Live discussion with Dr John Cape - 29th March 2017

Dr Cape will be hosting a live online discussion here on Wednesday 29th March, 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 23 Mar 2017 at 6:14 PM
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  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Thank you Dr Cape,

    That's very helpful. I think I'll leave it a while as you suggest (perhaps until I graduate), then I'll review. If I'm still waking before the end of the window but getting to sleep quickly I think I'd consider both shortening the window and pulling it back.

    Do I recall from previous expert sessions that any adjustments should be done at the rate of 1/4 hour a week to try to prevent further disruption of sleep?

    Doodle.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi. Sorry to hear you are struggling. It is normal to have times after making progress when things slip back and indeed having experiences of this and then recovering progress again is an important part of people coming to feel secure with their sleep and the gains they have made. But I am aware from previous live sessions as to how bad your sleep is and what a struggle this has been. You make a good point about the timing of your sleep window. For people who are sleepy tired earlier, it can make sense to bring the start of their sleep window forward rather than struggling to keep awake until when it has been set for later in the night (but keep the length of the sleep window the same). If doing this, it is worth changing this on your schedule as well, which this Sleepio library article describes how to do – https://www.sleepio.com/library/article/how-to-shift-your-sleep-window/

  • Sleepio Member

    • 38 comments
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    Graduate

    Thank you very much dr cape

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    So you get back to sleep OK, but that sleep does not feel restorative. Is that right? Improved sleep quality (feeling sleep is more refreshing) often lags behind improved sleep efficiency – people may be sleeping more efficiently but it takes a while after to feel they are sleeping more soundly.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Yes. When the Prof extends the sleep window (which he does when people are achieving 90% average sleep efficiency for a week) this is done just for 15 mins at a time. So reducing the sleep window it can make sense to do 15 mins at a time as well

  • Sleepio Member

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    Graduate

    Can you explain that if I set my sleep window earlier is this meant to get me back into a routine of sleeping ? Is that's the purpose- i.e. to reset your body clock ?

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Thank you Dr Cape,

    That's all very clear and helpful. I've got a better idea of how to manage the window now,

    Thank you, Doodle.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hormonal fluctuations are certainly an influence on sleep. See the following two Sleepio library articles:
    https://www.sleepio.com/library/article/hormones-and-sleep-a-two-way-street/
    https://www.sleepio.com/library/article/menopause-and-sleep-problems/
    As for treatment, you might be interested in this recent study on CBT for insomnia in the perimenopausal period:
    http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2522398
    While we haven’t specifically researched this for Sleepio, hopefully this will give you some reassurance that self-help approaches such as Sleepio based on cognitive behavioural principles can be helpful. This is probably because while anything physiological that disturbs sleep can cause sleep problems, what keeps sleep problems going is the cycle of concern about not sleeping and unhelpful sleep habits that results from the initial disturbed sleep, and these are what Sleepio targets.

  • Sleepio Member

    • 153 comments
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    Graduate

    Yes Sleepio has done wonders for my ability to get off to sleep quickly and if I do wake up I am almost always able to get to sleep again without having to implement the QHR. I shall persevere and hope my Sleep Quality catches up soon.

    Thank you for your help.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Sorry that I wasn't clear. By setting the sleep window earlier, I didnt mean to make it shorter, but just to start it earlier. So for someone with a sleep window of 5 hours from 1.00am – 6.00am, it may work better to shift it to 5 hours from 11.30pm – 4.30am if they are generally sleepy tired and ready to go to sleep at 11.30pm. This may fit their natural rhythm better.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Sorry to hear that it is taking you 2 hours to get to sleep. This must be very disheartening. I see you have just started sleep restriction. This often is very disruptive – indeed it is intended to be so to disrupt unhelpful sleep patterns and replace them by patterns that support better sleep. If you look at the Sleepio community discussions, especially the Session 3 General Discussion, you will see that very many users have struggled at this point. And this has come up in a previous post in the live session today. But from what you say this is a change for you from before. If you are logged on live, perhaps you could say what was your pattern before and what is happening now when you go to bed?

  • Sleepio Member

    • 38 comments
    • 2 helped
    Graduate

    Dr cape ,
    Thank you . I'm sorry to ask another question – What time do you think I should set my sleep window ?
    Thank you .

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi. Good to hear you have made a great start with Sleepio, even if now you feel you are stuck and not making further progress and even slipping back. As I replied to another user earlier, slipping back after making progress is normal. I would go so far as to say that nobody just makes steady progress and never slips back. If it is bit of an up and down ride for everyone. This is partly because all sorts of normal things can disturb sleep temporarily for everyone, but when this happens to someone making progress following a long time of having sleep problems it can feel that the sleep problems are returning and this of course creates a bit of worry which in its turn affects sleep and can lead to slipping back. Real solid improvement with sleep occurs after people have experienced a number of slip backs followed by recovery and renewed progress so slip backs no longer have the same impact

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    Hi again. You will need to decide for yourself as there isn't a clear rule as this is partly preference and partly trial and error. In your original post you said you struggle to keep awake in front of the tv at about 10.30 – 11pm but your set sleep window does not start until 1.30am. So sounds like you might be considering a start of some time after 10.30pm but before 1.30pm. Obviously the earlier the sleep window is set, the earlier it ends so a 10.30pm start would for a 5 hour sleep window mean a 3.30am getting up time which might feel just too early. Some people experiment with a slow shifting of the time window rather than all at once (so just shifting it 15 or 30 mins earlier to start with and seeing how that goes). All the best with it.

  • Sleepio Member

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    Expert

    Still time for another question if anyone has one?

  • Sleepio Member

    • 110 comments
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    Graduate

    If nothing more important is asked….I've always wanted to know some statistics about Sleepio e.g. how many people are doing Sleepio at any one time.

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    I dont have the stats and it depends anyway on how you do the calculation. You can count the number of people who start Sleepio in a time period (say a month) or the number who are registered at any one time which, as most people are registered for a year, is many more. Either way it is in the thousands. There are a lot of people with poor sleep out there!

  • Sleepio Member

    • 110 comments
    • 32 helped
    Graduate

    Thousands! With Sleepios 75% success rate that's a lot of people who are helped!

    Thank you Dr Cape,

    Night Night, Doodle.

  • Sleepio Member

    • 475 comments
    • 101 helped
    Expert

    OK. That's it for today. Thanks for all your posts. Dr Vicki Creanor will be doing the next live session – next week on Weds. All the best

  • Sleepio Member

    • 475 comments
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    in reply to Sleepio Member
    Expert

    PS I should have added that only a small proportion of people going through the Sleepio program post in the community discussions or in the live sessions. But from the analyses we have done, people posting in the end do better, probably because of the support they are getting from other users in sticking with the programme. So keep on posting!

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