Live Discussion with Dr Michelle Davis - 26th May 2021

Dr Davis will be hosting a live online discussion here on Wednesday 26th May, 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.

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

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Posted 20 May 2021 at 4:33 PM
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  • Sleepio Member

    • 1 comments
    • 2 helped
    in reply to Sleepio Member
    Session 3

    I have the same question. This is right on point. Thanks LambChop!

  • Sleepio Member

    • 1 comments
    • 0 helped
    Session 2

    Does it matter what time you should stop eating/having dinner before bed? Does eating a few minutes before bed really affect your sleeping?

  • Sleepio Member

    • 1 comments
    • 1 helped
    Graduate

    I have the same question. Thanks Lambchop.

    I'd also like to know that, without taking sleeping pills, what I could do if I wake up early (probably due to an urge to use the restroom, even though I don't drink much water during the day), and have difficulty going back to sleep afterwards or have very light sleep (having dreams I remember or being conscious of the surroundings or the feeling that I am still awake).

    In addition, should I trust the sleep scores provided by tracking devices like fitbit or apple watch, especially the sleep stages?
    Thank you.

  • Sleepio Member

    • 5 comments
    • 0 helped
    Graduate

    Is there such a thing as being too tired to sleep? I have found that some nights I wake up a few times during the night, despite struggling to keep my eyes open for about an hour before my bedtime. Often I wake up feeling unrefreshed. I have been following all the techniques such a writing down my worries, good and bad things about the day, no screens/caffeine etc, going for long walks during the day. Am I possibly overthinking this?

    Thank you.

  • Sleepio Member

    • 1 comments
    • 0 helped
    Session 3

    Could you mention something on anxiery and sleep? As i am finding myself avoiding going to bed until I am so exhausted that I have no other choice but to sleep, because I want to avoid that awful dread of trying to sleep for hours as my anxious thoughts are the most overwhelming at night. Is there anything i could do before bed to help me deal with the anxiety, making going to sleep seem less scary or simply any guidence at all would be super apprachiated. I have been falling asleep at anytime upto 9am sometimes, and this is completely messing up my sleep schedule and honestly life, because i am awake all night and sleeping all day.

  • Sleepio Member

    • 2 comments
    • 1 helped
    Session 5

    I’ve noticed that when I’m nervous about sleeping at bedtime; then I have a really bad night. However, when I am really sleepy due to lack of sleep on previous nights, then I am able to fall asleep fine.

    Since the onset of this episode about 3 to 4 weeks ago, I’ve also noticed I am watching myself a lot once I put my head on the pillow – like being in a hyper vigilant state. I even notice I am dozing off or am having twitches and jerks and that actually stops me from falling asleep …

    Getting out of bed when I can’t fall asleep does not make much difference as if I am still nervous the next time when I go to bed, then I fail to fall asleep.

    It seems to me that if I am able to solve the problem of being so nervous when I put my head on the pillow, it would help me a lot. Do you have any suggestions?

    In fact, I am so tired sometimes that when I do the breathing exercises in bed, it seems that I doze off and become awake right after and then it is really hard to fall asleep …

    Should I still perform the relaxation/breathing exercises when I adopt my sleeping position? Or should I do the relaxation exercises in advance, as part of a wind down routine?

  • Sleepio Member

    • 1 comments
    • 0 helped
    Session 2

    Could you comment on extreme fatigue from driving. I drive (2) hours to work each day (1 hour each way). Also, I drive 6 more hours a week for other family events. What can I do to reduce driving fatigue? This may be something that a sleep study will explain further.

  • Sleepio Member

    • 24 comments
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    Graduate

    Zul's query resonates with me as this is also exactly my problem, so thank you Zul for asking about this.

    My difficulty is similarly with getting to sleep, caused by anxiety about getting to sleep. Some nights it works fine, but on other nights, my brain goes into a hyper-vigilant state, where it seems to be constantly on alert to see if I fall asleep. This causes some completely sleepless nights. Getting up after being awake for 15 minutes at the start of the night following the QHR also triggers additional anxiety. So far, whenever I have got up following the QHR (at the start of the night) it seems to stimulate me and I am then awake for the rest of the night.

    I have found that using the thought-related techniques covered in the programme does help to some extent, but when the real anxiety spikes kick in, nothing seems to help. I would be interested in whether there are any indications about which of the thought-related techniques tend to be most helpful for severe anxiety spikes of this kind – thank you. (And apologies for turning up here like a bad penny as you have already provided some helpful advice in the past! )

  • Sleepio Member

    • 3 comments
    • 2 helped
    Session 3

    How does anyone access the webinar – I tried tonight – 26th May and didn't see any link to it

  • Sleepio Member

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

    Hi Lambchop,

    Great question (which lots of others on this thread seemed to also have, so you’re not alone in experiencing early waking!).

    Early morning awakenings are quite common and can be tricky, because sometimes it’s related to biology. Due to differences in circadian rhythms, some people are more likely to experience early awakenings. It can be helpful to remember that they happen occasionally for everyone, even “good” sleepers.

    That said, there are a few different options that you might experiment with. One option is to try shifting the bedtime later. This will increase the need for sleep (i.e., increase sleepiness) and make it more likely to sleep past the typical early morning awakening. Once someone is waking up at their desired wake time, it can then be helpful to gradually shift the bedtime earlier until the number of hours of sleep (or sleep window) is an optimal length. This is what Sleepio will recommend starting in session 3 as part of a technique called sleep restriction. It’s important to remember that sleep restriction doesn’t work immediately – it can take a bit of time to start to notice benefits, but it’s the most powerful technique for improving sleep.

    Another option is to lean into the early morning awakening and shift the bedtime earlier to account for the earlier rise time (i.e., in order to get a longer sleep window). I generally recommend that people experiment with their sleep window timing to discover what works best for them.

    Finally, research suggests that utilizing appropriate light conditions at the right time can be helpful. For example, dim light conditions are best when winding down ahead of bed time, and bright light exposure can be helpful upon awakening. Reducing exposure to light during times when you want to be asleep (and vice versa, getting bright light exposure after awakening) can be helpful for making adjustments to your sleep schedule.

    Here’s a link to a community discussion that discusses this issue:
    https://www.sleepio.com/community/discussion/early-awakening/

    For your final question – I generally recommend doing all activities that involve being awake (including relaxation techniques) outside of bed to help strengthen the bed-sleep connection.

    I hope this information is helpful, and you’re well on your way to session 3, where you’ll learn about sleep restriction, which is the best way to combat early waking.

  • Sleepio Member

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

    Hi Lisamarie D,

    Thanks for the question! I’ve copy-pasted my response to Lambchop below:

    ---
    Early morning awakenings are quite common and can be tricky, because sometimes it’s related to biology. Due to differences in circadian rhythms, some people are more likely to experience early awakenings. It can be helpful to remember that they happen occasionally for everyone, even “good” sleepers.

    That said, there are a few different options that you might experiment with. One option is to try shifting the bedtime later. This will increase the need for sleep (i.e., increase sleepiness) and make it more likely to sleep past the typical early morning awakening. Once someone is waking up at their desired wake time, it can then be helpful to gradually shift the bedtime earlier until the number of hours of sleep (or sleep window) is an optimal length. This is what Sleepio will recommend starting in session 3 as part of a technique called sleep restriction. It’s important to remember that sleep restriction doesn’t work immediately – it can take a bit of time to start to notice benefits, but it’s the most powerful technique for improving sleep.

    Another option is to lean into the early morning awakening and shift the bedtime earlier to account for the earlier rise time (i.e., in order to get a longer sleep window). I generally recommend that people experiment with their sleep window timing to discover what works best for them.

    Finally, research suggests that utilizing appropriate light conditions at the right time can be helpful. For example, dim light conditions are best when winding down ahead of bed time, and bright light exposure can be helpful upon awakening. Reducing exposure to light during times when you want to be asleep (and vice versa, getting bright light exposure after awakening) can be helpful for making adjustments to your sleep schedule.

    Here’s a link to a community discussion that discusses this issue:
    https://www.sleepio.com/community/discussion/early-awakening/

    ---
    I hope this information is helpful, and you’re well on your way to session 3, where you’ll learn about sleep restriction, which is the best way to combat early waking.

  • Sleepio Member

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

    Hi Mattyflattop,

    Great question. There is evidence to suggest that eating large meals close to bedtime can impact sleep. Laying down with a full stomach immediately can lead to issues like heartburn and indigestion, which can make it harder to fall asleep, as well as harder to stay asleep. However, many people do not find this to be an issue, especially with smaller snacks. In fact, many people have reported that eating a small snack before bed is an important part of their wind-down routine, and helps them to stave off nighttime hunger. Accordingly, the answer is different for everyone, and it will take some experimentation to find whether eating before bed is a good idea for you. Please keep in mind that there are TONS of factors that can impact your sleep quality (i.e., sleep habits, exercise, anxiety, stress, light exposure, hormones, etc.), so tracking your sleep with a sleep diary can be helpful to recognize correlations between various factors and nights of poor sleep. You can manually add tags to your sleep diary to help you find patterns between specific behaviors and nights of poor sleep. Information for how to do that is below:

    https://www.sleepio.com/library/article/how-to-use-the-sleep-diary-tagging-system/

    Hope this is helpful!

  • Sleepio Member

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

    Hi zoeykim,

    Thanks for the question! I’ve copy-pasted my response to Lambchop below. To address your additional question about tracking devices, I have a few thoughts. First, it’s important to interpret the output (or data) from wearable devices with caution. The accuracy of these devices are tested with healthy young adults and results may not be generalizable to other populations (fir example, people struggling with insomnia). Validation studies have demonstrated that these devices tend to do a decent job of estimating total sleep time, but that accuracy for measuring time in specific sleep stages is quite poor. Because of this, I generally recommend folks to try not to get too invested in (or concerned about) the details of the output. Focusing on the data can actually make people more anxious about their sleep, which occurs so commonly that it has a name in the sleep medicine field (“orthosomnia”). Instead, it can be helpful to use these devices to look at patterns in sleep (for example, differences in bedtime, wake time, and total sleep time). In generally, I typically encourage people to focus most on how they feel during the day rather than the output of devices (or even total sleep time).

    ---
    Early morning awakenings are quite common and can be tricky, because sometimes it’s related to biology. Due to differences in circadian rhythms, some people are more likely to experience early awakenings. It can be helpful to remember that they happen occasionally for everyone, even “good” sleepers.

    That said, there are a few different options that you might experiment with. One option is to try shifting the bedtime later. This will increase the need for sleep (i.e., increase sleepiness) and make it more likely to sleep past the typical early morning awakening. Once someone is waking up at their desired wake time, it can then be helpful to gradually shift the bedtime earlier until the number of hours of sleep (or sleep window) is an optimal length. This is what Sleepio will recommend starting in session 3 as part of a technique called sleep restriction. It’s important to remember that sleep restriction doesn’t work immediately – it can take a bit of time to start to notice benefits, but it’s the most powerful technique for improving sleep.

    Another option is to lean into the early morning awakening and shift the bedtime earlier to account for the earlier rise time (i.e., in order to get a longer sleep window). I generally recommend that people experiment with their sleep window timing to discover what works best for them.

    Finally, research suggests that utilizing appropriate light conditions at the right time can be helpful. For example, dim light conditions are best when winding down ahead of bed time, and bright light exposure can be helpful upon awakening. Reducing exposure to light during times when you want to be asleep (and vice versa, getting bright light exposure after awakening) can be helpful for making adjustments to your sleep schedule.

    Here’s a link to a community discussion that discusses this issue:
    https://www.sleepio.com/community/discussion/early-awakening/

    ---

    Hope this is helpful!

  • Sleepio Member

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

    Hi Kitten1,

    Thanks for the question. It might be helpful to first differentiate between tiredness (i.e., feeling fatigued, drained, etc.) and sleepy (i.e., feeling ready for sleep). If you are very fatigued (but not sleepy) it can be difficult to sleep. It’s also important to remember that everyone wakes up at times throughout the night (though many times people don’t remember it). Accordingly, waking up during the night is generally not something to be concerned about, unless the awakenings are prolonged (i.e., longer than 15 minutes), or are causing a lot of disturbance during the daytime (e.g., excessive sleepiness and fatigue). It sounds like this may be the case on the days when you wake up feeling unrefreshed, but it is hard to say whether it is truly a concern without having more information about how often it’s occurring. For that reason, it will be important for you to determine whether or not the daytime fatigue is poor enough to require additional help (i.e., from your doctor, or potentially via returning to the Sleepio techniques like sleep restriction again).

    I’m glad to hear you’ve been following the techniques you mentioned. I also recommend continuing to practice the quarter hour rule, as difficult as it can be, and getting out of bed if awake for longer than approximately a quarter hour (estimating this time, not looking at the clock) to prevent forming an association between being in bed and being awake. Other things that can be helpful for frequent awakenings are paying attention to light exposure (i.e., getting bright light exposure in the daytime and staying in dim lighting close to bedtime), and sleep restriction.

    I hope this is helpful!

  • Sleepio Member

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

    Hi evasigurds,

    Thanks for the great question. I’m sorry to hear you’re experiencing so much anxiety around sleep, but I want to reassure you that you’re not alone – it is very common to develop significant anxiety around sleep after experiencing sleep problems like insomnia.

    Sleep and anxiety have a bidirectional relationship, meaning that better sleep can lead to less anxiety, and reduced anxiety can lead to improved sleep. For that reason, focusing on techniques to reduce anxiety can be helpful for your sleep. In sessions 4 and 5 of Sleepio you’ll learn both cognitive and relaxation techniques to help combat anxiety related to sleep, but in the meantime there is a technique that may be useful to you, which is called scheduled worry time. The idea behind this strategy is to schedule 20 minutes a day (ideally in the same place, at time same time each day) to intentionally focus on your worries. Those 20 minutes should be used to focus on worries – that can look like cycling through many different worries and.or writing them down, or spending time problem-solving a specific worry. Once the 20 minutes is up, worry time is over. Outside of worry time (and at night), the goal is to remind yourself that you have a dedicated time and place to focus on your worries, and to remind yourself that you won’t as be effective at addressing those anxious thoughts at bedtime. It takes time and repetition, but over time, the brain will start to learn that there is a dedicated time and place for worrying, and it becomes easier to delay worrying until worry time (and thus worries interfere less with sleep).

    This is just one strategy of many for managing anxiety – many people find it helpful to discuss anxiety with their doctor, especially if they feel it’s too big to handle on their own.

    I’ve linked some info about the other techniques for managing anxious thoughts in Sleepio – I hope this is helpful information:
    https://www.sleepio.com/library/article/cognitive-techniques-in-depth/
    https://www.sleepio.com/library/article/challenging-your-thoughts/
    https://www.sleepio.com/library/article/how-to-use-the-thought-checker/
    https://www.sleepio.com/library/article/using-the-thought-checker-to-challenge-your-though/

  • Sleepio Member

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

    Hi Zul,

    Great question. As I noted above in my response to another member, it is not at all uncommon for sleep to be impacted by nervousness or anxiety about sleeping. When we feel anxious our sleep suffers (and when our sleep suffers, we feel anxious!) – it can feel like a vicious cycle.

    I would recommend engaging in the relaxation/breathing exercises that you mentioned, and I would generally recommend experimenting with when you do them to figure out when they’re most helpful. Including them as part of the wind-down routine, as you mentioned, can be very useful for getting into a good, relaxing habit before bed. They can also be used when you wake up at night or are unable to fall asleep. You might also try using the quarter hour rule (i.e., getting out of bed if you feel like you are unable to sleep for around 15 minutes) and using the relaxation techniques (in dim lighting, outside of bed) to help you wind down. I’ll also paste my response to another member above regarding other strategies for anxiety/nervousness around sleep, but please also keep in mind that this will be addressed in future sessions of Sleepio.

    ---

    Sleep and anxiety have a bidirectional relationship, meaning that better sleep can lead to less anxiety, and reduced anxiety can lead to improved sleep. For that reason, focusing on techniques to reduce anxiety can be helpful for your sleep. In sessions 4 and 5 of Sleepio you’ll learn both cognitive and relaxation techniques to help combat anxiety related to sleep, but in the meantime there is a technique that may be useful to you, which is called scheduled worry time. The idea behind this strategy is to schedule 20 minutes a day (ideally in the same place, at time same time each day) to intentionally focus on your worries. Those 20 minutes should be used to focus on worries – that can look like cycling through many different worries and.or writing them down, or spending time problem-solving a specific worry. Once the 20 minutes is up, worry time is over. Outside of worry time (and at night), the goal is to remind yourself that you have a dedicated time and place to focus on your worries, and to remind yourself that you won’t as be effective at addressing those anxious thoughts at bedtime. It takes time and repetition, but over time, the brain will start to learn that there is a dedicated time and place for worrying, and it becomes easier to delay worrying until worry time (and thus worries interfere less with sleep).

    This is just one strategy of many for managing anxiety – many people find it helpful to discuss anxiety with their doctor, especially if they feel it’s too big to handle on their own.

    I’ve linked some info about the other techniques for managing anxious thoughts in Sleepio – I hope this is helpful information:
    https://www.sleepio.com/library/article/cognitive-techniques-in-depth/
    https://www.sleepio.com/library/article/challenging-your-thoughts/
    https://www.sleepio.com/library/article/how-to-use-the-thought-checker/
    https://www.sleepio.com/library/article/using-the-thought-checker-to-challenge-your-though/

    ---

    I hope this is helpful, and hope you find something that helps soon!

  • Sleepio Member

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

    Hi Forget and Sleep,

    Sure – you raise a great point that a sleep study can be very useful for determining if there are problems (other than straightforward insomnia) that are leading you to feeling fatigued in the daytime. I definitely encourage you to do so if you are experiencing extreme fatigue while driving, which you indicated.

    It is important to differentiate feeling fatigued (or tired, drained, and slowed down) and sleepiness or drowsiness. If you are feeling sleepy or drowsy while driving, you will absolutely want to stop driving and take a nap in order to keep you and others around you safe. In general, naps are not recommended in Sleepio – but the exception is while driving or operating heavy machinery – if you find yourself feeling dangerously sleepy, it is vital to either not drive or to take a nap.

    It looks like you are just starting the Sleepio program. I hope as you begin to put the Sleepio techniques into place you will notice improvements in your sleep that help reduce daytime fatigue.

    Another thing to keep in mind is that daytime fatigue doesn’t always mean that you aren’t sleeping well at night. Other things can cause fatigue too, for example boredom. Keeping track of how you are feeling and when can help you to identify what might be causing the daytime fatigue.

    I’ve linked below a discussion on driving and sleepiness that I hope will be helpful:
    https://www.sleepio.com/community/discussion/driving-and-sleep/

  • Sleepio Member

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

    Hi Ellenyork,

    Thanks for the question (and no apologies necessary, happy to answer!). I’ve gotten a number of questions about anxiety and sleep today, so I’ve copy-pasted my responses below, but to address your additional comment about hypervigilance – this is definitely something that can happen when people are struggling with sleep. It is very common to develop anxiety, nervousness, or hypervigilance around sleep when you are experiencing sleep difficulties. I also want to reiterate something from the comment I copy-pasted below, which is that oftentimes targeting the anxiety specifically (versus the sleep) can be helpful. There are lots of techniques for managing anxiety, and your doctor will be the best person to help you figure out how to work on anxiety if that’s something you choose to do.

    ---

    As I noted above in my response to another member, it is not at all uncommon for sleep to be impacted by nervousness or anxiety about sleeping. When we feel anxious our sleep suffers (and when our sleep suffers, we feel anxious!) – it can feel like a vicious cycle.

    I would recommend engaging in the relaxation/breathing exercises that you mentioned, and I would generally recommend experimenting with when you do them to figure out when they’re most helpful. Including them as part of the wind-down routine, as you mentioned, can be very useful for getting into a good, relaxing habit before bed. They can also be used when you wake up at night or are unable to fall asleep. You might also try using the quarter hour rule (i.e., getting out of bed if you feel like you are unable to sleep for around 15 minutes) and using the relaxation techniques (in dim lighting, outside of bed) to help you wind down. I’ll also paste my response to another member above regarding other strategies for anxiety/nervousness around sleep, but please also keep in mind that this will be addressed in future sessions of Sleepio.

    ---

    Sleep and anxiety have a bidirectional relationship, meaning that better sleep can lead to less anxiety, and reduced anxiety can lead to improved sleep. For that reason, focusing on techniques to reduce anxiety can be helpful for your sleep. In sessions 4 and 5 of Sleepio you’ll learn both cognitive and relaxation techniques to help combat anxiety related to sleep, but in the meantime there is a technique that may be useful to you, which is called scheduled worry time. The idea behind this strategy is to schedule 20 minutes a day (ideally in the same place, at time same time each day) to intentionally focus on your worries. Those 20 minutes should be used to focus on worries – that can look like cycling through many different worries and.or writing them down, or spending time problem-solving a specific worry. Once the 20 minutes is up, worry time is over. Outside of worry time (and at night), the goal is to remind yourself that you have a dedicated time and place to focus on your worries, and to remind yourself that you won’t as be effective at addressing those anxious thoughts at bedtime. It takes time and repetition, but over time, the brain will start to learn that there is a dedicated time and place for worrying, and it becomes easier to delay worrying until worry time (and thus worries interfere less with sleep).

    This is just one strategy of many for managing anxiety – many people find it helpful to discuss anxiety with their doctor, especially if they feel it’s too big to handle on their own.

    I’ve linked some info about the other techniques for managing anxious thoughts in Sleepio – I hope this is helpful information:
    https://www.sleepio.com/library/article/cognitive-techniques-in-depth/
    https://www.sleepio.com/library/article/challenging-your-thoughts/
    https://www.sleepio.com/library/article/how-to-use-the-thought-checker/
    https://www.sleepio.com/library/article/using-the-thought-checker-to-challenge-your-though/

    ---

    I hope you find some anxiety strategies that are helpful for you!

  • Sleepio Member

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

    Hi Lambchop,

    The live discussion is not a webinar, but rather a chat where I'm responding to questions posted. I posted a response to your previous question above!

    Hope this helps.

  • Sleepio Member

    • 2 comments
    • 0 helped
    Session 3

    does having too much sleep in effort to catchup on sleep affects?
    if so what else can i do to recuperate as opposed to “catching up” on sleep?

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