Live discussion with Dr Vicki Creanor - 10th August 2016

Dr Creanor will be hosting a live online discussion here on Wednesday 10th August, from 8:15 to 9:45pm British Time or 3:15 to 4:45pm US Eastern Standard Time.

She 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.

Please do note that, as per our guidelines, Dr Creanor will not be able to give personal medical advice. Her 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 4 Aug 2016 at 11:22 AM
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  • Sleepio Member

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    Graduate

    I read in one of the Sleepio articles that this treatment is successful for 70% of people. Other similar CBT sites also claim success for 70-80% of people. My average sleep quality hasn't increased since week 2 and I am now at week 12. I have tried restricting sleep even further. How long should I persevere before concluding I am one of the 30%? Or did the 30% just give up too early….

    (I don't wish to discourage others by posting this – Sleepio clearly works for so many people – however for whatever reason and no matter how carefully we follow the profs rules for some of us progress is still very slow. Will we all get there eventually?)

  • Sleepio Member

    • 1 comments
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    Graduate

    Why do I not sleep for most of the night and then can do about 5.30 a.m. Why can I not sleep earlier ?

  • Sleepio Member

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    Expert

    Hello and welcome to the live sleepio session where we discuss the psychology of sleep and the sleepio programme.

    I see there are a few questions posted already so I'll wait to see if anyone has any live questions they'd like answered now, then move onto those waiting…

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there,

    Often when people are experiencing poor sleep over a prolonged period of time, they can wake up in a confused state, not knowing whether they are awake or asleep. This is very common and can be related to the particular type of sleep you're having at the time you wake up (ie. deep sleep/lighter sleep).

    In terms of waking up early, if it has only been for a short while, we would recommend people look at what's going on for them that week/the past few weeks – could there be something that is causing anxiety and leading to early wakenings? If people wake up early consistently for a number of weeks, shifting the sleep window back (going to bed earlier) might help to get a good period of sleep despite waking earlier than in the previous sleep window.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Negative thoughts going round your head is one of the most common reasons for not being able to fall asleep when you go to bed.

    The challenging thoughts part of the programme will help people target these thoughts and find more positive ways to think about certain things, however scheduling in a 'worry time' earlier in the day (not in the evening as it's too close to bedtime) to list all one's worries and then problem-solving them (either alone or with someone) can also help reduce the thoughts that creep in a night time.

    Keeping a pad and pen beside the bed can also help get thoughts out the head and onto the pad when trying to fall asleep.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Sometimes, even when we seem to get a 'good' night's sleep in terms of the length of time we sleep and the lack of nighttime wakenings, we still feel unrefreshed during the day. This is known as non-restorative sleep. It can be very frustrating. Research is emerging about this particular type of sleep problem, but so far, studies have shown the benefits of following cognitive behavioural therapy techniques (like those on which Sleepio is based). Regular bed and sleep times seem important in terms of refreshing sleep as well as managing anxiety, using relaxation and challenging any negative thoughts. If all the techniques are being followed correctly, however, and sleep still feels unrefreshed, it may be worth people visiting their GP/doctor to check for any underlying reasons that may be affecting sleep, or looking at stress/anxiety/depression that might be playing a part in in this feeling during the day.

  • Sleepio Member

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    Expert

    It certainly is frustrating to lie awake all night. For some people, they genuinely do lie awake all night some nights. For others, it feels like this, even if they get small sections of sleep through the night.

    As humans, we need sleep and the body will get sleep when it requires it. However, anxiety that as built up about not sleeping is often enough to make the body so alert that it prevents it from sleeping. The brain is on hyper-alert mode as a fear response kicks in when we start thinking too much about sleeping. This (and poor habits that further prevent sleep) is what often causes one to lie awake all night.

    The Sleepio programme tackles this anxiety and teaches new, helpful, adaptive habits to promote healthy sleep because of the common nature of the above scenario.

  • Sleepio Member

    • 42 comments
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    Graduate

    Since I've been on SRT, my sleep has yo-yoed between getting a decent chunk sleep one night, then getting zero hours the next (I'd had short sleep before SRT but never actually zero).

    Is this variation to be expected? In a way it seems like it's mirroring the pattern I had before, but in a more extreme way. Is this to be expected when starting SRT?

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    Often when devices are used that track activity during sleep, they can show different readings from what we might record ourselves. Especially in sensitive mode, such devices can measure natural tossing and turning as being awake, which is not helpful when calculating our efficiency. In order to combat this for those in similar positions, it may be worth calculating the efficiency yourself, as described in the programme (using total sleep time and total time in bed).

    I would recommend those already on 6 hours for sleep restriction stick with this number of hours and keep going as they are for a while longer to see what changes can be made before looking at a reduction.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    Sleep can become very variable when starting sleep treatment, especially sleep restriction, so this is normal for those starting this part of the programme. It usually does even out as the body gets used to new patterns.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there,

    I think it's worth everyone knowing and reminding themselves of the fact that good sleepers actually do wake up once or twice a night and that this is perfectly normal. They tend to get back to sleep quickly and their sleep does not bother them, hence they class themselves as a good sleeper. Waking a couple times a night is OK, as long as one can return to sleep quickly.

    Hormonal issues such as puberty and the menopause can negatively affect sleep. The menopause often leads women to waken more at night time, however what 'good' sleepers can do well is get back to sleep and not worry about their sleep too much, leading to less disruption. Hormonal changes can also lead to increased anxiety or lower mood, so the techniques within sleepio can also target these difficulties too, all in all helping increase the likelihood of better sleep and wellbeing.

  • Sleepio Member

    • 2 comments
    • 0 helped
    Graduate

    Just wondering if anyone else out there has sleep apnea as well as difficulty sleeping. I'm new to the program. I just completed session 3 on Monday.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there,
    Although we would love to provide estimates of how long it will take to improve sleep, it varies so much from person to person that it would be unwise to provide such figures. Even within the same person, depending on the type of day they've had, their sleep will vary.

    When someone has had poor sleep for a while, it's important to remember that certain maladaptive habits have to be unlearned then altered, which takes time. It's really important to make any expectations realistic so as not to put too much focus on big changes happening too quickly. Focus on any small changes that are happening and see them as a success. There will be blips along the way, but as long as people can still see general improvement, this is positive.

  • Sleepio Member

    • 2 comments
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    in reply to Sleepio Member
    Graduate

    Wow, I wish I could have that kind of sleep efficiency. Have you thought of getting your iron checked? That can cause tiredness. I have sleep apnea, insomnia and I'm anaemic as well. Always sleepy and tired

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    People form very negative associations between their bed/bedroom and sleep once a sleep problem kicks in that it can serve to maintain the sleep problem for a long time. So, the QHR (quarter hour rule) tries to break this association by asking people to take themselves away from their bedroom after trying to get to sleep/back to sleep for 15 mins (the length of time we recommend you try as this is how long it takes good sleepers to get to sleep/back to sleep) so that they reduce the length of time they spend in bed trying to get to sleep and not succeeding (the longer this goes on, the stronger the negative association will be).

    We recommend that people so try and get back to sleep for about 15 mins as they may succeed and this is good training for the future, rather than just getting up (good sleepers do not just get out of bed immediately – they attempt to fall asleep again).

    In terms of sleeping later than the scheduled wake time, we recommend that people be careful not to do this. This is because it can reduce the ability of the person to sleep well that night as the sleep pressure in the evening may then be reduced if sleep was taken for longer than scheduled in the morning.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there,
    When people consistently wake early, we tend to look at a number of things:
    – are they following the techniques as laid out by the programme?
    – is there an underlying psychological/physical health issue that is causing the early wakenings (we advise to have this checked by the GP/family doctor)
    – is age playing a part?The older we get, the lighter we sleep and we often wake earlier
    – is the person's sleep pattern set to wake early naturally? If this is the case, one can set the same sleep period/window but shift it so that they go to bed earlier and so get a good amount of sleep while still waking early

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there,
    Many people who struggle to get to sleep find that melatonin can help, however the Sleepio programme uses techniques that do not use drugs to achieve the same outcome, including getting to sleep initially.
    In terms of worrying thoughts, they are often what keep people awake at night and prevent sleep. As people progress through the Sleepio programme, there are lots of techniques which can help people to: – challenge their negative thoughts – schedule in worry time to a different part of the day to avoid them creeping in at night and – relax when they start to feel anxious/have anxious thoughts

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    Unfortunately CBT doesn't work for some people, whether it's for sleep or anxiety or depression etc etc. Some treatments work better for some and sometimes we aren't 100% sure why this is, given us humans are complex beings! It could be the style of the treatment, the timing of it or something else. It could also be that the treatment is not being effective because there is another underlying psychological/physical health issue causing poor sleep that is not being tapped into by CBT. Also worth bearing in mind that some people find CBT hard to commit to and that is the part that makes it tricky for them, if they have lots of other commitments in their lives.

  • Sleepio Member

    • 1339 comments
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    in reply to Sleepio Member
    Expert

    Hi there,
    For those who cannot fall asleep for a large chunk of the night, it can vary as to the cause. Anxious/worried thoughts may be keeping them awake until the point where the body gives in and falls asleep later on. It could be that their lifestyle means that they are over-stimulated and so can't wind down until later in the night. It could be that they have got into bad sleeping patterns so the body has learned that it sleeps better later on in the night, or it could be that their internal biological clock finds sleep naturally easier later in the night.

    So lots of reasons as to why, but the Sleepio course targets all of these to help people get the best sleep they can get, whatever is preventing them to sleep well at present.

  • Sleepio Member

    • 1339 comments
    • 214 helped
    Expert

    That's all for just now – thanks for the posts today – speak to you again soon.

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