sleepio is changing my life. Not only will I sleep better but get fit in the process. Thanks for your answer to Megan and Tracylit. It is easy to expect results quickly and forget that it takes a while for the process to bed down. Once we stick with it does the body clock get reprogrammed such that sleep will become consistently more stable. I suppose I am still in that phase of low sleep confidence after some 25 years of putting up with unpredictable sleep.

  • Sleepio Member

    • 409 comments
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    in reply to Sleepio Member
    Graduate

    Hi, there are a number of reasons for that. It could be down to what caused the awakening and what stage of the sleep cycle someone was in. It is also because the good sleeper has a very strong bed-sleep connection therefore they can easily fall back asleep. The good sleeper also has few anxiety related thoughts about waking up so they can just return to sleep. For the poor sleeper, night time awakenings cause negative thoughts and this causes anxiety. Anxiety is energising and keeps us wakened. Their bed-sleep connection is also less well developed. Have a look at my earlier reply to Megan for some advice managing this. Sleep restriction is the best remedy at squeezing out night time awakenings however other techniques are helpful that you will have learned (relaxation, cognitive techniques). You will continue to see improvements with this.

  • Sleepio Member

    • 2 comments
    • 1 helped
    Graduate

    Thanks for your reply. Yes i guess it is early days and I cannot expect results within just a couple of weeks. Sleep should be so easy, its hard to understand that something that is natural and that the body so desperately needs, can be so difficult….
    I have read in different places that insomnia is associated with depression etc. At what point should you look toward depression as a cause of insomnia? I don't feel too low, more just tired, although sometimes I an so tired it really does affect my mood and relationships….

  • Sleepio Member

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

    Good stuff- getting fit and sleeping- great news! Yes, you are exactly right. Sleep restriction kick starts a reprogramming process to get your body clock back to normal. It can take time, especially if you have had sleep problems for many years however most people see improvements pretty quickly. Keep it up!

  • Sleepio Member

    • 409 comments
    • 91 helped
    Graduate

    We are out of time everyone. Thanks for joining me tonight and I hope you all manage the clock change! Tracylit, as you have asked a question I will answer it- just stick with me a moment!

  • Sleepio Member

    • 1692 comments
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    in reply to Sleepio Member
    Graduate

    Thanks. I am actually able to return to sleep. It's just the disruption that I don't like – 4-6 times a night. I will continue with SR as you have suggested and review if there's anything that is causing me to wake up so often.
    Have a good evening, Dr. Keenan and thanks for all your answers today!
    Angie

  • Sleepio Member

    • 20 comments
    • 2 helped
    Graduate

    Thanks Dr Keenan for your time tonight and advice!

  • Sleepio Member

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

    You are right- depression and insomnia can co-exist and some people feel that insomnia is caused by depression whereas other people feel that depressed mood is caused by insomnia. You might not be able to get a firm answer on this however I think it is more helpful to think about the various factors that are perpetuating the insomnia and working on that. This CBT program is based on an understanding of insomnia using the three p's (predisposing factors, precipitating factors and perpetuating facotrs). You should find that by using the tools in this program that your sleep starts to improve and with this your mood may well too. There are some articles in the Sleepio library about causes of insomnia and mood. Please look them up as it is always helpful to develop insight into your difficulties. Please continue to utilise the online support too.

  • Sleepio Member

    • 409 comments
    • 91 helped
    Graduate

    Thanks again everyone for your questions and joining me tonight. Good night.

  • Sleepio Member

    • 409 comments
    • 91 helped
    Graduate

    Thanks again everyone for your questions and joining me tonight. Good night.

  • Sleepio Member

    • 107 comments
    • 43 helped
    in reply to Sleepio Member
    Graduate

    Thank you for your very helpful reply, Dr Keenan. I think the main problem for me is the inability to put the day fully to rest, especially when I've been upset about something. It leaves me feeling mentally over stimulated, and I can't switch the emotions off enough to get sleepy tired. I think it's this anxiety that wakes me up quickly too. The problem is, I've got quite a lot going on in my personal life at the moment, which means I'm struggling with more than insomnia, so you're right about having feelings of frustration and anger when I wake. I think this is the root of the problem.

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