Live Discussion with Dr Michelle Davis - 8th January 2020

Dr Davis will be hosting a live online discussion here on Wednesday 8th 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.

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Posted 19 Dec 2019 at 7:37 PM
  • 16 comments
  • 4 helped

Comments

  • Sleepio Member

    • 5 comments
    • 6 helped
    Graduate

    Hi there,

    I'd like to ask a question about sleep, although I'm not sure if this is the right format to do so -- please let me know if it isn't.

    My question concerns sleep restriction. It has been quite effective in improving my sleep, however, I still get hit by temporary bouts of insomnia.

    When this happens, I tried to leverage sleep restriction to reduce bedtime to bring insomnia under control. So for example, I would reduce my bedtime hours from 7:30 to 6 and it helps. The trouble is that now for me to return to 7:30 hours in bed I would need another 6 weeks if I want to do it properly and increase it by 15 mins per week. I wonder if it's safe to speed up the process in situations like this and return back to where you started within a week or so.

    Please let me know what you think.

    Many thanks!

  • Sleepio Member

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

    Wondering same thing.

  • Sleepio Member

    • 22 comments
    • 6 helped
    Graduate

    Hi Dr. Davis,
    I am doing a little better on my sleep, usually around 5 hours instead of 1-4 hours. But even on days when I get close to 6 hours, I am still exhausted all day. My muscles feel weak, which has been going on for 3 years since I got off of amitriptyline. Do you have any suggestions of how I can get some energy? Thank you so much.

  • Sleepio Member

    • 11 comments
    • 6 helped
    Graduate

    Hello Dr. Davis,

    I've just started doing sleep restriction and am enjoying getting to sleep a little quicker. I have a concern at the moment however, regarding Sundays. Ever since I've had insomnia I've never been able to sleep well on Sundays, as I know that I have work the next day. I hit about 60% sleep efficiency last night (Sunday the 6th) for compared to my average of 70%. If I want to improve then I need to average at least 90%, and I fear that Sunday nights are going to hit me in this regard, even if I'm able to sleep well throughout the rest of the week.

    Is this a common problem? And if so are there some techniques I can try? Perhaps going to bed even later on Sundays (I'm currently restricting to 5 and half hours in bed)?

    Thanks

  • Sleepio Member

    • 3 comments
    • 2 helped
    Graduate

    Hi Dr Davis
    My sleep is much better and I’m getting about 7 hours a night. However I’ve developed a habit of waking up every 2 hours. I get up and go to the bathroom and then fall asleep within 5-10 minutes.(I don’t NEED to go to the bathroom so often but it’s now part of my routine and helps me to go back to sleep.) I feel I’m waking up from a deep sleep each time. Do you ha e any suggestions?

  • Sleepio Member

    • 10 comments
    • 1 helped
    Graduate

    I started Sleepio at the end of November and had made some progress but then December with Xmas and a holiday knocked me back. I have re-started and my sleep window is 11 – 5.30. I find I fall asleep fairly quickly and sleep for about 1.5 hours (feels stood quality) then I’m awake and up and downstairs for next couple of hours. Should I be reducing my sleep window to squeeze out awakenings or leave it as it is and will naturally get better?

  • Sleepio Member

    • 1 comments
    • 0 helped
    Graduate

    Hi Dr Davis,
    How important is it for me to get out of bed soon after awakening in the morning?
    Thank you
    Chris R

  • Sleepio Member

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

    Hi De1pher:

    Thanks for the question! It’s great that sleep restriction continues to work for you.

    Generally, it is recommended to shift the sleep window incrementally (as you noted). However, it doesn’t have to be a 15 minute increment; the recommended increment typically falls between 15-45 minutes. Also, the window is typically shifted incrementally in both directions (i.e., both increases and decreases to the sleep window are done gradually).

    That said, Sleepio is a self-help program so it will be up to you to figure out how to implement sleep restriction in a way that works best for you.

    Hope this is helpful!

  • Sleepio Member

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

    Hi GK99 – here was my response to the question you expressed interest in:

    Generally, it is recommended to shift the sleep window incrementally (as you noted). However, it doesn’t have to be a 15 minute increment; the recommended increment typically falls between 15-45 minutes. Also, the window is typically shifted incrementally in both directions (i.e., both increases and decreases to the sleep window aredone gradually).

    That said, Sleepio is a self-help program so it will be up to you to figure out how to best implement sleep restriction in a way that works best for you.

    Hope this is helpful!

  • Sleepio Member

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

    Hi Hoping,

    I’m glad to hear your total sleep time is improving, though I’m sorry to hear you’ve still felt tired. Typically, recommendations for increasing energy include getting some light to moderate exercise (not too close to bedtime), using caffeine (also not too close to bedtime!), and paying attention to sunlight exposure (i.e., getting exposure to bright light first thing in the morning, and being in dim light conditions prior to bedtime). If engaging in those activities still is not helping as sleep continues to improve, it is generally recommended to speak with a medical doctor, who (with your medical history) will be in a better position to understand your lack of energy.

    Thanks for the question!

  • Sleepio Member

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

    Hi sikluke,

    Thanks for the question! Glad you are getting to sleep a little more quickly.

    It is not uncommon for a person to experience sleep problems when they are worried about or anticipating something that is coming up the next day. And if you Google the “Sunday scaries”, you'll see that many others experience some anxious anticipation the day before the work week begins!

    A few thoughts come to mind –

    First, my general recommendation would be to not focus too much on the sleep efficiency numbers. The most important “metric” is not the sleep efficiency score, but rather how someone feels during the day (i.e., level of energy or fatigue). Focusing on the score too closely can be unproductive, as it can produce anxiety or worry about the score being too low.

    Next, the cognitive techniques presented in sessions 4 and 5 are designed to help with worrying and stress. These are often effective if someone is having trouble sleeping on a particular night due to concerns about what’s happening the next day.

    Typically, it is not recommended to change your sleep schedule on a particular day, as it is generally best to keep the same sleep and wake times every day.

    Hope you find this response helpful!

  • Sleepio Member

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

    Hi Arabella,

    Very glad to hear your sleep is improving!

    First, it’s important to note that it’s not at all uncommon to experience waking up at night, and awakenings under 20 minutes in length are generally not considered atypical or clinically significant.

    For someone who is experiencing awakenings that are impacting their daily functioning (i.e., causing excess fatigue or low energy), I might recommend that they experiment with different activities, particularly ones that can be done in bed (for example, a few minutes of mindful breathing or a relaxation exercise). It might take some experimenting with different activities to find what works best for you.

    Hope this is helpful!

  • Sleepio Member

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

    Hi DanLevs!

    Thanks for the question! Glad to hear you’ve made some progress. It’s not at all uncommon for the holidays to interfere, and it’s great that you’re getting back on track with your sleep window.

    If someone is still experiencing awakenings with a sleep window of approximately 6 and a half hours, I would typically suggest decreasing the sleep window. However, the sleep window should never be reduced to less than 5 hours (or less than 6 hours if someone has a medical or mental health condition). If you have questions or concerns about further reducing your sleep window, your doctor will be in the best position to address them.

    I hope this is helpful!

  • Sleepio Member

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

    Hi Chris,

    Thanks for the question! In general, it is recommended to get out of bed upon awakening.

    There are a few different reasons behind this. The first is that it’s important to keep a consistent wake time each day. Staying in bed makes it possible to fall back asleep, which can impact the sleep schedule.

    The second is due to the fact that we develop associations between our beds and the activities we do in bed – for good sleep, we want to ensure that the bed is associated with sleeping, not being awake. Getting out of bed immediately upon awakening is a great way to ensure that the bed is only associated with sleep.

    Here’s an article on the science between the bed-sleep connection that you might find interesting:

    https://www.sleepio.com/library/article/the-bed-sleep-connection-the-science/

    Of course, everyone is different and it will be up to you to determine how to implement this information into your sleep routine in a way that makes most sense for you.

    Hope you found this information helpful!

  • Sleepio Member

    • 242 comments
    • 53 helped
    Expert

    Apologies for the delayed responses to the live sleep expert session questions for today. Thanks to all for your questions!

  • Sleepio Member

    • 22 comments
    • 6 helped
    Graduate

    Thank you!

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