Live discussion with Dr John Cape 15th June 2016

Dr Cape will be hosting a live online discussion here on Wednesday 15th June, from 7:00pm to 8:15pm British Standard Time or 2:00pm to 3:15pm 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.

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 9 Jun 2016 at 8:09 PM
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  • Sleepio Member

    • 302 comments
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    in reply to Sleepio Member
    Expert

    Hi. Your question is almost identical to one posted by another user. So do look at the answer I posted earlier. The other user also queried whether going to the restroom in the night be a habit rather than, I guess, because one “needs” to. I realise I didn't answer that and I imagine it could be a habit. But, as in my previous reply, good sleepers are not concerned about having to get up in the night even several times as they don't worry about having to get up and go quickly back to sleep. The worry and concern about having to get up is what can drive poor sleep, not the fact itself of having to get up. In terms of getting up and going to the restroom affecting sleep efficiency, yes this is true, but if one is back to bed and sleep again all within 5-10 mins the impact on sleep efficiency is minimal. So again, the key issue for sleep is getting back to sleep easily after having to get up rather than the fact of having to get up.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Exactly. You have put it perfectly. For many people the key is exactly as you have put it – “Sleep is easy if I don't worry”. But of course that is easier said than done. The mind is not so easily dealt with and hence the techniques to help it on its way

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi. You say your sleep efficiency has not improved and you are getting towards the end of the course and you are wondering why and are there any recommendations. 1. The first thing is that it is still early days and it can sometimes take many weeks before sleep efficiency improves even if someone is doing all the right things.
    2. The second is that it can sometimes be that some aspect of the way the person is carrying out the programme is subtly interfering, but can be difficult to spot.
    3. Third, it can be that sleep efficiency is not far off 90% anyway (for some people 90% sleep efficiency is too high a bar and increasing the sleep window when consistently averaging 85% or even 80% is appropriate).
    In terms of recommendations for someone in this position after only a few weeks of sleep restriction, our general recommendations would be to not consider this unusual (and not see it as something to worry about as worry will only make sleep less likely) and continue to review, explore and try out the various approaches covered by the Prof. But if there is a specific aspect of sleep that is bringing down sleep efficiency (e.g. going to sleep, waking up a lot, waking up early and mot going back to sleep, worrying thoughts keeping awake) then get back to me if you are on live now or let us know in a future live session and we might have a more specific idea.

  • Sleepio Member

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    Graduate

    Hi I have come back to Sleepio as I find my sleep pattern has changed again I am surviving on very little sleep and I feel exhausted during the day, I do keep myself awake and get up during night I find that I don't let myself fall asleep as soon as I am about to go I somehow wake myself up. I do listen to relaxation which does help however I don't get to sleep for long maybe a hour at a time and then after a few hours I am awake is this common.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi. You ask about whether sleep deprivation can cause various symptoms. Headaches and tension are quite common after lack of sleep, sometimes accompanied by dizziness or lightheadness (although not nausea). Sore/itchy eyes are also a symptom. Not chills as far as I am aware. You say you are getting 6 hours of sleep. How is this compared to before you started Sleepio and how is your sleep efficiency? And did you always feel terrible like this or is this new?

  • Sleepio Member

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    Graduate

    I am here and posted a question earlier. Thanks!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi you say you are coming back to Sleepio. Did you go through the programme before and it helped you? Is the problem you describe the same as before or different?

  • Sleepio Member

    • 1 comments
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    in reply to Sleepio Member
    Graduate

    Although it may not be normal, I also find that if I'm extremely tired, bordering on or past exhaustion, I also feel nauseous. At that point, I, too, feel chilled and alternately, overheated. So you're not alone.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi. Good to hear that you sleep efficiency has improved somewhat, although not sleep quality. You say that particularly difficult is waking up abruptly in the morning and being plagued by anxiety and dysphoria. Some good sleepers do wake up quickly, so of itself this isn’t necessarily a problem. But worrying, anxious, upsetting thoughts immediately on waking will wake one up abruptly and cause distress (and make it difficult to go back to sleep if before end of ones sleep window). So being clear about the content of the anxious upsetting thoughts on waking – exactly what the thoughts are about, whether about sleep or about other things – and using techniques like the thought checker or other techniques covered in sessions 4 and 5 might help.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi. No, I am afraid there isn’t a Chinese version of the Sleepio time schedule. Would this be very much more helpful for Chinese users?

  • Sleepio Member

    • 5 comments
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    in reply to Sleepio Member
    Graduate

    Hi John, 6 hours is the same as before I started sleepio (I just graduated last week). I am attempting sleep restriction again as I started seeing improvements in how I felt after a couple of weeks of it (I suspect improved quality but no increase in length of sleep), but I added time in bed too quickly and it unraveled. I have felt terrible for most of the last year, from around the time my sleep problem began, but it has got worse in the last month since attempting and not succeeding at sleep restriction.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Thanks for sharing this. Helpful to know that nausea and feeling chilled are experienced by others too when sleep deprived

  • Sleepio Member

    • 10 comments
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    in reply to Sleepio Member
    Graduate

    Thanks for getting back to me the problem is the same as before however never woke myself up as i was drifting off to sleep this is new.

  • Sleepio Member

    • 302 comments
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    in reply to Sleepio Member
    Expert

    Hi. Good to hear you have been making steady progress and sleeping more with less interruptions ………….. until last night. As it turns out, having a bad night, even a very bad night or a few such bad nights in a row, after making progress is the norm – it happens to most people. Progress is almost never steady all the way. The key thing for dealing with such “slips” as we sometimes call them is not to get alarmed or too worried about them as alarm/worry of course can interfere with sleep on future nights. So see them as part of the normal cycle of recovery. Good sleepers can have occasional bad nights too, even very bad nights, but they don't get worried that this means the next night is going to be bad too and so the next night is usually fine.

  • Sleepio Member

    • 302 comments
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    in reply to Sleepio Member
    Expert

    Hi. Increase in length of sleep can sometimes take a long time and turns out not to be what is most predictive of subjective quality of sleep. The focus in Sleepio on sleep efficiency is that having more concentrated sleep and less wakeful time in bed is associated with subjective sleep quality. It is very counterintuitive when you feel sleep deprived and just want MORE sleep to be told that maybe that isn't the best goal, but that is what the research shows. So, yes, wanting to hurry up with MORE sleep and spending more time in bed can lead to slipping back

  • Sleepio Member

    • 302 comments
    • 72 helped
    Expert

    OK, so if I understand correctly, the old problem was that you only sleep for an hour or so at a time and then are awake but now in addition you have difficulty falling asleep as if you wake yourself up when drifting off to sleep. So you have problems now both of getting to sleep and keeping asleep. Not surprising you feel absolutely exhausted. The full range of techniques in Sleepio are relevant for both these, so worth reviewing them again from the beginning. But for the new bit – what happens when you are drifting off to sleep that make you say it is like yo are not letting yourself sleep?

  • Sleepio Member

    • 302 comments
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    in reply to Sleepio Member
    Expert

    Good you could join live tonight. I know you posted earlier that you might not. Hope it has been interesting

  • Sleepio Member

    • 302 comments
    • 72 helped
    Expert

    Time is up for tonight. Happy to get back to you if anything is posted in the next 10 mins – otherwise it will need to with until next Wednesday's live session

  • Sleepio Member

    • 9 comments
    • 1 helped
    in reply to Sleepio Member
    Graduate

    Thank you for your reply Dr. Cape. Problem is there are no thoughts or dreams associated with anxiety upon awakening, but just a sudden autonomic sympathetic nervous system response. Not sure what technique I could try to preempt these events during the wake-up phase.

  • Sleepio Member

    • 2 comments
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    in reply to Sleepio Member
    Graduate

    yes, I think so. Many Chinese people are not so confidence with their English level, so when they open this app, and find it all in English, they may think it's hard for them to understand and get help from this app. Though I get great help from Sleepio and recommend it to many of my friends, but I find it's a little hard to promote an app without a Chinese version.

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