Live Discussion with Dr Michelle Davis - 20th November 2019

Dr Davis will be hosting a live online discussion here on Wednesday 20th November, from 8.30pm to 10.00pm British Time or 3.30pm to 5.00pm US Eastern Time.

They will discuss as many topics as possible in the hour 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, they may not be able to answer all in the time available, but will try to answer as many as they can.

Please do note that, as per our guidelines, Dr Davis will not be able to give personal medical advice including those about medication. Their 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 14 Nov 2019 at 10:42 PM
  • 16 comments
  • 10 helped

Comments

  • Sleepio Member

    • 22 comments
    • 6 helped
    Graduate

    Hello,
    I’ve had sleep problems for about 30 years. Took amitriptyline for at least 25 years. Stopped cold turkey almost three years ago, and haven’t felt or functioned right since. I’ve tried everything for insomnia. Been doing sleepio since June. Ups and downs. Only hit 6 hours once without med. Usually piece together 3-5.
    Saw sleep doc today. He said I can’t go on with less than 6 hours each night and prescribed ambien. I told him I don’t want to take it.
    He said I have insomnia because of my genes and that I can’t change my genes, so I need to take ambien.
    Does this make sense?
    I’m at a loss as to what I should do at this point. I do meditation/mindfulness. Helps a little but still not getting the sleep I need. My sleep window is 10:30-4:30.
    Thank you for your help.

  • Sleepio Member

    • 11 comments
    • 6 helped
    Graduate

    I took temazepam for years and I feel the body takes a long time to adjust to sleeping naturally. I came off this past July and I have Hope's to retrain my body.

  • Sleepio Member

    • 3 comments
    • 2 helped
    Graduate

    We have medical & recreational cannabis where I live. Are there any studies as of now about this plant and insomnia?

  • Sleepio Member

    • 11 comments
    • 5 helped
    Graduate

    Hi I have been on the programme since late July and although I “earnt” an extra 15 mins in the first 6 weeks and then decided to add another 15 mins subsequently as I was almost at 90% and finding it really hard to stay up any later.

    However I have never got to an average of 90% since the initial 6 weeks, sometimes 89% fairly consistently. I have wondered if the 89% is a function of recording how long it takes to go to sleep in quarter hours as I normally record half an hour as I am sure it is more than 15 mins.However I have never implemented the QHR at this stage as I feel sleepy and am sure I will go off pretty quickly, even though technically I should have got up again. I generally wake once in the night but am usually able to go to sleep within 15 mins. So my usual awake time is 45 mins total in a window of 6.75 hours.

    I have been wondering whether I should reduce the sleep window again to 6.5 hours to see if I can get over the 90%? Or do you have any other suggestions? I feel very tired most evenings and find it hard to stay up.

    Thanks

  • Sleepio Member

    • 1 comments
    • 0 helped
    Session 5

    Hello,

    I also have a strange relationship to sleep in that my insomnia can be triggered by physical effort (exercise).

    My problem started 10+ years back (I'm 39 now), and has been better or worse throughout that time. I have just passed into another “active” period where I have relentless insomnia.

    On days that I exercise (even light exercise) I can expect to go to bed at 10pm, and wake up at 02:30am without fail, no matter how tired I am. Now that pattern is spilling over to days where I don't exercise.

    On periods which my insomnia has been “passive” I can exercise or not and have more sleep, but it is borderline for me with patterns at 10pm to 4am.

    I don't smoke or drink regularly, I've stopped coffee, and I eat healthy, non-processed foods.
    Exercise has been a part of my life since I was 16.

    What to do?
    Thanks!

  • Sleepio Member

    • 9 comments
    • 3 helped
    Graduate

    My SW is 12-8:15 which is fantastic from were I was 6months ago. (I'd like to go earlier but not tired enough)
    I also wake up 2/3 times a night which I wanted to get rid off but feel I have accepted this now after posting this question before.
    My question is:
    Sometimes I wake up about an hour earlier and just get up, that makes my sleep efficienty high.
    I woke up this morning an hour earlier went down stairs and made a drink, after 30 minutes I felt very sleepy that I could have gone back to bed to sleep but it would have only been for about 15 minutes before the alarm went off. And it would have taken my sleep efficiency down. Am I wise to stay up? as sometimes I feel I am cheating the SE.

  • Sleepio Member

    • 1 comments
    • 0 helped
    Session 1

    Has Sleepio been shown to assist with individuals whose insomnia has taken hold during peri/post-menopause where hot flushes might not be the reason for poor sleep? Really interested to hear if you have any advice or thoughts on the Sleepio programme and how it might help in relation to this.

  • Sleepio Member

    • 242 comments
    • 53 helped
    in reply to Sleepio Member
    Expert

    Hi Hoping,

    Thanks for your question.

    I wanted to note a few things quickly before getting to your question. First, sleep need varies from person to person. Some people function well with 6 hours of sleep and some need closer to 9. We generally recommend that individuals pay attention to how they are feeling during the day to better understand how much sleep they need. Second, the amount of sleep we get does tend to shorten some with age. Here are some articles you might find informative:

    https://www.sleepio.com/library/article/is-it-true-that-people-need-less-sleep-later-in-li/

    https://www.sleepio.com/library/article/is-it-true-that-the-average-adult-sleeps-7-8-hours/

    In general, we recommend following a doctor’s advice as Sleepio is a form of self-help. However, please remember that it is always an option to seek out a second opinion from another medical professional if you receive advice that does not work with your lifestyle or choices.

    Finally, I wanted to point out that (if you’re not already) you can continue to use Sleepio after you’ve completed the 6 sessions in order to track your sleep and sleep efficiency.

    I hope this information is helpful!

  • Sleepio Member

    • 242 comments
    • 53 helped
    in reply to Sleepio Member
    Expert

    Hi Retta,

    Thanks for the comment! I’m not sure if you had a specific question, but unfortunately I cannot give you advice regarding discontinuation of your medication – your doctor would be in the best position to do that. I’m happy to see you’ve started with session 1 of Sleepio and I hope you find it helpful!

    Please feel free to ask any other questions.

  • Sleepio Member

    • 242 comments
    • 53 helped
    in reply to Sleepio Member
    Expert

    Hi Peninsula Mike,

    Thanks for the question. There have been some studies conducted to examine the effects of cannabis on sleep; however, this literature is still in the very early stages, and we still do not fully understand how cannabis impacts sleep, or how it affects insomnia. I understand that it is an area of interest and that lots of researchers are working to learn more.

    I hope this answers your question!

  • Sleepio Member

    • 242 comments
    • 53 helped
    in reply to Sleepio Guest
    Expert

    Hi Arabella,

    Thanks for posting. It looks like you have already completed the Sleepio program – congratulations!

    One thing to keep in mind is that nocturnal awakenings are to be expected – everyone wakes up in the middle of the night, but not everyone is able to remember waking up. These awakenings can become a problem when they last for 30 minutes or more, or if they are causing significant problems with daytime functioning.

    In general, when someone is waking up frequently (for 30 minutes or more) we would check to ensure that they are following the quarter hour rule (which is introduced in session 3 of Sleepio), and getting out of bed after they’ve been awake for approximately a quarter hour to do a relaxing activity in dim light until they are sleepy. You can review information on the quarter hour rule at these links:

    https://www.sleepio.com/library/article/the-quarter-of-an-hour-rule-the-science/
    https://www.sleepio.com/library/article/the-quarter-of-an-hour-rule-putting-it-into-practi/
    https://www.sleepio.com/library/article/when-should-i-return-to-bed-when-i-get-up-during-t/

    If you are sticking to the quarter hour rule and are still experiencing difficulty, it may be helpful to know that some Sleepio graduates have repeated the sleep restriction process if they find that they are still experiencing sleep problems – this is one of the best ways to reduce nocturnal awakenings. It may not be necessary, however, for people who wake up but are able to fall back asleep within 15 minutes or so. It will of course be up to you to decide what makes most sense for you. You’ll find a number of posts of the Community board from graduates who are focusing on their sleep once again after completing the Sleepio program.

    Hope this information is helpful!

  • Sleepio Member

    • 242 comments
    • 53 helped
    in reply to Sleepio Member
    Expert

    Hi Glisglis,

    Thanks for the question. Ultimately, since Sleepio is a self-help program it will be up to you to decide whether you should reduce your sleep window again, but I can provide some general advice, which will be similar to my response to Arabella above.

    First, please keep in mind is that nocturnal awakenings are common, and that everyone wakes up in the middle of the night (though not everyone remembers this). Typically nighttime awakenings can become a problem when they last for 30 minutes or more (each time), or if they are causing significant problems with daytime functioning.

    Typically, the advice I would give to someone who is trying to decide whether to make changes to their sleep window (or whether or not they need to implement the quarter hour rule) is to focus on their daytime functioning, rather than on their sleep efficiency score. If someone’s daytime functioning is similar on nights that they get 90% efficiency as it is to nights that they get 89% efficiency (which I should note is not a huge difference in terms of efficiency), they may opt not to make any changes. If they find that they are still experiencing difficulty remaining awake during the day, or that their nighttime awakenings are lasting longer than 30 minutes each time, they might decide to try either implementing the quarter hour rule, reducing their sleep window, or both.

    I hope this is helpful!

  • Sleepio Member

    • 242 comments
    • 53 helped
    in reply to Sleepio Member
    Expert

    Hi MCOMM,

    Interesting observation! There has been research conducted to investigate the relationship between sleep and exercise; however, in general, research tends to indicate that reduced levels of physical activity are actually associated with higher rates of insomnia, and that physical activity can have positive benefits on sleep. However, there has also been some research indicating that physical activity that is too strenuous too close to bedtime can be overly-arousing, which can make it hard to fall asleep at night.

    I think this article on the relationship between sleep and exercise might be of interest:
    https://www.sleepio.com/library/article/exercise-and-sleep/

    It looks like you’ve just started session 1 of Sleepio – great job getting started with working on your sleep! Session 2 will contain more information about lifestyle factors that influence sleep (including exercise!) and you’ve got several more sessions full of sleep techniques ahead.

    I hope this response was helpful!

  • Sleepio Member

    • 242 comments
    • 53 helped
    in reply to Sleepio Member
    Expert

    Hi LeeJohn,

    Congratulations on improving your sleep window over time! It definitely takes a lot of hard work and dedication.

    I’m glad you’ve made a decision that you feel comfortable with regarding the frequent awakenings. Similar advice will probably apply here, which is that you will ultimately be the judge of how to use the information presented in Sleepio. My general advice to someone wondering how to adjust their sleep schedule would be to, instead of focusing on the sleep efficiency score, focus on how they feel during the day. If sleep schedule changes (for example, the decision to go back to bed in the mornings for a short period of time) do not negatively impact someone’s daily functioning, I would typically advise them to do what works best for them (rather than what gives them the most efficient sleep score).

    I hope that answers your question and glad to see you are noticing benefits!

  • Sleepio Member

    • 242 comments
    • 53 helped
    in reply to Sleepio Member
    Expert

    Hi Wilbs,

    Great question! While this particular question has not been specifically addressed in research studies using Sleepio, there is some evidence to suggest that cognitive behavioral techniques for sleep problems (like those used in Sleepio) can improve sleep and mood in women experiencing menopause (Cheng et al., 2017; Guthrie et al., 2017; Nowakowski et al. 2017).

    There are many aspects to menopause that can impact sleep due to the relationship between hormones and sleep, including the impact of menopause on mood and stress, frequent urination, and the hot flashes you mentioned (which, as you noted, not everyone experiences).

    I thought you might find these articles on menopause and poor sleep helpful:

    https://www.sleepio.com/library/article/menopause-and-sleep/
    https://www.sleepio.com/library/article/hormones-and-sleep-a-two-way-street/

    Hope that helps!

  • Sleepio Member

    • 22 comments
    • 6 helped
    in reply to Sleepio Member
    Graduate

    Thank you very much for your help with my questions, and for the Sleepio program. It is so wonderful of all of you to have put together such an all-encompassing and necessary program for people struggling with sleep. I’m sure you have brightened, and even saved many lives. Have a great day.

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