Live Discussion with Dr Vicki Creanor - 10th July 2019

Dr Creanor will be hosting a live online discussion here on Wednesday 10th July, from 8.15 PM to 9.45 PM British Time or 3.15 PM to 4.45 pm US Eastern 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. If there are a lot of questions, she may not be able to answer all in the time available, but will try to answer as many as she can.

Please do note that, as per our guidelines, Dr Creanor will not be able to give personal medical advice including those about medication. 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 9 Jul 2019 at 3:20 PM
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  • Sleepio Member

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    Dear Dr Creanor

    I have been doing the sleepio program for about five months and getting some benefit. However, I have been taking zopiclone for many years and the doctor has suddenly stopped it. I am sleeping for four hours a night with half a 3.75 mg zopiclone and 10 MG of amitriptyline, which is what they have prescribed instead. I am really worried about getting to sleep at all without the Zopiclone, which I will run out of soon. And wonder if you could advise what I could do next? In regards of trying to get to sleep. Thanks your help in advance

  • Sleepio Member

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    Expert

    Hello and welcome to the live Sleepio discussion session. I'm Dr Vicki Creanor, a clinical psychologist with a special interest in sleep. I'll be here for the next 90 mins to answer all questions related to sleep or the Sleepio programme….let's get started….

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi and thanks for getting in touch. I'm so sorry to hear that you're struggling with frequent wakenings throughout the night. It's a really frustrating scenario when this happens. The first thing I would want to look at if someone presented to me with these persistent wakenings is whether there is anything else underlying that is causing these. Some examples are medical conditions, hormonal changes and mental health problems such as anxiety, stress and depression/low mood. All of these factors can cause frequent nightly wakenings and sleep can continue to be a problem despite treatment. I wonder if any of these apply here? Sometimes we find that the sleep problems are, in fact, secondary to another problem, and by treating the primary problem, the sleep improves as a result.

  • Sleepio Member

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    Expert

    HI there – first of all, well done in improving the sleep efficiency! That's great news! It is so frustrating when we wake just before we're due to get up, isn't it? The focus on the lack of time left to sleep often keeps us awake til then anyway. I'm not sure where in the world you live, however I wonder if this might be related to sunrise? Worth keeping the room dark using blackout blinds at this time of year as many people do wake with the sun coming in through the window, especially when sleep is in the lighter stages. I wonder as well if there are any noises around this time in particular that may be causing you to stir? One idea, if neither of these things is relevant, might be to shift bedtime a little later (30 mins) to see if this leads to a later wake time?

  • Sleepio Member

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    I have long believed my wakings are hormonally related (menopause). Do not know what to do about this.

  • Sleepio Member

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    I generally have felt healthy, mentally speaking, although the SR is changing that for the worse. Anything less than 6 hours of sleep, and I def start struggle to stay mentally stable.

  • Sleepio Member

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    Expert

    Hello and thanks for your question. First of all, I wonder if a chat with your GP as to the reasons for stopping this might explain things a little more as it seems you are unsure of why this has been so sudden? I wonder as well if it could be reduced more gradually (this would require a decision from the GP, too), to lessen the anxiety around this? In terms of what can be done to help people get to sleep initially, you can find ideas and techniques in the first part of the programme as you will still have access to this – some of these include: having a strict and consistent bedtime routine every night (including weekends), practising relaxation before bed, having a hot bath/shower 20 mins before bed, using thought blocking techniques/mindfulness if thoughts are racing at bedtime. Ensuring good sleep hygiene is maintained will be important, too (i.e. cool bedroom, dark bedroom, minimising noise). I hope this helps, but I would advise talking to your GP again for clarity and support re the medication change.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Often the menopause can have a significant effect on our sleep. If this is relevant to you, it is worthwhile seeking medical advice on what routes may be open to you. If temperature is a problem at night, keeping a cool bedroom and cool sheets will be important – sometimes having a fan in the room with a bowl of ice in front of it can help in summertime. There is a significant link between amount of sleep and mental health, so it is not surprising we start to feel less mentally well with less sleep.

  • Sleepio Member

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    At hot room certainly does not help, but I don't feel most of my wakenings are due to hot flashes, per se. It just seems… I wake up for no reason. But somehow I feel it must be related to peri-menopause. I don't wake up super sweaty – maybe sometimes a touch warm, but again, I just… wake up!

  • Sleepio Member

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    I'm not sure if HRT would help – I was initially against the idea, but now I'm desperate enough to consider trying i. But doctors seem reluctant to prescribe it.

  • Sleepio Member

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    Is it reasonable to think the SR tech will not help me if I continue with it at this time? I admit for the first time since starting it, I did not adhere to it beginning 2 nights ago. I slept longer by virtue of having a longer window, but did not sleep better (13 wakings last night).
    I should I persevere with the SR?

  • Sleepio Member

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    Expert

    Sometimes it is worth seeing a different doctor and explaining the effect on your life as you have done here. Taking in a written note of all the symptoms may help. Hormones can lead to broken sleep, however, even if not temperature related, so may be worth looking into?

  • Sleepio Member

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    ANYTHING is worth looking into at this point!

  • Sleepio Member

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    Expert

    Hi – it's a completely personal decision for each and every person as to how long we persevere with a technique. Having a break from SR can sometimes disrupt things a little, so this may be why there were more wakenings. If anyone does wish to pause the programme, the best way to do this is to email hello@sleepio.com and let someone know about the request.

  • Sleepio Member

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    I think I had more awakenings simply since I had more time in bed to allow for more, but I don't know.

    I may email the team. In my session with The Prof he offered me he option to change my sleep window, and, out of desperation, I put in something much much longer, which doesn't make much sense, as far as CBTi goes.

    I keep thinking “maybe one more week and something will happen” but there are just no signs of improvement. I am so torn, but my mental health is really declining.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    I would advise anyone whose mental health is declining to speak to their GP and explore all options. They also may be able to advise whether pausing the programme is in your best interest as they know more about your medical and psychological history.

  • Sleepio Member

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    That is surely reasonable advice, and I will do my best. It is very, very difficult for me to get medical care in the US, unfortunately, so this is not as easy as it seems.
    And perhaps that is the answer to my question: knowing the the SR is causing this decline in my mental health, and knowing it will be a long time before I can see a doctor, perhaps pausing it is the best course of action.

  • Sleepio Member

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    Expert

    If you feel that it is risky to drive and that your mental health is declining due to SR, it makes sense to pause this and see if it helps. SR is not going to be for everyone. You need to ensure you are safe first and foremost. It is frustrating that medical care is more tricky to access – perhaps a pharmacist may be easier to gain advice from more quickly.

  • Sleepio Member

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    Thank you for your time. It's helps to have my suspicions about the best immediate course of action validated. As hard as SR is, it also feels hard to pause it!

  • Sleepio Member

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    Expert

    That's all for this session. Thanks for the posts and I will speak to you again soon.

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