Live discussion with Dr Vicki Creanor - 13th August

Dr Creanor will be hosting a live online discussion here on Wednesday 13th August, 8.15pm-9.45pm.

She will discuss as many topics as possible in the hour and a half, starting with the most popular questions with answers being given in a way to give the most benefit to the general Community.

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+ post a question or comment ahead of the discussion, by clicking the blue ‘Add a comment’ button; or
+ vote on other people’s questions, by clicking the blue ‘Yes’ button underneath the relevant comment.

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Posted 7 Aug 2014 at 11:08 AM
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  • Sleepio Member

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    Expert

    Hi there Pei this is a great question, thank you. People are often baffled as to why they suddenly can't sleep and develop a sleep problem. Triggers can be anything from jetlag (this can definitely be a factor) to a few warm nights that cause a few bad nights' sleep. The key is to how we interpret this. If we write it off as bad luck and believe we'll get back on track naturally, we can usually throw it off. However, thinking about it a lot and worrying about now having a 'sleep problem' can really make things lead to a more pronounced difficulty. Then bad habits creep in and can make things worse. It's complex, but jetlag can be a trigger, yes. If you think about it, jetlag really throws our sleep pattern and body clock way off, as out time zones are so messed up and we quickly are forced to adapt.

    Thanks for your question hope that helps.

  • Sleepio Member

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    Expert

    Hi machado3. Well done with your progress so far. When you hit 90% efficiency, add on 15 minutes. It's up to you whether you add it to the start of the night or the morning end. Most people prefer to go to bed earlier as they start to struggle to stay awake and have to be up at certain times for work. Hope this helps.

  • Sleepio Member

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    Expert

    Hi correagabriel thanks for your post. There is a great article written by my colleague, Dr Simon Kyle, under 'sleep basics' which I believe answers your question very well. In case you can't find it, I have copied it here…I hope this helps – it's a very comprehensive explanation of what you ask:

    We actually have the deepest part of our sleep during the first third of the night, and there is a more rapid transition into deep sleep during this period. This is the phase of sleep where we are the least likely to wake-up from, in other words, our ‘arousal threshold’ is at its highest. Non-REM Stage 3 and Stage 4 together make up deep sleep, sometimes called slow-wave sleep, because electroencephalography (EEG) reveals higher amplitude waves occurring at much lower frequencies. Deep sleep is a form of synchronised sleep because the brain’s electrical activity settles to a harmonised rhythm.

    Deep sleep is known to be related to the amount of prior time spent awake (sleep pressure). For example, if one naps during the late afternoon for a prolonged period, the time spent in slow-wave sleep (SWS) during the subsequent night is reduced. Similarly, if one is sleep-deprived for 36 hours, then during subsequent sleep the amount of time spent in SWS is increased (as reward for the accumulated sleep debt). Sleep is therefore ‘homeostatic’. In addition to minutes of time spent in deep-sleep, it is also possible to measure the intensity of deep sleep through looking at the power of slow-waves, measured as slow-wave activity. Both slow-wave sleep minutes and slow-wave activity have been found to decrease markedly with age. On average, females have more SWS than men, though there are great individual differences in the duration of SWS.

    Slow-wave sleep has most often been associated with memory consolidation, next-day learning ability and vigilance. Emerging work also suggests that SWS suppression in healthy adults leads to reduced insulin sensitivity, highlighting a potential link between SWS disturbance and increased risk of diabetes. Sleep and psychiatric disorders, including insomnia, have been associated with reductions in SWS. Night-time stress, pre-sleep, has also been found to be associated with reduced SWS once asleep. Indeed, the expression of SWS is associated with low levels of the stress hormone cortisol, as well as reductions in sympathetic nervous system activity and increased parasympathetic nervous system activity. The emerging picture from experimental research is that SWS is involved in critical aspects of cognition and daytime functioning, and that it assists in the optimum maintenance of many brain and bodily functions.

  • Sleepio Member

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    Expert

    Hi there – hopefully the previous answers have helped, rvbseattle.

  • Sleepio Member

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    Hi RichardB – with any medication it's important to discuss this, as you have done, with your medical doctor. I know many people who have stopped medication and have found help through cognitive behavioural therapy (on which sleepio is based), so it can be done. As long as you speak to your doctor about how to wean yourself off it properly to stay safe.

  • Sleepio Member

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    Expert

    Hi sleepymountain – thanks for your patience in me getting to your question. I have had a look at the library to see if there are any articles which may be of help in answering this question, however I can't see one that fits at the moment. It is not something I am familiar with in terms of this scale you are referring to; my work has always been in a clinical outpatient setting rather than sleep studies so this is what I know most about. I'm sorry I can't help in this instance, however what I would suggest is asking this question again as some of the sleep experts will have been involved in sleep studies like the one you talk about and may be familiar with this scale.

    Sorry not to be able to answer this for you – I hope one of my colleagues can soon.

  • Sleepio Member

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    Graduate

    Yes – I now understand that changing the window relates to my target sleep efficiency (as a practical matter, though, the website doesn't seem to let me adjust the length of the window – just the placement). But thanks for clarifying that I can extend the window if I feel my sleep efficiency is progressing.

  • Sleepio Member

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    Expert

    Hi Isabelleke67 thanks for your post. Yes I would recommend talking to your gynaecologist any time you feel you should. In my opinion it's always important to check out health concerns whether we are on other programmes or not, but it sounds as if you have had input from them in the past so they probably know you well and can suggest what might help.

    Also, remember that 2 weeks isn't very long to see changes in sleep – just make sure your expectations are realistic so you don't worry too much about slower progress – it takes time to unlearn old sleep habits.

    All the best.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    No problem. Thanks for checking. I appreciate it!

  • Sleepio Member

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    Graduate

    Yes you are right. You can't add the 15 minutes without the prof's okay, unless you do it without actually having an adjustment made in your online file. The 15 minutes is usually offered after a weekly average of 90%.
    anniem

  • Sleepio Member

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    Expert

    Hi again, Isabelleke67. There will be lots of techniques you learn throughout the Sleepio programme over the next few weeks. These will teach you exactly what to do with regards to naps – we recommend that these are cut out completely in order to make sure that the sleep in your bed is of a high quality. Your question will be answered by the next week or so of techniques where you will be taught, step by step, how to target the problem you're asking.

    All the best.

  • Sleepio Member

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    Graduate

    Thanks, anniem, very helpful. My efficiency isn't going up much but I think if I extend the window I'll get some solid sleep later in the night – and efficiency might actually go up.

  • Sleepio Member

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    Hi Jas44 – yes, safety is definitely a priority for you and your family. Absolutely. You can always postpone the sleepio programme to a time that suits better and that will not compromise safety. Thanks for your question – a very important one!!

  • Sleepio Member

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    Graduate

    ps I can't believe I'll ever get to 90% – but as long as I'm getting enough hours, I'll be happy.

  • Sleepio Member

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    Expert

    Hi rvbseattle, it's important to only extend the window if you have seen the efficiency rise to 90% – if you increase it without this rise, you may find that you take a backward step in terms of more time in bed but more wakefulness, hence reducing efficiency.

  • Sleepio Member

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    Expert

    You're welcome – I hope someone can help you on this.

  • Sleepio Member

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    Graduate

    Hmm – my efficiency seems to be stuck: I feel that if I don't force myself to wake up and get out of bed the last sleep of the night will add a couple of hours – with no more waking time – and so the efficiency will actually go up. If I get 4-30 out of 6 hours in bed (75% efficiency) but waking with an alarm I might get 6 hours out of 7-30 in bed (80% efficiency).

  • Sleepio Member

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    Expert

    I understand it's frustrating and I see what you mean, however it's worked out like this based on evidence of how sleep works for most people. I would recommend sticking by the programme – you may see a plateau in efficiency but doing all the other techniques alongside restriction will eventually increase this.

    Hope this makes sense.

  • Sleepio Member

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    Expert

    Thanks for joining me today/tonight – lots of great questions. See you next time.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Thanks. I'll work on it!

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