Live discussion with Dr John Cape - 1st February 2017

Dr Cape will be hosting a live online discussion here on Wednesday 1st February, 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 26 Jan 2017 at 12:12 AM
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  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    Welcome to Sleepio and, yes, welcome I am afraid to the hardship of sleep restriction. An earlier post I replied to was also on how tough sleep restriction is. It can feel excruciating, but it is effective. Research suggests that this is the single most effective approach to improving sleep, but it is hard. 5 hours can feel so little, but once someone is sleeping consistently for the 5 hours, the Prof increases the sleep window. It is possible to shift the timing of the 5 hours if, for example, you decide it might be better regularly to get to bed before midnight (and get up earlier): https://www.sleepio.com/library/article/how-to-shift-your-sleep-window/. But sticking with it is what we know works. All tge best with it and let us know how you get on

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    Hi. You say you usually get to sleep OK, but then wake up after 4-5 hours and cannot get back to sleep. This is one of the commonest sleep problems and one that Sleepio is designed to help. I see you have just started so all the approaches that address this are ahead of you. Sessions 3-5 contain the key approaches, but there are issues in the first 2 sessions that can also be key for some people so we encourage people to work through the sessions as set out. Hope it is helpful for you. Do come back and ask questions in future Wednesday expert sessions.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    You are clearly sleeping very poorly. Sleepio does help people who sleep as poorly as you describe. Sleep restriction sleep windows set by Sleepio are based on what people are sleeping currently (you very little) but not so low as to not allow sufficient core sleep in the first instance. So in effect there is a minimum sleep window. Given how badly you are sleeping at present, it cannot be tougher than that. Do come back and post next week what happens

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    You raise an important issue and one that I don't think gets enough attention. Being sleepless and awake a long time in the night can be a very lonely experience (it also can be uncomfortably cold in winter months) and lead people into rather gloomy thoughts. You are quite correct that we wouldn't recommend going online and chatting as this is likely to be activating/arousing and make it even more difficult to get back to sleep. When up under the QHR, Sleepio’s general advice is to do something relaxing which engages attention but is not arousing; if attention is engaged (e.g. by reading), then thoughts will be on this rather than dwelling on being alone and up at night. Gloomy thoughts can also be looked at and put in perspective using the thought checker (which you can see by reviewing session 4 in the Sleepio Library -https://www.sleepio.com/library/area/session4/)

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Practicing progressive relaxation in order to improve skill at relaxing should be done during the day and not in bed – https://www.sleepio.com/library/article/progressive-relaxation/
    Using what you have learned is best done in the wind down routine not in bed. It can also be done when just got into bed for people skilled at relaxation and able to get to sleep quickly doing progressive relaxation. But a long progressive relaxation session in bed (over quarter of an hour) is not such a good idea.

  • Sleepio Member

    • 475 comments
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    In reply to a deleted comment
    Expert

    Great to get your feedback about support. Always pleased to help. As for your questions:
    (1) Some links to the “the the” thought blocking technique:
    https://www.sleepio.com/library/article/blocking-out-thoughts/
    https://www.sleepio.com/library/area/session5/
    (2) Could you email your question about getting a notice about extending access to the Sleepio team at hello@sleepio.com? I don't have the information on this, but they should be able to help you
    (3) Also email them your question about the difficulties accessing Sleepio by iPhone.
    All the best

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi. You ask how best to get back to sleep after being woken up in the night by a phone call and having had to be properly awake to deal with information in the phone call. This is the sort of situation that is likely to interfere with sleep even for good sleepers. Some of the approaches covered in sessions 4 and 5 could be helpful. For example adapting the “putting the day to rest” approach to put to rest the phone call if thoughts of this are keeping one awake could be useful – https://www.sleepio.com/library/article/putting-the-day-to-rest/
    or the thought blocking technique – https://www.sleepio.com/library/article/blocking-out-thoughts/
    It might also be useful to review the types of intrusive thoughts –
    https://www.sleepio.com/library/topic/types-of-intrusive-though/

  • Sleepio Member

    • 95 comments
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    Graduate

    Many of us have experienced getting over-tired at bed time when we've by-passed that sleepy-tired phase and pushed ourselves into such exhaustion we can't even fall asleep. While practicing SR, is it necessary to wait until our designated bed time when we are feeling so sleepy-tired we an barely function? In other words, is it okay to go to bed when sleepy-tired on some nights if it's only 15 – 30 min. before our sleep window begins?

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    Good to hear that you have made improvements and are feeling more relaxed. Could you email your question about accessing the materials following March to the Sleepio team at hello@sleepio.com? They will have the information relevant to you. All the best with continuing to improve.

  • Sleepio Member

    • 18 comments
    • 3 helped
    in reply to Sleepio Member
    Graduate

    Thank you Dr Cape, I moved my sleep window last night because I found it hard to wait so long to go to bed. I used to be told that an hour before midnight is worth two after! I also felt that getting up earlier will give me more productive time, rather than waiting to go to bed. I will stick with it, was a tough day today with more to come, I know. I will try to find your reply about sleep restriction. Thanks again.

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    Yes, it is fine to shift the time of your sleep window either as a one off (an appointment) or on an ongoing basis (because you find an earlier or later time for going to bed/waking up generally suits you better) as long as the sleep window is the same length. So your 7 hours could be shifted earlier of later, but needs to remain 7 hours. If making a regular shift, you can even change this on your schedule: https://www.sleepio.com/library/article/how-to-shift-your-sleep-window/

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    Feeling “half asleep”, as you put it, is often when people are drifting in and out of sleep. It can be very difficult when this happens to know how long one has been asleep and how long awake and can be very disconcerting. Even good sleepers drift out of sleep in the night but go straight back to sleep and don't remember that they woke up. Is this or other aspects of your sleep changing at all in the few weeks since you started Sleepio?

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    All the best with it

  • Sleepio Member

    • 475 comments
    • 101 helped
    In reply to a deleted comment
    Expert

    It’s definitely best to do something activating to keep oneself awake to the start of the sleep window. But if this is a regular problem, one option is to shift the sleep window to start earlier (and end earlier). It could be that going to bed earlier just suits better. This is fine to do and in a couple of earlier posts today I included a link of how you can actually change the timing of the sleep window on your Sleepio schedule

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    Thanks for this. There is indeed evidence that blue light disturbs sleep more and reducing this can be helpful. As such, blue light filtering glasses should help. But still would advise caution because, as well as light, some checking of phones, tablets, computers etc may be activating of itself (especially but not only if work related) and as such better to avoid close to bedtime

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    Thank you for your two very helpful posts in reply to questions/issued raised earlier this evening. Very useful to have your input

  • Sleepio Member

    • 475 comments
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    Expert

    We have come to the end of our time today. I think I have managed to reply to all posts. If not, do posts again before or even better during next Wednesdays session. All the best with making progress with your sleep this coming week

  • Sleepio Member

    • 4 comments
    • 0 helped
    in reply to Sleepio Member
    Graduate

    No. I have the same pattern. It happens for no apparent reason about 2 nights a week.

  • Sleepio Member

    • 4 comments
    • 0 helped
    in reply to Sleepio Member
    Graduate

    This half sleeping problem has gone on for 3 years. it started when I had to stay alert at night while looking after a sick/dying relative. Though I haven't had to do this for the last 18 months, I still experience the sensation of not falling properly asleep.

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    Thanks for the clarification. So this is not every night and, from the way it started, sounds like hyper vigilance – being super alert to some aspect of the environment. This is not an uncommon experience of mothers of infants and also when living with someone who is very ill and needs caring for quickly or people in conflicts situations including wartime. The hypervigilance occurs even at night, so people wake up more frequently and automatically hyper alert to checking out what is going on around them in relation to the concern they are hypervigilant to. This can continue beyond when it is needed, especially when the reason people have had to be hypervigilant has gone on for a long time. One would expect this to pass after time, but if the cause of the hypervigilance has been particularly stressful, traumatic and/or long lasting then people may need specific help with this aspect.

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