Live Discussion with Dr Jen Kanady - 29th January 2020

Dr Kanady will be hosting a live online discussion here on Wednesday 29th January, 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, 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 23 Jan 2020 at 7:28 PM
  • 15 comments
  • 2 helped

Comments

  • Sleepio Member

    • 2 comments
    • 3 helped
    Graduate

    I have just started week five and unfortunately I still wake up about four times during night and then wake early. Whilst this is difficult to cope with what is worse is trying to stay awake during the evening. I find myself fighting sleep and feeling unwell when trying to read or watch TV, then when my sleep window starts i am wide awake. Also during the day I feel as if I am in a fog. In these circumstances should I let myself fall asleep rather than fight it. Any other advice would be welcome.

  • Sleepio Member

    • 9 comments
    • 1 helped
    Graduate

    Dear Dr Kanady,
    When I wake around 4-5am and can't get back off to sleep…are we expected to do the 15 minute rule? If I do that and put the light on that will be my brain in action for the day. Instead I stay in darkness & point a flashlight at the wall clock and maybe dose off after that a little. Is that OK , please? Best wishes Olga Andrassy

  • Sleepio Member

    • 52 comments
    • 22 helped
    Graduate

    Hello Dr Jen Kanaday,

    I graduated a week ago. Just did Session 7 this morning. I am still on SR and have had added since Session three 45 minutes in total to my SW. Got another 15 minutes today brings it to an hour total SW. I have been averaging 6 hours 30 minutes sleep since last week in a 6 hour 45 minute SW. I am obviously pleased with this. The problem is I am still waking up roughly four times a night each time for a few minutes each. Usually one of the times is to go to the toilet so I know why I am waking up for this and I think it is because of my SW moving. I think I can sort this out. The three other times I don’t know why I am waking. I exercise every day and am out in the fresh air walking twice a day and don’t drink tea or coffee after 13.00pm. The awakenings are making me struggle to get out of bed in the mornings. Have you got any suggestions or advice to stop the other three awakenings? Thank you in advance.

  • Sleepio Member

    • 52 comments
    • 22 helped
    Graduate

    I forgot to say that the four awakenings have been going on since Session 3. Sorry about the misspelling of your name.

  • Sleepio Member

    • 1 comments
    • 0 helped
    Session 5

    Dear Dr. Kanady,

    I started my Sleepio program this week, but at the moment am actually sleeping really well. I tend to go through periods where I have a lot of sleep anxiety and difficulty getting to sleep, but right now things seem pretty steady and good. Which is great! But I worry that because the beginning of the program is just me recording my sleep diary, that since it's showing that I'm getting really good sleep, the program will then be very different from what it would be if my sleep log were showing a period of time where I have a lot of trouble sleeping. Should I pause my program and come back when things are worse? If not, how will Sleepio really be able to help me with a problem it can't measure (because I'm not having it at the moment)? Thanks for any info!

    Chris

  • Sleepio Member

    • 23 comments
    • 9 helped
    Graduate

    Hello, please could you clarify your advice about exercise. The Prof said not to exercise 'too late'. Is there a rule like for caffeine and alcohol, so many hours before bed. I play badminton 3 times a week, finishing at 9.30. Do you think it may affect my sleep? At the moment my SW doesn't start til 12.30, but hopefully that won't be for too long! I can't play during the day as I work. Thanks. Liz

  • Sleepio Member

    • 6 comments
    • 0 helped
    Graduate

    I have started the sleep restriction I have improved my sleep effiency. My window 12:00 to 5:30. My challenges staying awake until 12:00 and those early wakings usually at 4:00 am

  • Sleepio Member

    • 394 comments
    • 123 helped
    Expert

    Greetings Sleepio community!

    My name is Jennifer Kanady and I am a clinical psychologist with an expertise in sleep. For the next hour and a half, I will be answering any and all sleep-related questions.

  • Sleepio Member

    • 394 comments
    • 123 helped
    in reply to Sleepio Member
    Expert

    Hi Jane,

    Thanks for reaching out. Maintaining the prescribed sleep window is one of the most challenging aspects of the program. To better understand the science behind the the pro-sleep schedule, please refer to this Sleepio library article: https://www.sleepio.com/library/article/the-pro-sleep-schedule-in-depth/

    Interestingly, what you describe is actually quite common in individuals with sleep problems. Individuals will often report feeling sleepy on the couch while watching television, but then feel wide awake upon getting into bed. The scientific term for this phenomenon is called “conditioned arousal” and boy is it frustrating! The idea behind conditioned arousal is that you are used to not being able to sleep at night, so the bed/bedtime becomes a place of anxiety/tension/arousal rather than a place for relaxation and sleep. For individuals experiencing conditioned arousal, relaxation exercises (such as progressive muscle relaxation) and imagery can be helpful. Following the quarter of an hour rule and maintaining a consistent relaxing wind-down routine before bed may also help combat conditioned arousal.

    In terms of your question, the general recommendation is to stick to the prescribed sleep schedule as best as possible. That being said, it is important to note that Sleepio is a self-help program and it is up to the individual to figure out how to apply the individual techniques in a way that works best for them.

    Please feel free to reach out with additional questions.

  • Sleepio Member

    • 394 comments
    • 123 helped
    in reply to Sleepio Member
    Expert

    Hi Olga,

    Great question. For awakenings before the prescribed rise time, the general rule of thumb is to engage with the quarter of an hour rule. And you are absolutely right! Turning on a light will tell your brain that it is ready to start the day. Light has a significant alerting effect. Therefore, the recommendation is to avoid bright light when trying to sleep and to expose oneself to bright light when trying to stay awake. When getting out of bed as part of the quarter of an hour rule, the general recommendation is to do something relaxing in dim light conditions.

    For more information about light levels and sleep, please take a look at this Sleepio library article: https://www.sleepio.com/library/article/the-ideal-light-levels-for-sleep/

  • Sleepio Member

    • 394 comments
    • 123 helped
    in reply to Sleepio Member
    Expert

    Hi Life on Mars,

    Please note that I am responding to both your messages within this response.

    It sounds like you have made amazing progress with sleep restriction! Congratulations, that takes a lot of dedication and work!

    The thing I like to remind people about nocturnal awakenings is that everybody experiences them. Waking up in the middle of the night is unavoidable, completely normal, and is to be expected. What differentiates individuals is that some people remember these awakenings and some people don’t. Nocturnal awakenings only become problematic when these awakenings are prolonged and/or if they cause significant distress or impairment.

    Expectation management can be helpful for individuals who experience shorter nocturnal awakenings (e.g., understanding that these awakenings are typical and unavoidable). Also, worries about these awakenings might be a nice opportunity to practice those cognitive skills learned is session 4 and 5 of Sleepio.

    Also, thanks for the apology about misspelling my name. And please don’t worry about it; it happens all the time!

  • Sleepio Member

    • 394 comments
    • 123 helped
    in reply to Sleepio Member
    Expert

    Hi Chris,

    Such a great question, thank you for asking. While Sleepio was designed with poor sleepers in mind, Sleepio can also help individuals without sleep problems to develop healthy sleep habits. Many of the skills taught in Sleepio are great for promoting healthy sleep, regardless of how you are sleeping currently. For example, maintaining a regular sleep schedule, devising a winddown routine, and monitoring caffeine and alcohol use are all healthy habits to develop.

    In session 3, you will learn a skill called sleep restriction. The general idea behind sleep restriction is to limit the amount of time in bed to the amount of time spent asleep. To accomplish sleep restriction, the Prof will work with you on establishing a sleep window based on your sleep diaries. Your sleep window will certainly be influenced by how you are sleeping currently. However, if you learn and understand the principles of sleep restriction, you should be able to apply sleep restriction during periods of poor sleep as well.

    Ultimately, it is up to the user to figure out when starting Sleepio makes sense for them.

    Please feel free to reach out with any additional questions.

  • Sleepio Member

    • 394 comments
    • 123 helped
    in reply to Sleepio Member
    Expert

    Hi Liz,

    Great question. The relationship between exercise and sleep is a bit nuanced and I am happy to provide additional information.

    Exercise is great for sleep because exercise increases the sleep drive, which makes initiating and maintaining sleep easier. However, if you exercise before bed, exercise can have the opposite effect and can make initiating sleep more difficult. One of the reasons for this is that exercise increases the core body temperature, which can make falling asleep more difficult. Given this, the general rule of thumb is to avoid intense exercise (e.g., increased heart rate, lots of sweating) in the 3-4 hours before bed.

    It is also important to note that this is the “general rule of thumb.” Everybody is going to react to exercise before bed differently.

    For more information about the relationship between exercise and sleep, check out this Sleepio library article: https://www.sleepio.com/library/article/exercise-and-sleep/

  • Sleepio Member

    • 394 comments
    • 123 helped
    in reply to Sleepio Member
    Expert

    Hi Terrence,

    I am happy to hear that you have already started to see improvements in your sleep efficiency!

    Unfortunately, the benefits of sleep restriction tend to be gradual and the timeline differs from person to person. Typically, individuals need 2-4 weeks of sleep restriction before they start to notice significant changes to their sleep. My general advice is to stick to the sleep schedule as best as possible. That being said, it is also important to remember that Sleepio is a self-help program and that users know best how to implement the skills taught in Sleepio in a way that works for them.

    Some activities that other Sleepio users have found to be helpful for staying up until the prescribed bedtime include doing household chores, speaking with a family member/friend, watching TV while sitting on a stool, and getting ready for the next day (e.g., planning an outfit, meal prep, etc.).

    For early morning awakenings, the general recommendations are to keep engaging with the quarter of an hour rule and to be mindful of light exposure. E.g., maintaining dim light conditions if you are trying to return to sleep.

    Please feel free to reach out with any additional questions.

  • Sleepio Member

    • 394 comments
    • 123 helped
    Expert

    Signing off now. Thank you for all the great questions. For any lingering questions, please take advantage of our next live expert chat on Wednesday, February 5th.

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