Live Discussion with Dr Jen Kanady - 3rd July 2019

Dr Kanady will be hosting a live online discussion here on Wednesday 3rd July, from 8.00pm to 9.30pm British Time or 3.00pm to 4.30pm 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 1 Jul 2019 at 7:28 PM
  • 10 comments
  • 2 helped

Comments

  • Sleepio Member

    • 7 comments
    • 2 helped
    Session 5

    Hi there! I have a few questions about Session 3.

    1. The course talks about “Sleep and only sleep in your bedroom”. I understand why it says this, as most people have bedrooms conditioned for sleeping. The thing is, I still live with my folks, so my bedroom isn't just for sleeping…my computer, tv, music, and art supplies are all in this room. It's the only spot I have in my house to myself besides my vehicle. What do you suggest when your bedroom is practically your entire living space?

    2. As I mentioned before, I live with my folks, who both work full time. (Moving out is not an option at this time.) My school-age niece and nephew live with us, and since my folks have to leave early in the morning, during school months, I have no choice but to get up at 7am and take them to the bus stop, which interrupts my sleep pattern for at least 30 minutes. I have no choice in this matter as they're not old enough to get to the bus stop themselves. Even though it's the summer months right now, I still may have to take them to their day camp if one of my folks can't do it on the way to work, which will interrupt my sleep for even longer. What can I do when it comes to this problem?

    3. I work 2nd shift, so I generally get off work at midnight, but the chance is there that I may have to stay over. If this happens, how should I adjust my sleep pattern?

    Thanks much for your help!

  • Sleepio Member

    • 394 comments
    • 125 helped
    Expert

    Hello Sleepio community! My name is Dr. Jennifer Kanady and I am sleep psychologist. I look forward to answering any and all sleep-related questions in the next hour and half.

  • Sleepio Member

    • 2 comments
    • 0 helped
    Graduate

    Hi Dr Kanady,

    I had managed to go from 6.5 to 7.5 hours sleep restriction over about 2 months.

    While I was happy with my progress, my sleep still wasn't in a block. I generally woke one or two times in the night. The critical factor to a good night's sleep became my ability to get back to sleep. The problem being that that ability could vary. And has created a concern about longevity.

    Rather than rely on developing getting back to sleep consistency, I thought I would try to get all my sleep into a block. To do that i thought I could try returning to 6.5 hours sleep restriction and use pushing my sleep drive to get my sleep into a block and build up again to more time.

    It's not working so far. I wonder if I need to work from my average number of hours I get in a a block (around 5) and work up instead of working from my average time asleep?

    Or would it best to accept that i am unlikely to get it into a block (thought that was't an issue for 40 of my 41 years alive) and focus on developing getting back to sleep skills.

    Just not sue what my best next move is.

    Thanks,

    Joey

  • Sleepio Member

    • 394 comments
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    in reply to Sleepio Guest
    Expert

    Thanks for your question, Jam19. While certainly frustrating, waking up several times throughout the night is actually quite common and is to be expected! Most individuals wake up several times throughout the night, though not everybody is able to remember these awakenings. It sounds like you are already doing some really great work around this; managing expectations about nocturnal awakenings can be a helpful exercise. For awakenings that are more pronounced, sleep restriction can be a useful tool. For example, shifting to a later bedtime will increase a person's need for sleep, thereby making it more likely that the person sleeps through the night. I also appreciate your comment: “being negative probably makes it continue.” You are absolutely right! As you learned from the Prof, negative thoughts or worries about sleep only serve to maintain or worsen the sleep problem. Thoughts like these are a nice opportunity to practice the cognitive therapy techniques introduced in Sleepio.

    Here is a nice article on nocturnal awakenings: https://www.sleepio.com/library/article/frequent-awakenings-when-will-they-go-away--/

    And here is a nice article on challenging unhelpful thoughts about sleep: https://www.sleepio.com/library/article/challenging-your-thoughts/

  • Sleepio Member

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

    I can't figure out how to see this discussion thread! It says there are a number of comments but i can't get to them.

    Jacquie, I have the exact same problem. Really keen to see the thread. Hopefully it contains some possible approaches / solutions…

    Thanks,

    Joey

  • Sleepio Member

    • 394 comments
    • 125 helped
    in reply to Sleepio Guest
    Expert

    Hi Jacquie. Early morning awakenings can be tricky because sometimes it’s a matter of biology. Due to differences in circadian rhythms, some individuals are predisposed to be a “lark” or a “morning person.” In the sleep field, this phenomenon is referred to as “advanced sleep phase” or a “morningness circadian preference.” This shift in the circadian rhythms can become even more pronounced as we age.

    Here is a nice article about circadian preferences: https://www.sleepio.com/library/article/do-you-really-get-people-who-are-owls-and-others-w/

    There are a couple of techniques that may be helpful for addressing early morning awakenings (e.g., waking up at 4:30 AM). One possibility is shifting the bedtime later, thereby increasing the need for sleep and making it more likely to sleep past 4:30 AM. Once the target wake time is achieved, I generally recommend shifting the bedtime earlier until achieving the desirable sleep window. This would be very similar to what you did as part of the sleep restriction protocol in Sleepio. Another possibility is embracing the early morning awakening (e.g., 4:30 AM) and making 4:30 AM the new rise time. For this option, I generally recommend shifting the bedtime earlier to account for the earlier rise time. Another thing that can be helpful for early morning awakenings is capitalizing on the impact of light and dark conditions on circadian rhythms. More specifically, evidence suggests that dim light conditions are best when winding down at night and bright light conditions are best first thing in the morning. Reducing exposure to light during times when an individual wants to be asleep can be helpful for adjusting the circadian rhythm to a schedule that is more desirable for the individual.

    Here is a nice community post that further discusses early morning awakenings: https://www.sleepio.com/community/discussion/early-awakening/

  • Sleepio Member

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

    Hi Joey,

    If you hit refresh on the page, the new comments should show up. The most recent comments will be on the bottom of the page. The page is not organized by question and answers. Instead, the page is organized chronologically. Hope this helps!

  • Sleepio Member

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

    Hi Joey,

    I love your problem solving around this issue and your approach very much aligns with what I would typically recommend! Sleep restriction is one of the most powerful interventions for consolidating sleep. Generally, I recommend that a person decrease their time in bed window to the actual amount of time spent sleeping (not the largest amount of time sleeping in one “block”). So if a person is sleeping 6.5 hours on average, I would typically limit their time in bed to 6.5 hours for the first week. After a week on this schedule, if the person’s sleep efficiency is less than 90%, I would generally keep the sleep window the same or would reduce the sleep window by 15 minutes (e.g., 6.25 hours in bed). I would repeat this process until achieving a 90% sleep efficiency. Once achieving a 90% sleep efficiency, I would then increase the window by 15 minutes every week until achieving the optimal sleep window. One important thing to keep in mind when decreasing the sleep window is to never decrease it to under 5 hours. Also, sometimes it takes a few weeks for the brain to adjust to the new sleep window and improvements are not always apparent initially. Keeping the same schedule for several weeks in a row is not uncommon.

    I also noticed your comment about being concerned about longevity. Having some concerns about sleep is quite common and expected. However, as I am sure you know, becoming overly concerned about sleep can be counterproductive. When an individual is experiencing frequent worries about sleep, I generally recommend engaging in cognitive therapy techniques like challenging unhelpful thoughts about sleep. A nice article on this approach can be found here:
    https://www.sleepio.com/library/article/challenging-your-thoughts/

  • Sleepio Member

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

    Hi SnowyAshton,

    Thanks for the really great questions. Please see below for some thoughts:

    (1) Navigating a unique home environment always calls for some creative thinking! In an ideal world, the bed and bedroom would be for sleep and sex only. The science for this is nicely summarized in this article: https://www.sleepio.com/library/article/the-bed-sleep-connection-the-science/ However, not everybody is able to treat the bedroom in this manner because of unique living situations (e.g., roommates, living in a dorm, living in a studio apartment, etc). For situations like these, I generally recommend that a person keep the bed a sacred space (e.g., the bed is for sleep and sex only). If the bedroom is the only place to engage in activities like watching television or working on a computer, then I generally recommend that a person do those activities outside the bed. One option is to set up another space in the bedroom, separate from the bed, where these activities can be performed.

    (2) Great question! It is generally recommended that an individual keep a consistent rise time. When varying the rise time from day to day, it confuses our internal circadian clock. Our circadian clock thrives under stable conditions (e.g., maintaining a consistent rise time). One example of when our circadian clock is not functioning optimally is jetlag. Jetlag happens when our circadian clock is not aligned with the time in our environment. Variations in rise time are exactly like jetlag. Even though we aren’t traveling to a different time zone, the circadian clock becomes confused about what time to wake up. That is why when establishing a sleep schedule, I recommend that an individual choose a consistent rise time. Generally, the way we choose the rise time is figuring out the earliest time that an individual needs to get up for work, school, or other obligations. This may seem less than ideal initially. However, the more we wake up at the same time, the easier it becomes! Eventually, a person can learn to love getting up at 7:00 AM!

    (3) Another great question! Reiterating what I said above, maintaining a consistent rise time is one of the most powerful things a person can do for sleep. Generally, I recommend that an individual maintain the same rise time, regardless of what time that individual goes to bed the night before.

  • Sleepio Member

    • 394 comments
    • 125 helped
    Expert

    I am signing off now. A big thank you for your lovely questions. For any outstanding questions, please take advantage of our live expert chats every Wednesday.

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