Live discussion with Dr John Cape - 28th January

Dr Cape will be hosting a live online discussion here on Wednesday 28th January, 8.15pm-9.45pm GMT.

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Posted 23 Jan 2015 at 3:20 PM
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  • Sleepio Member

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    Expert

    Hello everyone
    Looking forward to the discussion with you over the next hour and a half. Do chip in with live posts. And feel do feel free to come back and disagree with me if you think I have missed the point or got something wrong!

  • Sleepio Member

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    Expert

    There are quite a few really great questions around sleep restriction. So I think I shall start with these.

    Zeebee and Lew, I see you are both struggling to keep awake until the time set for the start of your sleep window. Not easy when you feel sleepy tired! Sounds like you are both doing well with the sleep restriction (congratulations. Lew on graduating), but this part is a struggle. A couple of things you can try. You can start your wind down routine later, so you are doing energising activities that keep you alert until later (you can check back to the session 2 materials for ideas on these). Or you could experiment with shifting your sleep window to earlier, so that it is the same length but you go to bed earlier and get up earlier. There is no problem with doing this, as long as the sleep window (the time between going to bed and getting up) is the same. If this works for you, there is a description in the Library on How to Shift your Sleep Window under the heading Technical Help.

    Adele, I see you are having a related problem with feeling incredibly tired during the day. You have clearly made a fantastic start with sleep restriction (SR) – very quick improvement in your sleep efficiency. As you have seen from other posts, it is common to feel tired during the day when starting SR. But best try other energising activities than caffeine during the day!

    Liz, you raise a really important point about sleep restriction after graduation. From your post you did really well with it, despite it being particularly difficult for you. But sounds like after you graduated, you didn’t keep up the SR routine. Is that right? When it’s such a struggle over the 6 week course, it’s not surprising to want a break when you graduate. But establishing a new sleep habit takes much longer than 6 weeks. Keeping going is hard. And setting a sleep window that works for both you and your husband I see is tricky – I shall come back to this later if there is time this evening, but if I don’t, check out the article in the library “Do you really get people who are 'owls' and others who are 'larks'?”

  • Sleepio Member

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    There are a couple of good questions about variability from night to night. One or two nights you sleep well, then the next night you hardly sleep at all or have a weird kind of sleep. Adele and Daluvd, you both report this in different ways as you started sleep restriction

    When we notice some variability in our sleep, we can start analysing, trying to find a reason for it, going over it again and again in our mind, wondering why and what we can do to make the next night better. Anyone else find this? The problem is ….... not the variability so much as the tendency to go into detailed self-analysis. This can lead to the vicious cycle of racing thoughts that keep you awake, so rather than the analysis helping it makes sleep worse. Does that sound familiar?

    Variability in sleep is common, not just in poor sleepers or as people make progress with Sleepio, but at times in good sleepers. The reasons why sleep was better or worse on a particular night will be subtle and multiple and usually unknowable, so in the end a counterproductive route.

  • Sleepio Member

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    Expert

    The vicious cycle of thinking is vividly described in your post, Kirke. For the benefit of others, I shall repeat what you posted:
    “I was wondering how it would be possible to avoid self-fulfilling prophecies about bad night's sleep. 

It is a sudden thought/fear about possible not sleeping, which suddenly appears and then becomes bigger and bigger worry. And when, when it truly fulfills, it can create potentially an avalanche of such worries.”

    Familiar? Marcus, guess from your post this is familiar to you! And gilder-guy from Arizona, great observation that you have noticed that on the days when you don't obsess about sleep, you sleep better

    Can such thoughts be avoided entirely? If you could avoid them, you wouldn’t need the Sleepio programme as you would be sleeping fine! For now, you need to accept that these thoughts will come into your mind and use the various approaches for dealing with thoughts in the Sleepio programme. Are you using the thought checker? It is ideal for these kind of thoughts about sleep as in the cool light of day you (1) write down the thoughts you typically have at night (2) challenge/ answer each thought with a more accurate thought. Or, for those of you later in the programme or graduated, have you tried and found useful any of the approaches for dealing with thoughts covered in sessions 4 and 5?

    There are of course all sorts of different thoughts that people have at night, and the different kinds of approaches to dealing with thoughts the Sleepio programme covers can each be useful for some thoughts. 2springers, you talk about meditation having been helpful to you, which of course is similar to the mindfulness approach described in session 5 – have you been using this at night as well or just in the day?

  • Sleepio Member

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    Graduate

    Dr. Cape,

    Actually I do use Thought Checker twice per day, in the morning and in the evening. I find it very, very useful. But still.. There are bigger waves in our lived when even thought checker does not help :)

  • Sleepio Member

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    Hi Machado3
    As well as yours, there is another query posted earlier today, about waking up in the night and having difficulty getting back to sleep. As a graduate, you will know that this is where the quarter of an hour (QHR) rule is king. I am wondering if you are following the QHR? I know it is incredibly hard to keep it up especially over a long time and, in your case, I see it is a year. Would be useful to know what you are doing and your experience of it.

  • Sleepio Member

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    Graduate

    You know what was interesting, my partner and my closest people concluded that I became self-obsessed during Sleepio programme. I did, indeed, and I must be honest that it was easier because external events, worries and changes are actually one of the biggest triggers for stressing out and, consequently, insomnia. But it is mission impossible to avoid social life and all changes. I guess, I must be more mindfully accepting not only about poor sleep time to time, but also external events and “phenomena” :)

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Yes, I did keep up the SR routine, I only stay in bed for 7.25 hrs. But I have noticed that if I go to bed around 9:30 then my sleep is broken (waking at least every hour) until I wake around 1:30 and can't go back to sleep til around 4:30. After I go back to bed I only let myself sleep for the rest of the 7.25 hrs. My observation is that having broken sleep and staying awake for 3 hrs. in the middle of the night leaves me feeling awful in the morning and dragging myself around all day.
    If I go to bed around 11:30, I sleep more solid til 4:30, wake briefly, and go back quickly for the same total of 7.25 hrs. I feel more refreshed in the morning and more energetic during the day.
    My question after reading the owls and larks article still is: Is it possible to change a person's sleep clock or am I just struggling unproductively and should I just go with what feels right for me. Thanks, Liz

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi Kirke
    Good to hear you are using the thought checker and that it is useful.

  • Sleepio Member

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    Hi Liz
    So have I got this right? Going to bed at 11.30 works for you and left to your own devices you might sleep through OK, but as your husband has to get up at 4.30, you wake up, but then you do fall back to sleep OK. If so, this sounds fine to me, as long as your getting up time is consistent.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hello Ms Mac

    I am sorry to hear that you have had to go int hospital so soon after starting the programme. Yes, hospital isn't a place you can organise your own sleep schedule and I would like to be there if you did suggest it to your neurologist! I dont have any specific knowledge about MS and sleep (your neurologist presumably must), but the cognitive behavioural approach to insomnia has been used successfully in people with sleep problems linked with a range of physical illnesses, including cancer.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi zeebee
    I am interested in you saying your sleep problems are very recent. Is it really just since November? I ask as transient sleep problems (lasting a few days to some weeks or months) are common and it is only when people get into the vicious cycle of worrying about sleep or trying to catch up on sleep (with progressively worse sleep efficiency) that insomnia as a self-perpetuating problem kicks in

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Wise words, Kirke. All the best

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi gin-gin
    Good to hear all the progress you have made. I would be interested too if anyone else has had the experience of weight increase with sleeping better. It does seem quite possible if poor sleep is accompanied by a lot of anxiety, restlessness and agitation

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi
    Sounds like you have been through a tough time. There is a good article in the library on Sleepiness, fatigue and impaired concentration which talks about the problem of day-time fatigue. I don't have any specific tips, other than for dealing with thoughts about the fatigue which often accompany the fatigue – thoughts like “how am I going to manage today feeling like this?” Some of the approaches to dealing with night-time thoughts set out in the programme are relevant for these too. From what you say you are using mindfulness which is good. As your sleep improves, so should the fatigue. All the best with it

  • Sleepio Member

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    Any final query or comment?

  • Sleepio Member

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    Graduate

    Yes – when my problem was extreme – I lost about 20 pounds because the insomnia lead to the anxiety which killed the appetite. When my sleep improved – the anxiety waned and appetite came back – but not all twenty pounds. I did cut back on wine, made better food choices, spent more time outdoors walking and even took up yoga – which I highly recommended.

  • Sleepio Member

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    Expert

    Thanks, gilder-guy. Helpful to hear your experience.

  • Sleepio Member

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    Expert

    Well that's it for tonight. Thanks all for your posts.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hi Dr Cape,
    Not sure if you continue to read these posts once the live discussion has finished – unfortunately I couldn't get online the night of the discussion – but I just wanted to say thanks for your reference to the Sleepiness, Fatigue, and Impaired Concentration article in the library, which you mentioned in a reply to theincrowd. It was reassuring to read this and find that feeling fatigued during the day is a normal part of this process. For anyone else struggling with fatigue/daytime tiredness, there's also a helpful discussion, if I remember rightly it's called How Do I Cope In the Daytime?
    Completed Session 5 this morning and was able to add 15 mins to my sleep window, which I'm sure will help. I think my body is ready for the extra sleep now. I'm also cutting down on the caffeine – not easy for a coffee lover!

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