Live Discussion with Dr Jen Kanady - 26th June 2019

Dr Kanady will be hosting a live online discussion here on Wednesday 26th June, from 7.00pm to 8.30pm British Time or 2.00pm to 3.30pm US Eastern Time.

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

Please do note that, as per our guidelines, Dr Kanady will not be able to give personal medical advice including those about medication. Her 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 20 Jun 2019 at 12:58 PM
  • 14 comments
  • 1 helped

Comments

  • Sleepio Member

    • 2 comments
    • 0 helped
    Graduate

    I started with a sleep window of 5 hrs 15 mins three weeks ago and managed to score a high enough sleep efficiency to have increased by 15 mins last week. I am doing well enough this week to be hopeful of getting another 15 min increase. My difficulty is that these last few days I have been incredibly tired. Instead of just (!) fighting to stay awake in the evenings I’m now desparately tired all day as well to the point that working is difficult. Given that this is about the same amount of sleep I was getting before I started the programme but it was very broken why am I so tired? Why has it got worse? Is there anything I can do about it?

  • Sleepio Member

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

    I’m not saying this is you …but I recently experienced a similar situation I had my baby, baby was fast asleep but I could not sleep, I found out this was due to postnatal depression, maybe worth checking it out.

  • Sleepio Member

    • 16 comments
    • 5 helped
    Graduate

    Can I ask for your thoughts on Melatonin please? As it is a natural hormone which declines in levels as you age, is it OK to use this from your late 50s onwards? I believe a low dose (2mg) slow release product Circadin is available on prescription. Is this a useful adjunct to the Sleepio programme on a long term basis?

  • Sleepio Member

    • 15 comments
    • 9 helped
    Graduate

    Hello Dr Kanady,
    I'd like to ask about anxiety please. It seems that lots of people in the community have an issue with this too. It's not just anxiety about sleep, but I suspect general anxiety is a big cause of my insomnia. Often I feel like I could sleep if my body and mind didn't feel on high alert somehow.
    The CBT part of Sleepio is not helping me because I feel like identifying individual thoughts is like trying to pick out individual vegetables from a blended soup.
    I'd be grateful for any thoughts please.
    Thank you

  • Sleepio Member

    • 1 comments
    • 0 helped
    Pre-course

    Hi! I would like to receive some advise on how I can change my sleeping posture. I sleep face down and I would like to change to my left side.
    Is there any advise? Any book I can get? Any video?
    Regards!

  • Sleepio Member

    • 384 comments
    • 120 helped
    Expert

    Hello. My name is Dr. Jen Kanady and I am a research and clinical psychologist. I look forward to answering any and all sleep-related questions in the next 1.5 hours!

  • Sleepio Member

    • 384 comments
    • 120 helped
    in reply to Sleepio Guest
    Expert

    Hello and great question! Generally, it is recommended that individuals maintain the same rise time (e.g., 7:00 AM) regardless of what time the individual goes to bed. Having a regular rise time serves as a really important anchor for both circadian rhythms and the homeostatic sleep drive. For these reasons, maintaining a consistent rise time can be a powerful intervention.

    Also, it is great that you are not going to bed when you don’t feel sleepy! That is a wonderful stimulus control technique. When individuals go to bed before feeling sleepy, that can lead to tossing and turning, which is not helpful for initiating sleep.

  • Sleepio Member

    • 384 comments
    • 120 helped
    in reply to Sleepio Guest
    Expert

    Hello and thank you for your question. Navigating sleep after having a baby can certainly be tricky!

    There is no limit on the number of “get ups” when you are having difficulty initiating and/or maintaining sleep. The scientific foundation for this tool is that we want the brain to learn that the bed is for sleep and sex only. That is why there is no limit to the number of “get ups” as spending time awake in bed is counterproductive and teaches the brain that the bed is a place for wakefulness.

    Feeling sleepy while doing activities outside of bed and then feeling wide awake once getting into bed can be caused by conditioned arousal. Conditioned arousal typically occurs when individuals struggle with and/or worry about sleep. When this happens, the bed and the bedroom can become associated with arousal (e.g., stress, tension, anxiety, feeling wide awake) rather than sleep. In addition to getting out of bed when unable to sleep, research indicates that doing a relaxing activity before bed can be helpful for combating conditioned arousal. People have found progressive muscle relaxation to be a helpful technique for this purpose.

    You might also check out these resources on sleep and parenting:
    https://www.sleepio.com/articles/parent-sleep/
    https://www.sleepio.com/community/discussion/pregnancy--postpartum-sleep/

  • Sleepio Member

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

    Hi there. Experiencing more sleepiness/fatigue in the early stages of sleep restriction is actually quite common. Sleep restriction increases the sleep drive (e.g., our need for sleep), which makes us more sleepy during the day. The basic idea behind sleep restriction is that the increased sleep drive will then make it easier to fall asleep and remain asleep at night. So those feelings of tiredness actually means that the treatment is working! In general, individuals have found that the first couple of weeks of sleep restriction are the hardest. However, if an individual is able to push through those initial weeks, the sleep schedule gets easier and daytime functioning improves. Research demonstrates that exposing yourself to bright light (e.g., sunlight), exercise (e.g., taking a walk), and socializing (e.g., talking with a coworker/friend) are helpful techniques for combating daytime fatigue. Also, in situations when sleepiness is dangerous (e.g., driving a car), it is always recommended that you take a safety nap!

    You can also check out community conversations for additional support around sleep restriction:
    https://www.sleepio.com/community/discussion/dealing-with-the-new-sleep-regime/

  • Sleepio Member

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

    Hello and great question. Please see this helpful resource about melatonin: https://www.sleepio.com/library/article/what-is-melatonin/. Also, research has demonstrated that Sleepio is effective as a standalone treatment (e.g., without melatonin).

  • Sleepio Member

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

    Hi there. You are absolutely correct; anxiety and sleep are very closely related and exhibit a bidirectional relationship. That is, anxiety can often lead to sleep problems and sleep problems lead to greater anxiety, causing a vicious cycle. The good news is that research demonstrates that treating sleep disturbance can lead to a reduction in anxiety symptoms. I understand that it can be difficult to pinpoint a particular thought when engaging in cognitive therapy. The general idea is that you try to isolate one thought in order to practice the skill. Then you can apply the skill to other thoughts as they arise. Another set of skills that have been shown to be helpful for anxiety close to bedtime are relaxation exercises. Progressive muscle relaxation is one example of a technique that has been shown to alleviate anxiety, thus making it easier for an individual to fall asleep.

    For community support around this matter, you can always visit this community conversation:
    https://www.sleepio.com/community/discussion/depression--early-waking/

  • Sleepio Member

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

    Hello and thank you for your question. I am not aware of any research or advice for changing sleep positions. I would encourage you to reach out to the community to see if anybody has any ideas about how to successfully change sleeping positions. As with any change in our behavior, the first few weeks are the most difficult, but slowly we get used to the change and find it less disruptive.

  • Sleepio Member

    • 384 comments
    • 120 helped
    Expert

    Signing off now. Thanks everyone for the great questions. If you have any additional inquiries, please don't hesitate to reach out. Live discussions with sleep experts happen every Wednesday.

    Happy sleeping!

  • Sleepio Member

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

    You might find that placing a pillow between your legs will help you stay on your side and not roll onto you front.

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