Live Discussion with Dr John Cape - 30th March 2016

Dr Cape will be hosting a live online discussion here on Wednesday 30th March, from 7:00pm until 8.15pm BST.

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.

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.

To keep up with new comments as they are posted you will need to refresh this discussion page.

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Posted 28 Mar 2016 at 11:50 AM
  • 60 comments
  • 14 helped

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  • Sleepio Member

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

    I get this, it's called ear worm. It drives me mad! I've found that doing puzzles helps, the trickier the better.

  • Sleepio Member

    • 230 comments
    • 44 helped
    in reply to Sleepio Member
    Expert

    Hi again
    For advice about sleeping aids, we would suggest you consult your doctor. Sleep can work with or without them. In general consistency in other things is helpful when making a big change starting sleep restriction. But appreciate a week feels a long time with worse sleep.

  • Sleepio Member

    • 230 comments
    • 44 helped
    in reply to Sleepio Member
    Expert

    Hi jurassicworld
    Nice question – what should you think about when trying to get to sleep. Not bizarre at all. What Prof covers in sessions 4 and 5, which I see are coming up next for you, should give you some tips. Which of these will be most useful will depend on the individual and their current thoughts or visual images when they are trying to sleep. One cannot think about nothing – that is impossible. People often find it useful to try out two or three of the techniques the Prof describes and see which works best for them.

  • Sleepio Member

    • 230 comments
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    in reply to Sleepio Member
    Expert

    Hi again
    I don't know about the apps you describe, but there is good evidence that blue light is more likely to stimulate wakefulness than light without blue in the spectrum. This is mentioned in the following Sleepio library article:
    https://www.sleepio.com/library/article/the-importance-of-the-sleeping-environment/
    So minimizing exposure to blue light in the hour before bedtime and in ones bedroom at night makes sense.

  • Sleepio Member

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

    I have tried repeating the word “the” and it does not help. I will try doing puzzles as EM75 suggested.

  • Sleepio Member

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

    Thanks,

    My GP insists that melatonin is not available in the UK in any form (neither over the counter nor with prescription, nor as a supplement). Who should I contact to get help with this disorder? The GPs I've spoken to in the UK haven't heard of DPSD. The first one advised me to get up the same time every morning. According to the Oxford Handbook restrictive therapy like this only leads to deficit and has no effect on the hour you go to sleep next evening with people with DPSD. (It seems it is suggested for people with APSD) But I know this all too well from 15 years experience and don't need to read up to know it. The GP however didn't know it. So my question is who should I contact to get help? I would really appreciate if you could answer this.

  • Sleepio Member

    • 230 comments
    • 44 helped
    in reply to Sleepio Member
    Expert

    Hi Sleepiouser
    Yes, weeks 3-5 are often the hardest and as you have seen you are in good company in finding this! You ask about naps. Generally these are not recommended as they reduce sleep drive which can make it harder to sleep at night. But you raise an important point about driving. If you need to drive (and especially if you drive regularly for work), then having a nap to ensure safety is sensible

  • Sleepio Member

    • 230 comments
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    in reply to Sleepio Member
    Expert

    Hi nakulj
    Taking a nap is fine and can be helpful if someone doesn't have a sleep problem. It’s when someone has insomnia that it is inadvisable. A nap during the day means there is less sleep drive at night and when someone has difficulty sleeping, low sleep drive at night will make it more difficult to sleep. As Sleepio is designed to help people who have sleep problems, this is why Sleepio recommends no napping. However there can be exceptions such as when someone is concerned they are too tired to be safe to drive, as in the reply I have just posted.

  • Sleepio Member

    • 230 comments
    • 44 helped
    in reply to Sleepio Member
    Expert

    Hi jd411
    Welcome to Sleepio. The free field tag texts are just for users own use. They can be helpful to look back on and track to see if any of the events or circumstances being tracked are associated with sleep. Sounds like you are on to this already which is a great start, Akll the best with it

  • Sleepio Member

    • 230 comments
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    in reply to Sleepio Member
    Expert

    Hi gardenia
    Welcome to Sleepio. I see you have just started. The pattern you describe of having several nights of good sleep followed by a couple of nights where you cannot fall asleep at all and keep thinking all night is one Sleepio can help with. In some ways you are in a fortunate starting position in that many nights you have a good sleep pattern. The techniques that may end up being most relevant to you are covered by the Prof in session 3 and 4. But you need to build up to those and sessions 3 will be a key foundation as well. Hope it is helpful for you. Do come back and post at a future Wednesday live session.

  • Sleepio Member

    • 230 comments
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    in reply to Sleepio Member
    Expert

    Hi Missunshine86
    Yes, finding somewhere out of the bedroom can be a huge challenge if in a studio or houseshare! There is a recent Sleepio community discussion group for students that started in part because of just this:
    https://www.sleepio.com/community/discussion/student-sleep/
    In the end, if there is absolutely nowhere outside the bedroom (not even bathroom/ensuite), then people have to find a place in the bedroom away from the bed to be, but this is obviously not ideal

  • Sleepio Member

    • 230 comments
    • 44 helped
    in reply to Sleepio Member
    Expert

    Hi HelenC
    Your question about what to think of in bed is very similar to one I answered earlier. I see you are on session 2. What Prof covers in sessions 4 and 5 should give you some tips. People often find it useful to try out two or three of the techniques the Prof describes and see which works best for them.

  • Sleepio Member

    • 230 comments
    • 44 helped
    in reply to Sleepio Member
    Expert

    Hi Em75
    Difficulty falling asleep is definitely one of the key problems that the cognitive behavioural approaches for insomnia that Sleepio is based on treat effectively. All the techniques in Sleepio are relevant, but you are correct that the sleep restriction approaches covered in session 3 are when the treatment really starts and initially for many of not most it can feel a case of things getting worse before they get better. All best with it

  • Sleepio Member

    • 230 comments
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    in reply to Sleepio Member
    Expert

    Hi Elizabeth
    Welcome to Sleepio. Good question about diary keeping. There is both a Sleepio Library article and Discussion Forum on How accurate does my diary have to be (shall paste the Discussion forum link here):
    https://www.sleepio.com/community/discussion/how-accurate-does-my-sleep-diary-need-to-be/
    It will always be an estimate as if someone is so intently clock watching to be absolutely accurate this isn't good for sleep!

  • Sleepio Member

    • 230 comments
    • 44 helped
    in reply to Sleepio Member
    Expert

    Hi again
    Yes, I didnt mean to suggest that just stress can bring this on in the first instance. Anything energising or arousing can do so – and long travel on its own can do this

  • Sleepio Member

    • 230 comments
    • 44 helped
    in reply to Sleepio Member
    Expert

    Thanks, EM75. That was the term I was looking for.

  • Sleepio Member

    • 230 comments
    • 44 helped
    in reply to Sleepio Member
    Expert

    Hi
    Welcome to Sleepio. What you describe is similar to what can happen in Delayed Sleep Phase Disorder that another user was asking about. The link to the Sleepio Library article on this is: https://www.sleepio.com/library/article/what-is-delayed-sleep-phase-disorder/
    What is helpful is that you identify a particular type of situation (occasional parties) which get you off track when you have got you have been back in a consistent sleep routine. Being pre-warned and making a plan in advance to deal with the times of risk of getting off schedule is what can help

  • Sleepio Member

    • 230 comments
    • 44 helped
    Expert

    I am afraid we have come to the end of the live session time today. I haven't managed to answer all your posts as there were so many today. There will be another live session next Wednesday, so do come back and post again then if I didn't get around to answering yours.

  • Sleepio Member

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

    What you are describing sounds exactly what I am going through. The goal may be to become sleepy tired, but if the mind is racing then becoming sleepy tired may not be enough. I have found the mp3 autogenic training to be helpful as well as mindfulness – cloud meditation. But if factors like not sticking to schedule wreak havoc, then all bets are off. If worse comes to worst, there's always tomorrow night!

  • Sleepio Member

    • 230 comments
    • 44 helped
    Expert

    Hi Eve
    Sorry it was very busy last evening and I wasn't able to get back to you. By adaptations to CBT for DSPD, I meant shifting the sleep window forward over time until it reaches the time that works for the person’s life and then sticking rigidly with that sleep window time. This is a behavioural treatment, part of the family of cognitive behavioural treatments (CBT) for sleep disorders (Sleepio is based on standard CBT approaches to treating insomnia), and is sometimes called chronotherapy. It is the most well established treatment for DSPD. Light treatment – exposure to bright light in the morning (and reduction in light exposure in late evening) – has the next best evidence. Evidence for melatonin is the least well established – its effects tend to wear off. I have pasted below the piece on treatment of DSPD from the American Academy of Sleep Medicine:
    http://www.sleepeducation.org/sleep-disorders-by-category/circadian-rhythm-disorders/delayed-sleep-wake-phase/diagnosis-and-treatment
    Other CBT approaches for sleep as used in Sleepio (but without the shifting forward of the sleep window) have been used for treatment of DSPD often in conjunction with light treatment, but the behavioural component of shifting forward the sleep window is the element with the best evidence. In terms of where in the UK you can get specialist help for DSPD, there are very few specialist NHS sleep disorder clinics, other than for sleep apnoea, although there are some private clinics. Sometimes within NHS Improving Access to Psychological Therapy Services in England there are CBT therapists with a special interest in sleep disorders.

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