Live Discussion with Dr Jen Kanady - 14th April 2021

Dr Kanady will be hosting a live online discussion here on Wednesday 14th April 2021, from 8.00pm to 9.30pm British Time or 3.00pm to 4.30pm US Eastern Time.

They 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, they may not be able to answer all in the time available, but will try to answer as many as they can.

Please do note that, as per our guidelines, Dr Kanady will not be able to give personal medical advice including those about medication. Their replies to questions will be made in such a way as to help as many people as possible who might have similar issues.

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Posted 8 Apr 2021 at 6:13 PM
  • 22 comments
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  • Sleepio Member

    • 2 comments
    • 2 helped
    Graduate

    I read the article “What accounts for unrefreshing sleep?” in the Library. I often wake up feeling unrefreshed even after 7 hours of sleep. It states that you can “'knock(ing)-out' deep- or slow-wave sleep (by using sound to shift the brain into lighter phases of sleep)”. My question, is there a way to “knock” myself into deep sleep, either with a sound pattern or otherwise? Also, if there are any clinical studies you would please reference it would be highly appreciated. Thank you again.

  • Sleepio Member

    • 2 comments
    • 0 helped
    Graduate

    I just finished the sleepio course and am still struggling with my main problem: Sleepiness during the day.

    In my opinion it is caused by not getting enough sleep in the night because of early waking. I am 59 years old and recognize usually you don´t need as much sleep at this age than in earlier decades.

    My health is good, I don´t take any drugs (although I tried a few sleeping helpers in the past). I am not overweighed and sleep apnea has been ruled out by two different sleep laboratories.
    I know early waking is an important symptom of major depression
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181883/
    but I don´t feel depressed. I had been to a psychotherapist, she did not seem to think I needed any psychotherapy and explicitly no antidepressant medication.

    I do not have any problem falling asleep at bedtime. Sleepio has helped me to reduce those frustrating hours in the middle of the night with no sleep (e.g. from 1 am to 3 am). Before sleepio my usual bedtime was 10:30 pm, according to the Profs advice now it is 11 pm. There are still nights when I wake up at 3, 4 or 5 o´clock and feel pretty refreshed then. Sleepiness sometimes arrives at 5, usually at about 6 and I have to leave the house for work at about 6:30 am.

    My work consists of some stressful and of some tedious hours. It is vital that I keep awake even in boring situations. My boss already told me if my work wasn´t so reliable and of high quality in stressful situations, he would have sacked me because of several occasions of having fallen asleep in boring situations.

    I can drink coffee as much as I want, it doesn´t change my sleepiness during the day efficiently. So at least its no problem for me to refrain from coffee from 4 pm.

    Do you have any suggestions?

  • Sleepio Member

    • 11 comments
    • 0 helped
    Graduate

    Is there any way to compress my sleep schedule? When I try to make my waking time earlier, my go-to-bed-time also moves earlier. What I would like to do is keep my current bedtime, but make my wake-up time earlier. I can't figure out how to do this. Thank you.

  • Sleepio Member

    • 1 comments
    • 0 helped
    Graduate

    Hi. I'm a recent graduate of Sleepio and have been doing well on it. I'm in the process of trying to move my bedtime 15 minutes earlier as my sleep efficiency is consistently over 90%, but I've found it very difficult to fall asleep as I had been doing on the previous schedule and finish up getting up again, returning to bed much later and getting less sleep overall. This feels like a backwards step. I've been less strict on the get-up time, sometimes sleeping an extra half an hour in the morning – is that the reason? I've been on holiday for the last 10 ten days and it's a bit antisocial for my husband when I set the alarm so early! Any advice appreciated.

  • Sleepio Member

    • 1 comments
    • 0 helped
    Session 5

    Hello, I won't be able to join the session since my sleep window starts at 20:15, and this is more likely to be stimulating than relaxing ;)
    My current problem is around broken, unrefreshing sleep and I'm hoping that Sleepio will help me – I've just started week 3.
    However I would be very grateful for some sleep advice around how to train for endurance running (I have a 24hr race in August and a 200 mile 5 day event next year). Is it worth stopping every few hours for a short nap or just keep going until I physically can't keep moving any more and have a longer sleep before setting off again? And how far in advance should I start adjusting (disrupting) my sleep schedule to get accustomed to this?
    Thank you.

  • Sleepio Member

    • 22 comments
    • 16 helped
    Graduate

    I will be very interested in the response to the questions posted here about sleep, hormones and the menopause. Before the menopause, I consistently had very poor sleep in the days before each period, which then was completely relieved at a stroke on day 1 of the cycle. It was like a switch being thrown.
    Is there any evidence that hormonal disturbances of that kind can linger post-menopause? I still get very bad nights with no sleep about every two to three weeks, for no apparent reason, and wonder if this is the vestiges of a hormonal reaction, of some kind.
    My sleep has generally improved since I started Sleepio, but the bad nights arrive so suddenly, and yet on a
    sort of regular cycle, that I wonder if there is a hormonal cause. I may well be clutching at straws, though.

    Thank you.

  • Sleepio Member

    • 4 comments
    • 3 helped
    Graduate

    Hello, I am a graduate of the programme and was doing pretty well having many nights of 6 1/2 to 7 hours of nearly continuous sleep. But in the last few months my sleep has deteriorated again.
    Early waking was always been my issue (no trouble falling asleep) and I now consistently wake up about 1 to 1 1/2 hours before my normal wake up time. If I follow the QHR rule and get out of bed then by the time I am starting to get sleepy it’s almost time to get up for the day.
    Are there any special techniques to address this issue? Should I restart the programme?

    Any advice would be much appreciated.
    Thank you.

  • Sleepio Member

    • 376 comments
    • 120 helped
    Expert

    Hello Sleepio Community and welcome to the live expert chat. My name is Jennifer Kanady. I am a clinical psychologist with an expertise in sleep and I am here for the next 1.5 hours to answer any and all sleep-related questions.

  • Sleepio Member

    • 12 comments
    • 5 helped
    in reply to Sleepio Member
    Graduate

    Hi Dr Jen
    I have just started week 5 and have some questions about QHR.
    I often feel that I spend some time drifting between light sleep and being awake, not sure for how long. If I get up at this point it wakes me up and I tend to be awake for longer, if I stay in bed and try progressive relaxation using the download I get back to sleep but its probably well over 15 mins.
    This seems to work for me but I don't want to subvert the programme as I'm finding it really helpful overall.
    Any advice would be much appreciated.

  • Sleepio Member

    • 376 comments
    • 120 helped
    in reply to Sleepio Member
    Expert

    Hi MayC,

    Thanks for the question. Sleepio doesn't explicitly cover sleep and comorbid conditions (e.g., menopause, thyroid disorders). However, the good news is that the cognitive and behavioral techniques in Sleepio have found to be effective across many different conditions.

    Also, the library articles may be a good resources. For example, here are some library articles that you might find to be helpful:


    • Hormones and sleep: https://www.sleepio.com/library/article/hormones-and-sleep-a-two-way-street/



    • Menopause and sleep: https://www.sleepio.com/library/article/menopause-and-sleep-problems/



    Congrats on starting Sleepio!

  • Sleepio Member

    • 376 comments
    • 120 helped
    in reply to Sleepio Member
    Expert

    Hi Sarah V,

    Great question. Sleep and hormones are very closely related.

    See here for an article that explains this relationship: https://www.sleepio.com/library/article/hormones-and-sleep-a-two-way-street/

    Sticking with the Sleepio techniques regardless of the time of month will be helpful. Also, anticipating heightened sleep problems and acknowledging that it is temporary can also be helpful (e.g., not increasing any sort of sleep-related anxiety).

    Also, I don't know of any research that supports eating porridge before bed. In general, you want to make sure that you are aren't going to bed too hungry and aren't going to bed too full.

  • Sleepio Member

    • 376 comments
    • 120 helped
    in reply to Sleepio Member
    Expert

    Hi Dee,

    Great question. There are a couple of things you can do to increase the amount of deep sleep you get. First, exercise has been shown to increase the amount of deep sleep and sleep quality. Second, keeping a consistent sleep/wake schedule is helpful for sleep quality. The research on the impact of certain sounds on sleep is in its infancy. Early research suggests that this “Delta Wave” music may have a beneficial effect on sleep quality (e.g., Gao et al., 2020, Frontiers in Neuroscience) with other research finding that these types of beats aren’t efficacious for those with insomnia (e.g., Bang et al., 2019, Journal of Clinical Pharmacology). In general, if this type of music is helpful and isn’t disrupting sleep, then I would say go for it. But I wouldn’t recommend this as an intervention for sleep disorders such as insomnia and would instead recommend gold standard approaches, namely CBT.

  • Sleepio Member

    • 376 comments
    • 120 helped
    in reply to Sleepio Member
    Expert

    Hi Paul007,

    I am sorry to hear that you continue to struggle with daytime sleepiness. Early morning awakenings (i.e., waking up before intended without being able to return to sleep) can be very frustrating. People often report that it is difficult to return to sleep during these awakenings, which makes sense given that the sleep drive is low. Some things that can be helpful during these awakenings is reducing exposure to light and limiting activity (e.g., avoiding things that have an alerting effect). I also sometimes encourage experimenting with the sleep schedule. Everybody has a different circadian preference and some individuals are morning people; e.g., their circadian rhythm tells them to get into bed and wake up early. Circadian preference also shifts with age and as we move into older age, our circadian rhythms tend to shift forward towards a morningness preference. Sometimes shifting the schedule forward by an hour (e.g., going to bed an hour earlier) can be helpful for these awakenings as well.

    I am glad to hear that you have been proactive about getting a sleep test as sleepiness can sometimes be a sign of other sleep disorders (e.g., sleep apnea). If daytime sleepiness continues to be a problem, you might consider speaking to your doctor and/or getting a referral to a sleep specialist who can provide more personalized care.

  • Sleepio Member

    • 376 comments
    • 120 helped
    in reply to Sleepio Member
    Expert

    Hi Bev,

    Are you trying to compress your schedule within the program? If so, that is something our user happiness team can assist with. I would suggest emailing hello@sleepio.com and they should be able to help.

    Thanks.

  • Sleepio Member

    • 376 comments
    • 120 helped
    in reply to Sleepio Member
    Expert

    Hi New Monastic,

    Great question. I have a couple of thoughts:

    1. Sometimes it's difficult to know when to stop increasing your sleep window. E.g., when have you reached your optimal sleep window? I usually tell people to pay attention to two things: (1) how they are feeling during the day and (2) if their sleep problem has returned. If sleep has gotten worse, that sometimes means that the window has been shifted too far and going back to the previous window might be helpful.

    2. Certainly varying the rise time can make falling asleep more difficult. However, if you find that this later rise time works better, then shifting the bedtime to later to accommodate the later rise time may be helpful. The one thing to keep in mind is whether this rise time is feasible with your work schedule (as you mentioned you were on holiday).

    3. Experimenting with a sleep schedule can be helpful. Figuring out what works best with work and social obligations and also what works best for functioning during the day is a great way to figure out an optimal schedule. I have also worked with individuals in the past who have compromised with their partner about a sleep schedule that works for both of them.

    Keep us posted and let us know what you figure out!

  • Sleepio Member

    • 376 comments
    • 120 helped
    in reply to Sleepio Member
    Expert

    Hi Tinkerton,

    Thanks for the great questions. During session 3 you will be introduced to sleep restriction, which is helpful for not only initiating sleep, but maintaining sleep as well. Sleep restriction is a powerful sleep intervention that limits time in bed to the actual amount of time spent asleep and then increases time in bed each week as sleep improves. Sleep restriction works because it capitalizes on the two processes that regulate sleep: (1) process S (our sleep drive) and (2) process C (our circadian rhythm).

    Unfortunately, I don't have any experience with sleep related to 24-hour endurance running and am not in a position to comment on the best approach. In general, we are not meant to be awake for extended periods of time. Doing your best to stick to a nighttime sleep schedule would likely be helpful (though I recognize this won't be possible during the 24 hour run). Maybe speaking to other members in your running community about what has worked for them will be helpful.

    Good luck with your run!

  • Sleepio Member

    • 376 comments
    • 120 helped
    in reply to Sleepio Member
    Expert

    Hi Ellenyork,

    Please do see my responses pertaining to sleep and hormones above. It is possible that hormones are continuing to impact your sleep. Sometimes tracking sleep can be helpful for highlighting these associations. In general, and as mentioned above, the techniques introduced in Sleepio have been found to be helpful for many individuals (including those in perimenopause and menopause).

  • Sleepio Member

    • 376 comments
    • 120 helped
    In reply to a deleted comment
    Expert

    Hi Shirley Ann,

    I am sorry to hear that your sleep has regressed. Certainly reintroducing Sleepio techniques may be helpful. More specifically, getting back to sleep restriction can be helpful for combatting early morning awakenings. Some other things that might be helpful is being mindful of light and darkness cues (e.g., avoiding light when trying to sleep) and/or playing around with the sleep schedule (e.g., what happens when you shift your sleep schedule earlier?). I generally like to remind people that they tackled their sleep problem once and that they can do it again. Keep us posted about how things are going!

  • Sleepio Member

    • 376 comments
    • 120 helped
    in reply to Sleepio Member
    Expert

    Hi Wide eyed,

    It sounds like you are doing some really great experimentation here. In general, the recommendations in Sleepio are not a one-size-fits-all and sometimes adhering too strongly to recommendations can lead to more anxiety and poorer sleep. My general recommendation is to experiment and tailor the interventions introduced in a way that makes sense to you. If your experimentation is leading to better sleep, that's great! If you notice that your sleep isn't getting better, then maybe try adhering more closely to Sleepio recommendations. Best of luck and keep us posted!

  • Sleepio Member

    • 376 comments
    • 120 helped
    Expert

    OK, signing off now. Thanks for the great questions and looking forward to chatting again soon!

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