Live Discussion with Dr Michelle Davis -28th August 2019

Dr Davis will be hosting a live online discussion here on Wednesday 28th August 2019, 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 22 Aug 2019 at 12:02 PM
  • 18 comments
  • 3 helped

Comments

  • Sleepio Member

    • 1 comments
    • 1 helped
    Graduate

    Hi,
    I work night shifts every other week for a run of 7 nights 8pm-8am followed by 7 nights off. I find sleeping during the days when I'm working isn't a problem at all for me and never have trouble staying awake during my night shifts but it's trying to sleep overnight when I'm off that I have issues with. I either have trouble getting to sleep and/or wake up for several hours at about 2am.
    Do you have any advice for shift workers regarding how best to get back into a normal nighttime sleep routine after coming off a run of night shifts?
    Also, if there is opportunity to get a few hours sleep on a quiet night shift is it best to do this or stay awake all night and just sleep during the days?
    How does shift work impact on using Sleepio? I've read that week 3 relies on sleep scheduling and I'm worried about how I'm going to manage this.
    Many thanks,
    Claire

  • Sleepio Member

    • 22 comments
    • 6 helped
    Graduate

    Hi – I’ve been doing Sleepio for nine weeks and am feeling good about my sleep improvement. Averaging five hours, striving for seven but on the right track. I do still have low energy even after a good (for me) night of sleep, and wonder about that. Thank you!
    We will be going out of the country for two weeks and I am quite concerned about how I will manage sleep, and how I will have enough energy to function while away…and when we return home. Your help is greatly appreciated.

  • Sleepio Member

    • 16 comments
    • 5 helped
    Graduate

    Can the bed sleep association be bed or bedroom specific? I have had poor sleep for many years. I have followed all the sleep hygiene advice for my bedroom at home which is cool, dark, quiet and free of distractions yet it seems that sometimes when I am away from home I can get more sleep despite the bedroom not being ‘perfect’ for sleeping. I have looked at other factors during the day – activity/ exercise, daylight exposure, evening meal times and evening activities and can’t find an association or reason behind any of these.
    Thank you for your thoughts on this.

  • Sleepio Member

    • 10 comments
    • 4 helped
    Graduate

    Hello Dr Davis I have three questions

    1. Do you think there are techniques that are more suitable for fibromyalgia patients? I'm currently trying all the wonderful tools I've learned here.
    I am on the schedule carefully but still experiencing two nights a week of repetitive condition … The time I lie awake in bed goes by fast so I suspect I may be in an intermediate state that is between wakefulness and sleep so I open my eyes and watch the clock once an hour. During this time it is difficult for me to get up and get out of bed and abide by the law of the quarter hour because when I lie down I still get some rest for the body (maybe it has to do with having fibromyalgia …)
    Until I realize that it's been three hours and I get up and get out of bed and take Valerian drops that sleep. At this point I feel stressed because I think of the hours left until getting out of bed. At this point, the pain also begins (on nights when I sleep tight I don't wake up in pain)

    2. About the quarter hour law, I tried it for two weeks and I'm not sure it's for me
    It stresses me out and many times I go back to bed even if my body shows no signs of falling asleep. How will I know if I should persevere with this technique anyway?

    3. What should I do when bedtime comes and I don't feel sleepy? Go to bed anyway?
    Thank you for your help

  • Sleepio Member

    • 8 comments
    • 10 helped
    Graduate

    Hi
    I'm on holiday at the moment in Europe and finding the programme difficult to follow. I'm in France in a gite for the next 2 weeks and have decided to sleep in the spare bedroom. My problem so far has been when we have been travelling down and had to stay in a different hotel each night. Any advice?

  • Sleepio Member

    • 1 comments
    • 0 helped
    Graduate

    My child has been poorly and been up and down during night this week and this was my first week of sleep restriction. Can I put the sleep restriction back a couple of weeks until they are back at school. I'll still fill in sleep diary.

  • Sleepio Member

    • 2 comments
    • 1 helped
    Graduate

    I have found that although my sleep efficiency has improved (up to nearly 70%), my sleep quality is still quite poor and I am still very tired during the day. I am on my 7th week of the programme. Any advice to help improve this?

  • Sleepio Member

    • 242 comments
    • 53 helped
    Expert

    Greetings everyone! This is Dr. Michelle Davis reporting for a live session. I look forward to answering your questions over the next 90 mins.

  • Sleepio Member

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

    Hi Claire!,

    Great question. We have a guide for shift work, because sleep problems are so common among shift workers. You can access that guide here:
    https://www.sleepio.com/articles/shiftwork/shift-work-and-sleep-intro/

    The guide includes several things to try before, during, and after shifts that can help make the transition.

    You’re correct that sleep scheduling (or “sleep restriction”) starts in session 3. Many shift workers already have restricted or shorter than usual sleep windows and will be unable to adopt a new night-time sleep window. But, it can still be interesting and helpful for people who do shift work to learn about the concept of sleep restriction, even if they cannot apply the recommended schedule. When you get to session 3, you will be able to manually adjust your sleep window if the new recommendations don’t work for you.

    However, the session after (session 4) may be particularly useful for shift workers, as it describes a number of techniques to help relax both the mind and body at the end of a shift (these could be useful when coming off a run of night shifts).

    To specifically answer your question about whether you should take a nap on quiet nights – this is your decision, but I would just be aware of the function of a nap. A nap might make you less sleepy in the moment, but know that it will be more difficult to get to sleep the next time you try, because naps reduce your sleep drive. That said, you will be the best judge of whether you need to take a nap if you are too sleepy to be able to function at work, or if you choose to skip the nap because you don't want to reduce your sleep drive for when you want it to be high at bedtime.

    I want to let you know that many shift workers have successfully completed the program and often share tips and advice in the online community (you can try searching there for “shift” and “shift work” to see their posts).

    Check out the shift work sleep guide and the boards and feel free to check back in with us next time if you have further questions!

  • Sleepio Member

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

    Hi Hoping,

    Thanks for the question! Great job sticking with the program for 9 weeks, and I’m glad you’ve seen some improvement in your sleep.

    Well, you’re not alone! Fatigue is one of the most common complaints from people who are having sleep problems. You can expect this to improve with time and as you expand your sleep window.

    One thing to be aware of is that there is a common misperception that fatigue is always caused by lack of sleep – it can also be caused by boredom and inactivity! We often recommend that people who experience a lot of fatigue try noticing what they're doing when they start feeling tired and drained, and try to increase activities that make them feel more energetic.

    Here are some ways to increase daytime energy when you feel a lull: mid-day exercise (for example, a brisk walk), caffeinated drinks, and getting out in the daylight (very important because natural light helps keep us alert). If you find that your energy is extremely low and you’re feeling sleepy (as in, struggling to stay awake), or if you find that your energy levels don’t improve as your sleep continues to improve, you might want to speak with your doctor to rule out other causes.

    Here’s an article on fatigue and sleepiness that is often helpful to people struggling with daytime fatigue:
    https://www.sleepio.com/library/article/sleepiness-fatigue-and-impaired-concentration/

    And before your trip, please read this Sleepio guide to managing jet lag for tips on how to cope while you’re out of the country:
    https://www.sleepio.com/articles/jetlag/the-science-of-jet-lag/

    Hope this information is helpful and enjoy your trip!

  • Sleepio Member

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

    Hi Jacquie,

    Great and interesting question! There are many different stages of sleep – some lighter than others. In the early stages of sleep, you may find yourself drifting in and out (which sounds like the situation with being aware of your husband’s arm – you probably drifted awake during an early stage of sleep and became aware of his arm).

    An definite answer to your question of whether this experience counts as “sleep” or not is a bit tricky – though these early stages of sleep are technically part of the sleep cycle (wherein you’re going in and out of sleep as you are aware of some things), you’re likely not in the later, deep stages of more restorative sleep when this is happening.

    Here are some articles that may be interesting to you:

    https://www.sleepio.com/library/article/can-you-think-youre-awake-when-actually-youre-asle/

    https://www.sleepio.com/library/article/deep-sleep/

  • Sleepio Member

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

    Hi Ann!

    It sounds like you’ve done a lot of work to make your environment sleep-friendly! Great job.

    I’m sure it is frustrating, then, that you find you’re able to sleep better in other locations where you haven’t done all this work! You’re not alone – many people who have trouble with sleep find that they sleep better in other environments. This is likely because their own sleeping environment has become associated with arousal, or anxiety, about sleep.

    The bed-sleep association works two ways – a sleep environment can become associated with sleep (leading to being able to sleep easily there), but can also become associated with arousal and anxiety (leading to poor sleep or the inability to sleep there).

    It’s worth noting that worrying about getting good sleep can trigger poor sleep. Simply having thoughts about not being able to sleep well in your own bed can lead to arousal and anxiety while in bed (worsening the connection). This is especially common among people who worry a lot about their sleep, or what not getting sleep means (for example, that they won’t be able to function the next day, or that they’ll never be able to sleep). Luckily, the cognitive techniques described in Sleepio can be extremely helpful for people who struggle with these types of thoughts. You might try reviewing them.

    Here are some articles on the bed-sleep association and the cognitive techniques I mentioned:

    https://www.sleepio.com/library/article/how-can-i-improve-my-bed-sleep-connection/

    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, please let us know if you have more questions in the future.

  • Sleepio Member

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

    Hi Dreamto8Sleep!

    Thanks for your questions.

    As I’m sure you’re aware, pain can make it really difficult to work on your sleep! Here are some Sleepio resources on fibromyalgia that may be of interest:

    https://www.sleepio.com/library/article/fibromyalgia/
    https://www.sleepio.com/community/discussion/the-link-between-fibromyalgia-and-artheritis-and-i/

    Many people have difficulty with the quarter hour rule, so I want to emphasize the purpose, which is to teach the brain that the bed is a place for sleep.

    When someone can’t sleep, getting up out of bed to do an activity that promotes sleep helps them to maintain an association between their bed and sleep. Alternatively, lying in bed (especially while looking at the clock!) strengthens the opposite connection – it causes them to associate their bed with arousal (and maybe even anxiety).

    If you can manage, we sometimes recommend moving to the couch or another comfortable location to lay down and rest, just so that you’re preserving the connection between your bed and sleep (while still getting the rest that you find is helpful for you).

    Ultimately, you (and your doctor) are the best judge of what will work for you. If you’re unable to get out of bed due to pain, we always encourage modifying the program based on your needs – take what works for you!

    For your last question – we highly recommend not going to bed until you are sleepy (to preserve the sleep-bed association). Instead, we recommend engaging in an activity that is sleep promoting – being in a dim room, reading, listening to soft music, or any other activities that aren’t arousing.

    Hope this is helpful!

  • Sleepio Member

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

    Hi Sahn!

    This issue comes up frequently for people who are working on their sleep – events come up that get in the way! Our typical recommendation for those who are traveling is to do your best to stick to the sleep schedule. We realize that this is not always possible, but if you stick with it, can be a great opportunity to practice and learn more about your sleep.

    Ultimately, if you find that you can’t stick to your sleep window while traveling, you can always get back on track when you return. We do recommend continuing to monitor your sleep using the sleep diary.

    Here’s an article about decision-making around whether to continue with sleep restriction while traveling:

    https://www.sleepio.com/library/article/im-going-on-holiday-should-i-stop-the-sleepio-cour/

    And, in case it’s applicable, here is a Sleepio guide for managing jet lag:

    https://www.sleepio.com/articles/jetlag/the-science-of-jet-lag/

    Hope this information is helpful and enjoy your trip!

  • Sleepio Member

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

    Hi Sarah,

    Thanks for the question.

    As I mentioned in a previous response above, this issue comes up a lot when working on sleep problems. Life events can really get in the way of sticking to your plans.

    You have choices here – you can absolutely decide to “pause” your program and come back later. During this time, as you said, you can continue to collect sleep diaries to gather more accurate sleep information before starting the next session.

    But also, you might surprise yourself! You may also decide to go forth with sleep restriction, but to shift your sleep window to suit your current situation better. You don’t have to do every technique perfectly in order for it to be extremely helpful.

    You’ll be the best judge of what is right for you, but we do recommend keeping up with your sleep diary in the meantime!

    Best of luck.

  • Sleepio Member

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

    Hi Biggles57,

    Great question and a really common experience!

    Congratulations on your initial success! It’s common to fall off track or have life events that impact your sleep, and repeating the steps (especially sleep restriction) and being more diligent about sleep is the very best thing you can do! You'll find lots of posts on the community board from Sleepio members who have repeated the program and found it helpful the second time around.

    Keep at it!

  • Sleepio Member

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

    Hi Wanda68,

    Thanks for the question.

    For improving sleep efficiency and quality we always recommend sticking to the sleep restriction protocol (which it sounds like you're doing a great job of!). Unfortunately, it takes some people longer to get to higher efficiencies (and higher quality).

    I want to point out that if you’re feeling sleepy during the day, this actually means sleep restriction is working! By restricting your sleep, you’re increasing your need for sleep (or increasing your sleep drive), which is the purpose of sleep restriction.

    I also want to emphasize the importance of maintaining a regular sleep-wake schedule (in other words, keeping the same bed and wake times every day). This will help to stabilize your circadian rhythms and combat fatigue.

    It sounds like you’re doing a great job – keep it up!

  • Sleepio Member

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

    Thank you so much for your help. Sleepio has made such a positive difference for me.

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