Live discussion with Dr Jenna Carl - 26th April 2017

Dr Carl will be hosting a live online discussion here on Wednesday 26th April, from 9:00 to 10:30pm British Time or 5:00 to 6:30pm US Eastern Standard 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.

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

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Posted 20 Apr 2017 at 7:17 PM
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  • Sleepio Member

    • 18 comments
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    In reply to a deleted comment
    Expert

    Hi there -- interesting question!

    It's generally a great idea to stick with your optimal sleep window unless your sleep becomes problematic again. You can always go back sleep restriction if needed, and fortunately now you know how to do it!

    In phases of returning from vacation, in can be most important just to get back to those healthy sleep habits and routines that you've learned.

    Good luck!

  • Sleepio Member

    • 18 comments
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    in reply to Sleepio Member
    Expert

    Very good question.

    It is more difficult to implement some of these recommendations in a shared house, so I appreciate your question about this.

    I think the best that can be done in these situations is to be creative and find ways to achieve the spirit of the guideline. For example, if there is really no quiet space in the home that you can use, you might consider making a separate space in your bedroom (as far from your bed as possible) where you do any other non-sleep activities. Just not actually sitting in bed while doing other non-sleep activities is important.

    Another option would be getting noise cancelling headphones so that if you are in other parts of the shared house you can still be doing your work or doing something relaxing before bed.

    Many in the Community have likely figured out good creative solutions to these types of challenges -- so I might try posting there as well.

    Good luck!

  • Sleepio Member

    • 18 comments
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    in reply to Sleepio Member
    Expert

    Hi there,

    I'm sorry you are feeling so terrible right now. Most people find the first days of sleep restriction quite challenging, so you are not alone. But your health and wellbeing are of utmost importance so if you feel at all that those are in jeopardy, we would recommend that you consult your physician and/or consider stopping the sleep restriction. You might find it helpful to visit the General Discussion – Session 3 to see how others have coped with SR.

    Also, it is perfectly ok to shift your sleep window earlier if you think that would be a better fit for you. So you could adjust your in bed time to when you get sleepy at night. This library article describes how to do that: https://www.sleepio.com/library/article/how-to-shift-your-sleep-window/

    Lastly, for individuals who have health issues it is sometimes advisable to go with a less restricted sleep window. You are always able to increase your sleep window (ideally by the smallest amount necessary), if you need to for health or safety reasons.

    Hope this helps.

  • Sleepio Member

    • 18 comments
    • 6 helped
    in reply to Sleepio Member
    Expert

    Hi there,

    Sorry to hear your sleep has gotten worse recently. Without more information it is a bit hard to figure out what might have happened. But the good news is you know a lot about the factors involved in good and poor sleep at this point, so I would encourage you to take a bit of an inventory and figure out what you think caused your sleep to lapse recently. You could either go back through the program again or look at the review the list of habits outlined in session 2 here: https://www.sleepio.com/library/area/session2/

    Then based on what you find, you can make more targeted adjustments -- perhaps managing your thoughts, stress, or getting back to good sleep habits.

    Feel free to write back with more specifics if you would like additional help.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    I hear you -- it is quite challenging in those early weeks of SR. Congrats on sticking with it so far.

    Unfortunately, naps will interfere with the beneficial effects of the sleep restriction, since they will reduce the sleep pressure from building which is what improves your sleep at night. You might find the General Discussion for Session 3 helpful to hear how other people have coped during early SR.

    No problem with dreaming of naps though!

    Best luck to you.

  • Sleepio Member

    • 18 comments
    • 6 helped
    in reply to Sleepio Member
    Expert

    Hi there,

    Great question. Many people struggle with this issue, so you might appreciate checking out this related discussion thread in the Community: https://www.sleepio.com/community/discussion/needing-the-lavatory-in-the-middle-of-the-night/

    Brief nighttime awakenings don't have to significantly impair sleep quality. As you mentioned, this is very much about our perception of these awakenings. I think your idea of focusing on increasing your acceptance (and maybe self-compassion) sounds great. You may find the thought checker or mindfulness techniques helpful to keep working on greater acceptance. See this article in the library: https://www.sleepio.com/library/article/mindfulness-putting-it-into-practice/

    That said, I know this is challenging – keep up the great work. Perhaps soon you will hardly notice that you get up a few times for the bathroom!

  • Sleepio Member

    • 18 comments
    • 6 helped
    in reply to Sleepio Member
    Expert

    Hi there,

    It sounds as if there may be issues related to the bed-sleep connection and/or anxious thinking that are getting you activated once you get in bed. In cases like this, I would recommend reviewing the factors for improving your bed-sleep connection, and the QHR is one important technique here. It can be quite a powerful technique. Is there a reason you don't want to use it?

    If there is a lot of anxious thinking, then of course the thought checker and mindfulness techniques may be helpful as well.

  • Sleepio Member

    • 18 comments
    • 6 helped
    in reply to Sleepio Member
    Expert

    Great question.

    It is often more challenging to implement behavior changes in the context of a health condition. I would encourage you to consult with your physician to find out if they have any suggestions about how you apply this program. You also may find it helpful to check out this discussion thread in the Community for people using Sleepio in the context of similar health issues: https://www.sleepio.com/community/discussion/sleep-problems-with-post-viral-fatiguemecfs/

    Hope this helps!

  • Sleepio Member

    • 18 comments
    • 6 helped
    in reply to Sleepio Member
    Expert

    Hi there,

    I'm sorry the reduced sleep is so painful right now. Of course you long for a full night's sleep! Generally, people find the first few weeks the hardest, but as your sleep keeps improving and you lengthen your window it can start to feel well worth it.

    You may find it helpful to check out the General Discussion for Session 3 to see how others have coped and get support.

    In the meantime, congrats on your hard work with this. It sounds like you deserve some credit for sticking with it.

  • Sleepio Member

    • 18 comments
    • 6 helped
    in reply to Sleepio Member
    Expert

    Great work sticking with it! Nice to see you all supporting each other as well. This is hard work.

  • Sleepio Member

    • 18 comments
    • 6 helped
    in reply to Sleepio Member
    Expert

    Hi there,

    Good question.

    We want to make sure to account for the time you are awake at night after going to bed to ensure that your sleep efficiency score is calculated correctly. Most of the time people are awake in the night actually is time that they want to be asleep -- as you noted. And it is important that this is deducted from the time you went to bed and got out of bed in the morning for the day because that goes into your sleep efficiency assessment.

    So, in short you are doing it right if you enter the times as asked in the diary -- even though it doesn't ask about times awake in which you are wanting/trying to sleep.

    Does that make sense?

  • Sleepio Member

    • 18 comments
    • 6 helped
    in reply to Sleepio Member
    Expert

    Hi there,

    I'm so sorry you haven't seen any benefits yet. Have you fully implemented all aspects of the program?

    If so, it may make sense to see a physician for consultation and possibly an in-person sleep assessment.

  • Sleepio Member

    • 18 comments
    • 6 helped
    in reply to Sleepio Member
    Expert

    Working long hours and having your mind active at night can certainly interfere with sleep for people.

    It sounds like you have found some helpful techniques and may appreciate others that help calm the mind in Session 4.

  • Sleepio Member

    • 18 comments
    • 6 helped
    Expert

    Thank you all for your great questions and comments today. Hope the responses are helpful -- and wish you all the best luck.

    Dr. Vicki Creanor, PhD will be the host for next week's expert session and available for more of your questions.

  • Sleepio Member

    • 8 comments
    • 2 helped
    in reply to Sleepio Member
    Graduate

    Thank you for your reply. Unfortunately the link to the library article does not go to 'How to shift your sleep window' so I can't read this.

  • Sleepio Member

    • 30 comments
    • 13 helped
    Graduate

    I'm in Week 3 of my Sleepio journey, and I found the comments and replies super helpful. Thank you!

  • Sleepio Member

    • 15 comments
    • 1 helped
    in reply to Sleepio Member
    Session 4

    no suggestions on reading or otherwise-I'm very disappointed-just to say carry on with sleepio- were there any comments?

  • Sleepio Member

    • 18 comments
    • 6 helped
    in reply to Sleepio Member
    Expert

    Apologies – I'm not sure why that's the case. I'm pasting the article here for you.

    How To: Shift your Sleep Window

    Although it is best to stick to the same length of sleep window at the the same time every night, you may need to adjust it to make it more achievable for you – perhaps starting it a little earlier, or getting up a little later.

    To make an adjustment to your sleep window first find your Schedule: click the 'Case file' tab located at the top of the page, then select 'Schedule' from the list to the left.

    On your Schedule you will see a section labeled 'In Bed'; click the 'Edit' button to the top right of the section, and a box will appear to the right hand side showing 'Start' and 'End' times. The 'Start' time is the earliest time at which you should be getting into bed: your 'Threshold Time'. The 'End' time notes the latest time at which you should be waking and getting out of bed: the time at which your alarm should be set.

    You can shift your sleep window by adjusting the 'Start' or the 'End' time. To do so click the blue up and down arrows to the right of each time. You will notice that the length of your sleep window will not change, rather it's position on your schedule. Since your window is of a fixed length the whole block will move earlier or later as you adjust the start and/or end times.

    Once you are happy with the position of your new Sleep Window, click the 'Save' button.

    Of course, if you really feel that the length of your sleep window is not working for you, even though you can't make this change on your schedule, in practice you should adjust your window to what you feel is a more achievable length.

  • Sleepio Member

    • 18 comments
    • 6 helped
    in reply to Sleepio Member
    Expert

    Apologies if that wasn't clearer -- I was suggesting that you may appreciate the techniques in Session 4. Have you completed session 4?

  • Sleepio Member

    • 18 comments
    • 6 helped
    in reply to Sleepio Member
    Expert

    You also may appreciate checking out this exercise in particular on putting the day to rest: https://www.sleepio.com/library/article/putting-the-day-to-rest/

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