Live Discussion with Dr Michelle Davis - 23rd June 2021

Dr Davis will be hosting a live online discussion here on Wednesday 23rd June, 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 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, 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 18 Jun 2021 at 4:38 PM
  • 10 comments
  • 1 helped

Comments

  • Sleepio Member

    • 3 comments
    • 0 helped
    Graduate

    Dreams. Some relax us but what happens if theyreactiveaand stressful. Persistently waking feeling unrefreshed

  • Sleepio Member

    • 1 comments
    • 0 helped
    Session 4

    I work an odd schedule. One night a week I have a shift that ends at 2am. On another day, I start at 5am. This makes it hard to stay on a sleep schedule. Any tips for how to make the program work when you have to change the sleep schedule?

  • Sleepio Member

    • 2 comments
    • 1 helped
    Session 5

    I’ve noticed that some of the changes that I’ve made are making a positive impact on my sleep such as reducing caffeine, sleep restriction and avoiding napping at all costs while being awake.

    As discussed in a previous thread, if I am nervous before I put my head on the pillow, it’s likely that I will have a disturbed sleep at the very best, if not actual difficulty falling or staying asleep. The advice I got from a previous discussion was to perform the relaxation techniques prior to going to bed.

    However, I seem to hit an issue which is more fundamental/psychological. I feel like there is a curse on me which means that whatever I do, I will end up getting all nervous before bed and not sleep well which will then lead to all the negative consequences that will follow.

    As someone who has used CBT before and is aware of cognitive distortions, I know that this kind of thinking falls under “Jumping To Conclusion”, “Fortune Teller” and “Catastrophization” distortions. I know rationally, that I can’t be cursed because while life has definitely been far from perfect for me personally, I have a family and a job and enough to be grateful for.

    I have done a Google Search using terms like Curse Syndrome or Doom Syndrome but nothing seems to come up that matches my experience. In some cases, I have caused the worst to happen which is obviously a case of a self-fulfilling prophecy / self-sabotage. I know, for example, that this episode of insomnia that I am dealing with right now was triggered partly by this feeling of being cursed.

    So the questions I have are:
    1. Is there a term/name for this sort of feeling?
    2. I have enough examples of things that have gone well in my life to use in rationalising/countering the feeling but however much I rationalise, the feeling never goes away. What can I do to deal with it? While the feeling of curse does recede, it comes back ever stronger whenever I face challenges, like the current one I am facing with my sleep.

  • Sleepio Member

    • 3 comments
    • 0 helped
    Graduate

    I am currently trying to do the sleep restriction part of the course to improve my sleep cycle. I do not fall to sleep AT ALL without sleeping tablets. I was wondering if sleep restriction still works to help improve your sleep cycle even if you are on sleeping medication?

  • Sleepio Member

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

    Hi Penpot,

    Thanks for the question. I’m sorry to hear you’re having stressful dreams, and that you’re waking up feeling unrefreshed.

    Often during times of stress, our dreams can become more intense (or active) and distressing. For example, a recent study demonstrated that people were reporting more nightmares during the early stages of COVID-19 (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560506/ for this article). That’s just to say – what’s going on in our lives can impact our dreams, so in general, if people find that they are having stressful dreams, I often recommend trying to reduce stress (by increasing their level of physical, increasing their sense of social support by getting involved in social activities, etc.).

    Additionally, the contents of Sleepio won’t specifically target dreams or nightmares, but there is evidence that when people start to improve their sleep, this can lead to a reduction in nightmares (or active dreams), likely via general sleep improvement. I see that you’re on session 2; hopefully you will start noticing some benefits soon.

    My general advice would be to try to focus on stress reduction, and remember that this may be temporary. Alcohol (and other psychoactive substances) can also influence our dreams, so many people have found it helpful to limit alcohol consumption before bed.

    If you find that these dreams are not resolving on their own, or that they’re causing a lot of distress, you may want to speak with your doctor who can provide you with personalized advice.

    I hope this is helpful and wish you luck with the Sleepio program!

  • Sleepio Member

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

    Hi CarmenS,

    Thanks for the great question. Having a shifting work schedule can absolutely make it difficult to stick to a sleep schedule. We certainly understand that in these cases, it won’t be possible to stick to the same sleep and rise schedule each day. But there are still ways to improve sleep.

    In general, it can be helpful to focus on trying to adapt to the shifts so that you’re able to maintain alertness during shifts, and sleep when necessary (even if it takes place during the day). Some research has indicated that getting exposure to bright light prior to (or during) the night shift period can help someone’s internal clock (or circadian rhythm) to “reset”, which will allow them to sleep later in the day. Avoiding light in the early morning hours can also be helpful. Others have also found it helpful to schedule planned naps prior to a night shift (this is an example of how the “rules” of the program can be modified to suit individual needs!), or to use caffeine to help maintain alertness during a shift.

    Sleepio does have a guide specifically for shift work, which you can find here:
    https://www.sleepio.com/articles/shiftwork/

    Thanks for reaching out!

  • Sleepio Member

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

    Hi Zul,

    I’m sorry to hear you’re struggling with these types of thoughts, but this is a great question and one that might be familiar to others who struggle with tricky thoughts that interfere with their sleep.

    Anxious thoughts often pop into our heads that we know aren’t rational, and many people are able to easily dismiss them (or use some of the CBT techniques you described to work through them). Sometimes, however, thoughts can get really “sticky”, and cause a lot of distress. When this happens, doing things to try to combat or avoid the thought (like rationalizing it, challenging it, or trying not to think about it) can actually backfire, and make the thought more prominent. Focusing on the thought (and sending our brain the message that we can’t handle it, or that we need to get rid of it) can make it feel “bigger” than it actually is.

    There are a few different strategies that can be helpful for this (and I’ll describe one briefly below), but I really want to emphasize that if you find that you’re having a lot of difficulty managing these thoughts on your own, it can be extremely helpful (and will be important) to reach out to a therapist or medical provider who can help you specifically with this issue.

    That said, one strategy for dealing with sticky (or “obsessive”) thoughts is to practice acceptance. This is easier said than done (and a skill that improves over time), but can be an incredibly powerful tool. Again, it’s key to remember that trying to suppress or avoid thoughts can make them stronger (or amplify them). Here’s a commonly used example – imagine someone tells you, “no matter what, whatever you do, don’t think about a white elephant!”. When people are given this instruction, often a white elephant is the first thing that pops into their minds! We are not very good at suppressing thoughts. Instead, when people are struggling with these kinds of sticky thoughts, I recommend practicing first just noticing that they’re having a thought (and labelling it as such, e.g., “I’m having that thought that I’m cursed again”). This involves mindfulness – bringing oneself into the present moment and gaining the awareness of, oh, that thing is happening again, and it’s a thought. The next step is learning to practice acceptance and just letting the thought be present. It can be helpful to remember, “I’m having a thought that makes me anxious, but I accept that there’s not much I can do about it in this moment, so I’m just going to sit with it until it passes”. Over time, it is possible to retrain the brain to stop reacting so strongly to the thought through mindful awareness and acceptance.

    You asked about a name for this type of thought (i.e., feeling cursed), but I think it can be helpful to not focus so much on the contents of the thought (since you noted yourself that you do not believe it to be true), but rather labeling it as an irrational, sticky thought. Often this is called an “obsessive thought”.

    This sounds easy in theory, but can be difficult to apply (and somewhat difficult to describe in this short form!), so I hope that you will reach out for support from someone who can provide more personalized advice if you find that you’re still struggling with these kinds of tricky thoughts.

    Wishing you the best.

  • Sleepio Member

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

    Hi Karanus,

    Thanks for the question! It’s one we get a lot.

    Many people have used the Sleepio program while taking medication (such as sleeping tablets) and found it to be helpful. It will be up to you (and your doctor) to decide whether or not this is the best approach for you. In general, it’s important to remember that you should always follow your doctor’s advice regarding medication – starting, stopping, or changing medication can all have serious effects.

    That said, I’ve linked below an article that you may find insightful, as well as some community posts where others have talked about their experience using medication while completing the Sleepio program:

    https://www.sleepio.com/library/article/sleep-aids/
    https://www.sleepio.com/community/discussion/using-medication-while-doing-the-sleepio-course/
    https://www.sleepio.com/community/discussion/does-sleep-medication-work/

  • Sleepio Member

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

    OK. If I am taking medication to sleep, as well as completing the programme, how do I know if the program is helping? I don't get to sleep without medication but stay asleep once I'm asleep. I don't understand how I know if the program is working, as it is the medication getting me to sleep. My sleep diary is 'false' if you know what I mean, as I need the Zopiclone to get to sleep, I'm not going to sleep naturally. The programme still seems to be working out sleep efficiency etc, but I really don't know how accurate it is going to be, seeing I need to take the medication?
    I have not got to sleep a single night without Zopiclone in a month. My GP has no idea what else to do.

  • Sleepio Member

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

    Hi Karanus,

    Sorry, I missed this question during the live expert session. It is a tricky question and hard to determine what is “working” (i.e., is it the Sleepio or the medication). Some have tried experimenting with decreasing or stopping medication to see if they are able to cope without (during/after completing Sleepio); but unfortunately I'm unable to advise you on this. My two recommendations therefore are to work with your doctor on this, but also to remember that you can use the tags in the Sleepio sleep diaries to denote nights you took medication (if you do decide with your doctor to stop taking it daily). Many users have used this to track the impact of the medication (or lack thereof) on their sleep.

    Hope this helps!

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