Live Discussion with Dr Vicki Creanor - 11th September 2019

Dr Creanor will be hosting a live online discussion here on Wednesday 11th September, from 8.15pm to 9.45pm British Time or 3.15pm to 4.45pm 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 5 Sep 2019 at 3:59 PM
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  • Sleepio Member

    • 14 comments
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    Graduate

    PS: I do not take medication or use any sleep aids. I am not under the doctor for any other issues. My health is otherwise excellent.

  • Sleepio Member

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    Graduate

    My issue is awakenings, I have a 7hour SW and I get over 90% SE so as the weeks go I will be offered the additional 15 minutes which will be much appreciated as the alarm always wakes me up. However not once have I slept through the night, so would you suggest I do not take the additional 15 minutes when it is next offered

  • Sleepio Member

    • 7 comments
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    Graduate

    Hello Dr.Creanor,
    I graduated Sleepio two weeks ago and am still maintaining over 80% SE with occasional over 90% so I am very pleased with how well Sleepio has worked for me. Now that my sleep has improved I realise that I am dreaming at night and remembering my dreams in the morning. This has not been the case for years. I wonder if there is any research to show that dreaming improves with better quality sleep. I'd be interested in your views.Thank you.

  • Sleepio Member

    • 22 comments
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    Graduate

    Hi Dr., My sleep has not been going well – only until about 2:30 am each night, and that is all. I am working hard on this.
    But, on top of my already poor sleep, we will be going out of the country soon and the times will be turned upside down. Your advice of how to deal with this is greatly appreciated.
    Thank you!

  • Sleepio Member

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    Expert

    Good evening and welcome to tonight's live discussion session. I'll be here for the next hour and a half to talk about all things sleep in a manner that will be as helpful to the wider Sleepio community as possible. Let's get started…

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi and thanks for getting in touch. Sorry to hear you're still struggling after a block of 4-5 hours' sleep. I wonder if factors during the day have been looked at at all. For instance, we know that those who engage in regular exercise during daytime can often sleep for longer at night. We also know that caffeine and alcohol also have an impact on how well we stay asleep. I also wonder if naps are taking place at all? If so, these can have an impact on how long we stay awake for. Other factors such as low mood/anxiety should also be considered as they can contribute to early wakenings/poor ability to stay asleep – I wonder if any of these are at play and worth exploring?

  • Sleepio Member

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    Expert

    Sorry – forgot to reply to the last part of your question. As far as I know there is not a huge deal of research in the field of biaural beats in terms of the health benefits – much of the evidence is anecdotal, so I can't comment on this as yet. My belief is that anything anyone finds relaxing is beneficial for health, so of this is your experience, it sounds positive.

  • Sleepio Member

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    Expert

    Hello there and thanks for your post. Sometimes challenging these negative thoughts is hard. We tend to aim for challenging the more irrational thoughts, or more inflexible thoughts when doing this type of exercise, and it can be hard sometimes to see where the challenge should be placed. We are hearing more and more about the evidence that sleep problems contribute to health issues, but I wonder if taking a step back from a black and white view of this would be helpful. For example, many of the studies will comment on the fact that there are other factors at play – that poor sleep is not the only factor that will cause a person to be unwell. Underlying health conditions, family history, stress, diet, levels of exercise, mental health and social elements will also play a part. So a counter thought might be “sleep is one of the many variables that can contribute to a person's ill health, but I am working on this and aiming to be healthy in other aspects of my life in order to maximise my health as best I can”.

  • Sleepio Member

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    Expert

    Hi there – it sounds as if you've been doing a lot of work on your sleep so far, so well done with this. There are different ways to approach all problems – CBT and ACT are quite different in their schools of thought so I suppose to answer your question, I need to suggest that you go with what is most preferable to you. For me, I have worked with CBT – within Sleepio and in my clinics – for sleep problems and have found this to be an effective approach. So my (CBT-focussed) suggestion to anyone with broken sleep would be the sleep restriction and quarter-hour rule options. The fact you are sticking to regular bedtimes, being careful with diet and exercise, using relaxation techniques and maintaining good sleep hygiene in terms of computer use are all positives. It just comes down to what approach you feel most comfortable following.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hello and thanks for raising this question at this time of year – I'm sure many others are considering their options about this, too.

    There are two ways to approach the clocks changing. Either you do it in one go, or grade it. The choice is yours, but people with sleep problems often do find it a less anxiety-provoking option to gradually alter the clocks for bedtime.

    You can do it as slowly as you like, many people like to do it over 6 days (10 mins per day), others do it for 15 mins over 4 days.

    Bear in mind that it will also be helpful if you alter other things along with bedtime/rise time to make the change meaningful – so alter mealtimes, morning/evening routines etc too.

  • Sleepio Member

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    Expert

    Hi – thank you for getting in touch.

    So the general rule is that we should aim to use our bed for sleep and only sleep (with the exception of sexual activity), so some may argue that we only read/listen to podcasts etc before we get into bed. Others feel more flexible around this. I tend to think that if someone is reading/listening to something in bed this is OK if it helps them relax into sleep…as long as sleep occurs within approx 15 mins. If it goes beyond this time, though, I do not think it is conducive to be engaging in this activity in bed.

    I'm unsure from what you say here about whether you are getting out of bed after being awake for 15 mins, or whether at times you are lying awake for hours? If the latter is the case, I would just remind you of the quarter hour rule technique; use of this helps build a positive association between bed and sleep.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Sorry to hear you're struggling. It sounds as if you are actually doing all the right things. Getting fresh air, going for walks is all very helpful. Using caffeine is fine as long as it's a little earlier in the day – usually stopping it around lunchtime is a good idea (advice varies on this!). Talking to people can also help as can finding a stimulating activity to become involved with. It's so hard to exercise when tired so well done for finding the motivation to do so.

    You say this is not the norm? Blips like this occur. I would also suggest getting a second opinion from another GP if you are not satisfied with this GP's advice.

  • Sleepio Member

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    Expert

    No such thing as a silly question! Others will almost always have asked – or wanted to ask- the same question! Going through the course again will never be counter-productive – in fact, some people feel it is beneficial as they can focus on certain aspects more the second time around once they know a little more about their sleep patterns/problems.

    I wonder if you have always simply felt more tired later in the night? This may not be a sleep problem per se – more a natural chronotypal characteristic. Many of us can say whether we are a 'morning lark' or a 'night owl' – this may be a more extreme case of being a night owl?

  • Sleepio Member

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    Expert

    PS this can be tackled by gradually altering the time you go to bed and ensuring that you get light/darkness and at the right times of day to help adjust to this change.

  • Sleepio Member

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    Expert

    Hi there thanks for your question. I see you are at session 4, so this is still early days for your sleep to be settling out and finding a new rhythm. I would suggest taking the 15 mins and waiting a little longer to see if your sleep settles into a pattern whereby you can sleep in a more solid block. Alongside this, ensure that caffeine and alcohol are reduced and perhaps try more strenuous exercise during the day if possible to see if this helps maintain sleep in a longer block. It's unlikely you'll be having naps but if this is happening, cutting them out can help maintain more solid sleep at night.

  • Sleepio Member

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    Expert

    Great question! And I wish I could answer it more fully, however I'm not aware of the research on this. What I would suggest, however, is that perhaps you are able to have more full cycles of sleep these days, now your sleep is of a better quality, which may mean you are entering into more REM (dream) sleep than you did before. Often our bodies take what sleep they need at that time – perhaps now sleep is in a better state for you, you are having more typical amounts of time in each sleep stage? Just a hypothesis…

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    This is always a difficult situation for those who are struggling with sleep. It depends how long you'll be in the other country for, but adjusting to the new time zone as quickly as possible is often helpful – sleeping and eating and getting sunlight when the locals do can help to get the body adjusted as much as possible. Using caffeine (in the morning) can help to wake up at a reasonable local time and getting fresh air and sunlight during the daytime hours is essential. If it would be helpful, the Sleepio programme can be paused for the duration of the trip – simply email the request to hello@sleepio.com if this is something you'd like to do.

  • Sleepio Member

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    Expert

    That's the session over for this week – thanks for all the posts/questions and I will speak to you again soon…

  • Sleepio Member

    • 22 comments
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    in reply to Sleepio Member
    Graduate

    Thank you for your help!

  • Sleepio Member

    • 17 comments
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    in reply to Sleepio Member
    Graduate

    Dr Vicki,
    There are some studies that seem to have demonstrated good benefits from binaural beats: See https://www.psychologytoday.com/gb/blog/sleep-newzzz/201810/how-can-binaural-beats-help-you-sleep-better
    This includes 70% showing a reduction in Cortisol and 97% an increase in Melatonin, along with some showing reductions in anxiety etc.
    What do you think of these?

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