Live discussion with Dr John Cape - 16th August 2017

Dr Cape will be hosting a live online discussion here on Wednesday 16th August, from 7:00pm to 8:30pm British Standard Time or 2:00pm to 3:30pm US Eastern Standard Time.

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

Please do note that, as per our guidelines, Dr Cape will not be able to give personal medical advice. His 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 10 Aug 2017 at 10:32 AM
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  • Sleepio Member

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    in reply to Sleepio Member
    Session 5

    Thanks for that. I take 300mg of Trazadone at night but I can ask my GP about Prazocin. I wake myself up yelling too. I'm not going to bed for another 3 hours but I'm already worked up about it!

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    Hi. You describe a pattern of sleeping for 4 ½ hours then lying awake thinking for 4 ½ hours interrupted by dreams which also set you thinking. Sounds exhausting and I am not surprised it makes you worried about your mind. I note you are just on session 2 of Sleepio. In session 3, the Prof will set you a sleep window to change this pattern. So I would suggest hold on, when you are ready for session 3 go through it carefully and follow the Profs instructions. This will be the key part of Sleepio for you. And come back at a future Wednesday live session and tell us how you got on.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi again. If you are concerned about your hands and arms going numb in your sleep, then we would recommend you ask your doctor about this. Temporary numbness can occur when the weight of the body has been on a limb, but I can see you are worried about something more which is why we would always recommend people check their concerns out with their doctor

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    The nightmares must be really scary if they make you anxious about going to sleep. I hope you are getting helpful specialist treatment for your PTSD

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    The most common sleep problems come under the general heading of insomnia disorder and these are what Sleepio is primarily designed to help. There are a number of specific sleep disorders such as obstructive sleep apnoea and circadian rhythm disorders, which Sleepio can help, but need additional treatments or modifications. If you think you might have such a specific sleep disorder, we would recommend that you speak with your physician to clarify this. Or have you been told you have or suspect you have such a specific sleep disorder?

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Good to hear that you made a good start on sleep restriction, even though you have now run into a glitch. Some people who get overly tired or overly wound up waiting for the start of their sleep window have found shifting the start of the window to earlier helps (but of course keeping the window the same length). So if the prescribed sleep window was say 12.30am – 6.00am then shifting the sleep window to 11.30pm – 5.00am helped. If doing this, it is possible for you to change the timing of the window on your Sleepio schedule – see this Sleepio library article: https://www.sleepio.com/library/article/how-to-shift-your-sleep-window/

  • Sleepio Member

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    Expert

    Really interesting question and not one that I have been asked before, but I can see could be a real problem for a number of people. Yes, ending up with a long to do list and feeling that unless you do everything on the list that sleep isn’t going to improve would be troublesome for anyone (whether they have a general tendency to worry about things or not). That sort of worry will have the opposite effect to that intended – it will get people more stressed and less likely to sleep. Thanks for bring this to our attention. This certainly was NOT the intention when suggesting people add things to their to do list. And it certainly isn’t the case that missing doing things on the to do list means sleep wont improve – it would be a miracle if anybody always did everything on their to do list. I would suggest if people are finding the to do list more troubling than helpful, they (1) create a more basic list all of which should quickly become a habit; key things on the list would be do your wind down routine before bed when you remember, stick to your sleep schedule times, get out of bed after 15 mins if not asleep and only get back to bed when sleepy tired (2) consult the original longer to do list every week or so and see if there are things you are missing out that might be helpful. In terms of the various techniques the Prof introduces in sessions 4 and 5, most people try a few (not all) of these and find one or two that help and use these.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Good to hear that setting the sleep window has helped you. Waking up within an hour or so before the end of the sleep window I think is one of the trickiest problems. Awareness, either from checking the clock or through awareness of dawn/daylight, that it is only an hour or so before end of the sleep window acts to arouse people and make it harder to get back to sleep. This is often more of a problem in the lighter mornings in Summer in the Northern hemisphere. Following the quarter of an hour rule (getting up after 15 mins awake and only going back to sleep when sleepy tired) is still important to do, but people will often find that they are not sleep tired in the time running up to the end of their sleep window so don't go back to bed. Although this can feel frustrating, this is better than staying in bed for 1 – 1.5 hours before getting up which will only add to a waking up early = restlessness connection. So, even thought this is a particularly difficult habit to break, we would recommend people follow the quarter of an hour rule at these times and over time this then does improve (and sometimes the seasonal shift to longer hours of darkness helps).

  • Sleepio Member

    • 1 comments
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    Graduate

    Within the past few years I started snoring and it has affected my sleep and my husband. Any suggestions?

  • Sleepio Member

    • 26 comments
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    Graduate

    Hi. Dr. Cape
    My sleep window is about 2.5 hours

    Thanks

    Sag

  • Sleepio Member

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    Expert

    Thanks for your question. A lot of people do feel frustrated by being unable to sleep which I guess is why it comes up a lot. And the frustration/upset of being in bed and not sleeping is a key element that keeps causes arousal and prevents sleep. Irritability about not sleeping acts in the same way.

    In terms of reading, for many people and many books reading is arousing (the book is exciting or makes people think). This then isn’t helpful as part of a wind down routine. But some people find that some books or magazines do help them wind down. In which case this is fine. But reading in bed should be avoided as set out for the reasons described by the Prof in session 3 and in this Sleepio library article:
    https://www.sleepio.com/library/article/why-you-should-do-nothing-but-sleep-in-your-bedroo/

  • Sleepio Member

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    Expert

    Thanks. I was meaning the sleep window given to you by the Prof. You may be only sleeping 2.5 hours a night, but the Prof will have given you a considerably longer sleep window

  • Sleepio Member

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    Expert

    Yes, my earlier post in response to the similar question about waking up close to the end of the designated sleep window is relevant to you. And your point about this being more of a problem during the working week is well made. I note you are a graduate and wonder if in other respects your sleep has improved and your sleep efficiency is generally close to 90%. Is so, this this might be a case where 100% sleep efficiency is not a realistic goal and some element of waking up early and thinking about obligations at work is common even for good sleepers. However, if you are a more recent graduate and your sleep efficiency is generally below 80% then the recommendation would be to continue following the approaches covered in the program.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    You ask about snoring. There is normal snoring and snoring associated with sleep apnoea. I have pasted below links to Sleepio library articles on each of these:
    https://www.sleepio.com/library/article/snoring/https://www.sleepio.com/library/article/what-is-sleep-apnoea/
    If it might be sleep apnoea, it is important to seek medical advice. If it is normal snoring and it is affecting your husband, when you snore he can prod you to shift position and sleep on your side (where people are less likely to snore) or some bed partners wear ear plugs

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    See my post above about reading and the Profs specific advice about not reading in bed, which you will have seen in your most recent session with the Prof (session 3). In terms of the medical advice you have received to lie down for an hour during the afternoon, I can see this is a challenge to keep awake! Things to consider that might prevent sleep then are (1) an uncomfortable lying position if this is medically feasible (2) reading, playing a game on a device, or other mentally alerting activity that can be done lying down (3) having an alarm go off periodically.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    If you hover your cursor over where it says ‘Flag’ you will see it says ‘Flag as inappropriate’. This is so Sleepio users can report any post/comment they consider inappropriate in line with the Sleepio posting policy (at bottom of each webpage and link here: https://www.sleepio.com/postingpolicy/).
    In the policy there is a bit that says:
    “Please report any wrongdoing. Since Sleepio staff do not monitor the discussions on the Community we encourage you to ‘Flag’ any comments that you think do not meet the principles listed here. Your report will remain completely anonymous, and the reported user will not be aware that you have flagged their comment”.

  • Sleepio Member

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    Expert

    We have come to the end of our time for today. Thanks for all your questions. Asking questions helps not just you, but other users who have a similar concern. And we at Sleepio learn from your questions about aspects of Sleepio that can be improved. So please keep posting questions. There is a live discussion every Wednesday

  • Sleepio Member

    • 2 comments
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    in reply to Sleepio Member
    Session 3

    My doctor wouldn't carry out any investigation for a specific sleep disorder until I finished treatment with icope who have referred me to sleepio, do you think this is the best decision or should I go back to my doctor?

  • Sleepio Member

    • 9 comments
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    in reply to Sleepio Member
    Graduate

    Thanks very much. Hadn't thought of any of these.
    Georgian

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    Given that your doctor and/or the icope service has recommended you try Sleepio first, no reason not to go along with the recommendation. If you have positive reasons to believe you have a specific sleep disorder which your doctor has not detected, then makes sense to go along with their recommendation. The only relatively more common specific sleep disorder to be more careful to exclude is obstructive sleep apnoea which most doctors are well aware of and would refer you to a specialist clinic for:https://www.sleepio.com/library/article/what-is-sleep-apnoea/

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