Live discussion with Dr John Cape - 24th May 2017

Dr Cape will be hosting a live online discussion here on Wednesday 24th May, 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 19 May 2017 at 12:54 AM
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  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    I see you have recently started Sleepio. The sessions ahead of you build on each other to help improve sleep patterns, including helping achieve more consistent sleep. As they build up, you should feel equipped with an approach to deal with the various aspects of sleep that affect you, including when you have several nights without sleep. So, while I appreciate you may be exhausted and wanting something quickly now to help, I would encourage you to go through the program in order as this is what the evidence shows is best for improving sleep

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Good question. First, good that Sleepio has been a success for you in terms of sleep efficiency (SE). There is commonly a delay between improvement in SE and improvement in peoples’ experience of sleep quality. There is a reason for this. SE is what Sleepio directly targets (as cognitive behaviour therapy for insomnia also does), so SE improves first. Feeling more refreshed after sleep and feeling more alert in the day, doesn't automatically improve with SE, there is often a lag. Most people who improve SE also end up experiencing better quality sleep. Having said that, there is a minority of people who sleep efficiently and have sufficient total sleep time, but don't experience sleep as refreshing/restorative. This is called non-restorative sleep and less is known about why this is and what might help.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    This does sound rather confusing – I think I would be confused in your position. The only circumstance I know where it is possible to have a sleep efficiency of 94% with only sleeping 4 hours with a sleep window of 7.5 hours is when people wake up very early (long before the end of their sleep window) get out of bed under the quarter of an hour rule and don't go back to bed. Under these circumstances, time between first going to bed and final time of getting out of bed for the day (the denominator for calculating sleep efficiency) is much shorter than the sleep window so you can get high sleep efficiencies despite sleeping far shorter than the sleep window. Is this the case for you? Under these circumstances, we sometimes advise people enter the time of the end of their sleep window for final time of getting out of bed or the day (instead of actual final time of getting out of bed) as this then gives sleep efficiencies that are more helpful for the Sleepio program. If this isn’t what has happened for you, it may be there is some way you are completing your sleep diary that is leading to odd results (clicking the little question mark alongside each sleep diary entry gives a short explanation of what to enter). Either way it does sound like your sleep window may be longer than it should be.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Yes, babies need and get most sleep and as we get older we need progressively less sleep. This is very firmly established in the science of sleep. One of interesting reasons for this is that sleep is important in learning and memory consolidation and babies and children have most to learn.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Yes, fine to take melatonin while going through the Sleepio program if this is something you and your doctor feel is helpful for you. The evidence we have is that Sleepio is equally effective for people taking sleeping aids as those who do not (see also my reply to another user’s question today). I see you have also asked about taking Lunesta. Same applies to this. All the best with the program.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Thanks for your question. I see you are at session 2. Later in the program (session 4) different kinds of intrusive thoughts that keep people awake are covered and also (in both sessions 4 and 5) some approaches to dealing with such intrusive thoughts at night. You cannot jump ahead to look at these, so suggest you continue working through the sessions and managing these thoughts as best as you can until then.
    As for your second question about melatonin, you will see another user today asked about melatonin and I replied that it is fine to take it while doing Sleepio. Any queries or concerns about a medication people have we generally advise they check out with their doctor/prescriber who knows their particular medical history and circumstances

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Thanks for your question about what kinds of sleep problem Sleepio is most effective for. In terms of formal sleep disorder diagnoses, it is primarily designed for insomnia disorder, the most common type of sleep problem of all. But Sleepio also is helpful for a range of other sleep problems, although some of these need specific interventions in addition (most obviously sleep apnea). Is there a specific sleep disorder you are wondering about?

  • Sleepio Member

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    Graduate

    Hello I am here I posted earlier

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Helpful you asked this about completing your sleep diary when you nap during the day. For now, ignore day-time naps and just enter in the sleep diary about your sleep from first going to bed at night to getting up in the morning for the day. You will find later that the Prof doesn't recommend people with sleep problems take day-time naps as they reduce sleep pressure and can so make it more difficult to sleep at night. So when you get to this point, hopefully you wont be taking day-time naps!

  • Sleepio Member

    • 30 comments
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    Graduate

    Thanks for your help it is appreciated. I will certainly take on board what you have said, though as you say it is tough.

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    Delighted you have found the Sleepio course helpful. You will note from my replies to other user posts today that Sleepio is equally effective for people taking and not taking sleeping medication. At Sleepio we generally don't advise people about medication, as peoples medical histories and circumstances vary in ways that mean what is right for one person is not necessarily right for another, so we would always recommend issues about medication are discussed with your doctor/prescriber. So I cannot advise about your particular circumstances and query about melatonin, but there are plenty of people who decide in discussion with their doctor to continue with their sleeping medication (whether melatonin or other medication) after completing Sleepio and finding it helpful.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Thank you Dr Cape.

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    Not sure if the light from a Kindle Paperwhite is blue light (maybe not), but you will find as you get into the program (I see you have just started) that Sleepio recommends people with sleep problems restrict the bed to sleep and sexual activity. The reason for this is the for good sleepers, most of their time in bed is sleeping so they have a great bed = sleep association; but poor sleepers spend a lot of time in bed doing other things (in your case reading your kindle) which creates other kids of association (bed = reading) that interfere with sleep. All the best with the program and do come back and ask questions at future live sessions (every Wednesday)

  • Sleepio Member

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    Expert

    Any more questions?

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Thank you.

  • Sleepio Member

    • 475 comments
    • 101 helped
    Expert

    OK, we are just about at the end of our time for today so I shall sign off. Thanks for all your excellent questions. All the best with continuing to make progress with your sleep

  • Sleepio Member

    • 475 comments
    • 101 helped
    Expert

    OK, we are just about at the end of our time for today so I shall sign off. Thanks for all your excellent questions. All the best with continuing to make progress with your sleep

  • Sleepio Member

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

    Dear Dr. Cape, thank you very much for the response. The condition I was must curious about is RLS. Is the Sleepio program effective for those afflicted with RLS and if so what outcome might I expect?

  • Sleepio Member

    • 475 comments
    • 101 helped
    in reply to Sleepio Member
    Expert

    Thanks for letting me know that it is RLS you were wondering about. Clearly Sleepio does not address the primary cause of RLS, which is subject of research. Also, as you will be aware, people with RLS should get medical advice to check whether anything medically might contribute to the RLS. Caffeine, nicotine and alcohol can also be a factor as you are probably aware. While there is no research specifically on Sleepio and RLS, people with RLS often have secondary insomnia as anything that wakes people up or keeps people awake can trigger the insomnia cycle of increased concern/worry about sleep that increases arousal and makes sleep more difficult. So for people with RLS where this is happening, Sleepio could help this secondary insomnia. Hope this is of some help in you deciding whether Sleepio might be helpful for you

  • Sleepio Member

    • 7 comments
    • 2 helped
    Graduate

    Dear Dr. Cape,

    Thank you for the response to my question. Incidentally, I have indeed sought out medical advice for RLS, which in my case seems to have stemmed from my sever Apnea condition. So I suppose that my Apnea condition, led to RLS condition, led to Insomnia condition.

    I might add that the more personal and structured data entered and historically tracked into Sleepio the better to look for patterns, isolate root causes, and to note the result of any new treatment or lifestyle change. I realize the program does this now and hopefully will expand further into more personal tracking detail – (e.g. – AHI's). I wonder how many Sleepio users have multiple conditions (e.g.- Apnea, RLS, etc.) as well?

    In any case, I will continue on with Sleepio to see what positive effect may occur and post in due course. I am looking forward to work through the Sleepio program.

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