Live Discussion with Dr Michelle Davis - 27th January 2021

Dr Davis will be hosting a live online discussion here on Wednesday 27th January, 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 21 Jan 2021 at 6:52 PM
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  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi Peanut101,

    It looks like you’re on your first session – welcome to Sleepio and congratulations on getting started! I’m hopeful that many of your concerns will be addressed in later sessions, but here is a bit of information that will hopefully be of help to you until then.

    First, those days when you lie in bed and “get more awake”, it is vitally important that you get out of bed (if you’ve been awake longer than 15 minutes). Getting out of bed is difficult, but important for maintaining the bed-sleep connection in our brains. When you get up, engage in a non-stimulating, restful activity in low light conditions until you get sleepy.

    It’s great that you are exercising and getting fresh air. It might also be helpful to pay attention to your light exposure – aiming to get bright light exposure early in the day, and stay in low light conditions as you wind down at night.

    Regarding your comment about only noticing feeling tired during on certain days despite not sleeping well consistently, it’s hard to say what the cause might be – people simply respond differently to different amounts of sleep on different days.

    If you keep participating in Sleepio and find that you’re not noticing a benefit after implementing most of the techniques consistently, it may be helpful to consult with your doctor about your sleep problem and determine if you may require more than self help. In the meantime, though, my general advice would be to stick to the program as closely as possible and see if you notice some improvements.

    Hope this is helpful and best of luck!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi AnneDeC,

    Great question! Our devices impact our sleep in a few different ways. First, they can negatively impact sleep because the light that they emit is bright enough to inhibit (or restrict) the release of a hormone called melatonin. This hormone helps prepare the brain and body for sleep, and not having enough of it can negatively impact sleep. Additionally, light can cause an alerting effect, which can make falling asleep more difficult. Finally, the content on devices tends to be stimulating – for example, think about the content you see in the news or on social media. These can have emotionally and cognitively stimulating impacts. Even playing games or looing at your work schedule for the day ahead can be very cognitive stimulating – it gets the brain running!

    For more detailed information about the impact of electronic devices on sleep, see this Sleepio library article: https://www.sleepio.com/library/article/do-light-emitting-electronic-devices-disrupt-sleep/

    Hope this helps!

  • Sleepio Member

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    Expert

    Hi Claid,

    That sounds incredibly difficult. The most important advice I can give you is that it may be helpful to speak to a doctor or medical professional about the mental health issues you’re experiencing. The techniques in Sleepio can still be effective if you spend lots of time in your room, or if you are dealing with mental health issues; however, these are closely connected to sleep and may be important to address on their own.

    That said, are there ways you can avoid your bed, even while you’re in your bedroom? For example, sitting at a desk, or on a pillow away from your bed? This will help maintain the bed-sleep connection (i.e., our brain’s association between being in bed and being asleep). Spending time in bed while awake has a negative impact on sleep. Also, can you do things to change up the environment during the day (i.e., make sure you are getting bright light exposure, opening a window, etc.)? It’s important to get bright light exposure and fresh air during the day to regulate your circadian rhythm.

    I hope this information is helpful and that you get some relief (and better sleep) soon.

  • Sleepio Member

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    Expert

    Hi Luanna,

    Thanks for the feedback! I’m glad you found Sleepio helpful.

    I saw both of your posts – regarding the QHR, It sounds like you’ve experimented with different activities for when you get out of bed, so I won’t suggest the ones you’ve already mentioned, but you might try browsing the Sleepio community (or making your own post!) to get feedback for others on what types of activities work for them that aren’t too stimulating.

    Aside from that, as with all techniques in Sleepio, they are meant to be personalized by you to what is most helpful and feasible for you. If you find that following the QHR is negatively impacting your sleep (which was previously better), you might experiment with what happens if you don’t follow the rule. You may find that this is equally detrimental to your sleep, since the bed-sleep connection is very important, but you might find that you can fall back asleep more easily than you think.

    Regarding your second post, early morning awakenings can be tricky to tackle, but not impossible! It may be helpful to know that there are different circadian preferences and that the circadian rhythm tends to shift earlier with age. Sometimes leaning into the earlier rise time (e.g., in your case, potentially shifting your schedule to 11-5 rather than 11:45-5:45) can be helpful. I imagine you are already doing this, but it can also be helpful to pay attention to light cues during the early morning hours – making sure you are in dim light conditions around bedtime, and get early light exposure soon after your rise time. This can help regulate circadian rhythms.

    It’s also important to note that when people are fully implementing all the techniques and not seeing a benefit, we typically encourage them to speak to their doctor about their sleep to determine if they may need more than self help.

    I hope you’re able to find something that works well for you!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi Robert,

    Thanks for the question. To follow the program most closely, you would still get up at 5am and stick to the sleep window – sticking to it very closely is what causes sleep restriction to be effective. However it is up to you how to implement these recommendations in a way that works best for you!

    I’ve linked below some educational articles on sleep restriction that I hope you will find helpful!

    https://www.sleepio.com/library/article/do-the-times-that-determine-my-sleep-window-always/
    https://www.sleepio.com/library/article/sleep-restriction-putting-it-into-practice/
    https://www.sleepio.com/library/article/sleep-restriction-the-science/

  • Sleepio Member

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    Expert

    Hi Joanna,

    Thanks for the question and sorry to hear about the difficulties you’ve been having.

    First off – you’re not alone. Sleep restriction can be very intimidating and difficult for many people. I suggest you browse the Community board (or make a post yourself) to hear from others and how they’ve been able to cope with the lack of sleep during this time.

    I find it helpful to remind people that this time is temporary – and that things tend to get a bit worse before they get better. But – things will get better. Sleep restriction is an incredibly powerful tool for consolidating and improving your sleep – and over time, you’ll slowly increase the amount of sleep you’re getting. Both of these factors will help with daytime sleepiness.

    I’ve linked a few articles from the Sleepio library below that I think may be of interest to you – one on the science of sleep restriction and how it works, and one on how to manage daytime sleepiness.

    https://www.sleepio.com/library/article/sleep-restriction-putting-it-into-practice/
    https://www.sleepio.com/library/article/sleepiness-fatigue-and-impaired-concentration/

    Hope this is helpful and hope this difficult time passes soon!

  • Sleepio Member

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    Expert

    Hi Jocelyn,

    I imagine that it’s really frustrating to notice great progress, then feel a setback after getting ill. It definitely makes sense that you stopped sleep restriction in order to focus on getting rest and healing – very important. Many people who have had to stop SR for various reasons have successfully gotten back into it and continued to make progress, so don’t lose hope!

    There are a few different ways to reintroduce sleep restriction based on your preference. You could 1) establish your sleep window based on your current total sleep time (TST), 2) revert back to your original sleep window, or 3) gradually decrease your window, and then increase it again (called “sleep compression”). Any of these are good options, and you may want to experiment with multiple approaches before you find something that works for you.

    Best of luck and hope you are recovering well from COVID!

  • Sleepio Member

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    Graduate

    I have no problem going to sleep. Sleeping right through is my issue. my SR is 11.30 – 6.30 but i find i wake at 05.00. Even before i get out of bed to do the QHR i am sleepy therefore i could be out of bed for 5 mins and feel sleepy enough to go back to bed. But my mind is so active i can't get back to sleep and before i know it its time to get up at 6.30. I have tried deep breathing, staring at a spot on the ceiling so my eyes just want to close and the imaginary technique. Nothing works. I was upset this morning as I feel hope is fading.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Thanks for your advice. I'll try those techniques and looking forward to hearing more from this programme. Thanks again.

  • Sleepio Member

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    Graduate

    Hello Dr., In your experience, are there devices that might be helpful for us to learn about our sleep, like Apple Watch or Fitbit or something?

  • Sleepio Member

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    Graduate

    Thank you Dr, I will look at these articles.

  • Sleepio Member

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    Graduate

    Dear Doctor Michelle, What do you suggest I do for the sleepiness as I wake up to lessen so I do get up out of bed rather than lie there wanting to fall back to sleep? Thanks Joanna

  • Sleepio Member

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    Graduate

    Also, sorry keep thinking of things. How do we desensitize to snoring? Thanks

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi Lack lustre,

    Sorry to hear you're having trouble – that sounds frustrating! My general advice is to keep experimenting with different calming/relaxing activities during the QHR – and make sure you are doing them in dim lighting. Light exposure or overly stimulating activities will keep you up! You might check the Sleepio community (or make a post) to hear what's worked for others. Additionally, since you're not having trouble falling asleep, you might try shifting your sleep window back by 30 minutes (i.e., 11-6) to try to lean into the early morning wakening.

    Hope this is helpful!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi Robert,

    Great question. Many people find these devices helpful for staying motivated to work on their sleep, but there's not a lot of evidence that they are effective tools for improving your sleep. They also are by no means perfect in terms of monitoring your sleep, besides giving you a general idea of times when you were asleep versus awake. Therefore, I don't tend to recommend them, but don't think they are harmful as long as people don't become too attached to/concerned about the metrics (as this adds to worry about sleep, which leads to worse sleep!).

    Hope this helps!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi Joanna,

    Per your last two posts –

    As far as the sleepiness, I'm not quite sure I follow. Do you mean how do you make yourself less sleepy so that you can get out of bed? I think if you are sleepy enough that you can't force yourself out of bed you are likely to fall back asleep. I wouldn't recommend any stimulating activities as the idea is to maintain the sleepiness, but move it to a different location until you're sleepy enough to fall back asleep.

    As far as desensitization to snoring, this is what I was suggesting in the previous response – desensitize yourself by paying close attention to your emotional responses and thoughts related to the snoring. The first step is paying close attention to your thoughts and feelings when you wake up from the noise – are you catastrophizing or feeling very distressed? If so, try challenging your thoughts and trying to come up with a new perspective that leads you to experience less distress. The desensitization comes when you learn it's not as bad as you think, or that you can handle it better than you think. It's tricky, but it's all about reframing how you view the snoring.

    Hope this helps.

  • Sleepio Member

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    Graduate

    Sorry I didn't make myself clear! I am going to bed at 1am and supposed to be getting up at 7am but have shifted it to 7.30am. When I wake up at 7.30 I feel so tired as if I could stay in bed for a few more hours and struggling to get up to my alarm ready for the day. Any advice? Thanks Joanna and thank you re snoring!

  • Sleepio Member

    • 11 comments
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    Graduate

    Is it ok to go to bed and listen to a meditation or sleep relaxation or body scan in bed or not? obviously it would be bluetoothed from my phone and I have a sleep headband? Thanks

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi Sleepy575 –

    For the first question – you might experiment with shifting your sleep window back even later if possible (going to bed earlier or waking up at 7:45 or 8). Make sure you're getting bright light exposure to help yourself wake up in the mornings.

    As far as the meditation in bed – to stick most closely to the guidelines, this would be done outside of bed (in order to fully maintain the bed-sleep connection), but you should feel free to experiment and see what works best for you! The goal isn't perfection, it's figuring out what is doable/works best for your specific needs.

    Hope that helps!

  • Sleepio Member

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

    Hi Sleepy575 –

    For the first question – you might experiment with shifting your sleep window back even later if possible (going to bed earlier or waking up at 7:45 or 8). Make sure you're getting bright light exposure to help yourself wake up in the mornings.

    As far as the meditation in bed – to stick most closely to the guidelines, this would be done outside of bed (in order to fully maintain the bed-sleep connection), but you should feel free to experiment and see what works best for you! The goal isn't perfection, it's figuring out what is doable/works best for your specific needs.

    Hope that helps!

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