Live Discussion with Dr Vicki Creanor - 15th January 2020

Dr Creanor will be hosting a live online discussion here on Wednesday 15th January, from 8.15pm to 9.45pm British Time or 3.15pm to 4.45pm 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 Creanor 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 9 Jan 2020 at 3:02 PM
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  • Sleepio Member

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    Expert

    Thanks for getting in touch. It may be that there is still some underlying anxiety/stress that is causing the early wakenings, or it could well be that your body has learned this pattern following a period of stress. Or it could be a combination! Relaxation is helpful to incorporate into one's daily routine to reduce overall anxiety but also to reduce it before bedtime. Activity levels will also influence the ability to stay asleep – if someone does a good amount of physical activity during the day, the body is more likely to need more sleep – and stay asleep. Make sure to avoid alcohol and caffeine after lunchtime to help maintain sleep through the night and use the quarter hour rule when you wake to ensure the bed is not becoming associated with stress.

  • Sleepio Member

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    Expert

    Hello and thanks for your question. It's good to hear you are experiencing some good nights. It will take time for the mind and body to adjust to any new regime and this is the same for sleep. As much as we want things to improve as quickly as possible, it is unrealistic for something such as sleep to get fully back on track in a short space of time. Recovery is typically a mix of good nights and poor nights but things often continue to improve when the techniques are maintained. Lifestyle factors will also have an impact so aiming to maintain healthy, pro-sleep habits is also important during recovery. It's good you're keeping a diary of the better nights as sometimes these are missed/dismissed. Keeping this diary is often helpful to remind yourself how far you have come and to maintain motivation.

  • Sleepio Member

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    Expert

    First of all, welcome to Sleepio! I hope you find the programme helpful. If you're unable to change it on the page, I would suggest getting in touch with the tech team at hello@sleepio.com to ask them if they can help?

  • Sleepio Member

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    Expert

    Hi there, sorry to hear you're struggling with this wakening. I wonder if you have implemented sleep restriction and the quarter hour rule?

  • Sleepio Member

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    Expert

    Hello – thanks for your post. There is an article within the library that you may find helpful. It is something that can be more common than you think:

    https://www.sleepio.com/articles/sleep-science/can-you-think-youre-awake-when-actually-youre-asle/

    Sometimes underlying anxiety can be causing this, so practising relaxation before bed (and throughout the day) may help. When you cover the quarter hour rule (getting out of bed if you believe you have been awake more than 15 mins), I would also say that, if you feel awake enough to make the decision to get out of bed, do this and this may help to break this cycle. It will also help to improve the association between bed and sleep, rather than strengthening the association between bed and this tricky 'in between' state.

  • Sleepio Member

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    Expert

    Thanks for getting in touch with this interesting question.

    When it comes to sleep, the body takes what it needs. If we are over tired or sleep deprived, the next time we go to sleep, it will likely go into deep sleep much quicker than usual and will take what deep sleep it has missed out on. If we have to wake up during deep sleep (due to an alarm), it will be difficult to rise from this state as our body becomes confused, thinking it should still be asleep – it is not naturally ready to wake. Thus, we feel groggy, as if we are almost hungover.

    Similarly, if we sleep too much, our bodies get confused again and do not understand why sleep is happening when it expected movement, daylight and fuel. It upsets our internal clocks and again, we feel terrible, as if we were jetlagged. Oversleeping is also linked to low mood, which also makes us feel sluggish and fatigued. So, if low mood is also at play, this could be having an effect too.

    Sticking to regular bedtimes and wake times can help, as well as avoiding napping – this can also upset the biological clock and disrupt bedtime sleep. Getting plenty of fresh air and exercise during the day and relaxation at night will also be beneficial to help the body distinguish daytime from nighttime.

  • Sleepio Member

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    Expert

    Hi there – thanks for your question on this. It is common for people to fall asleep where the carry out the quarter hour rule period – they are usually exhausted and the place they are sitting is often made comfy so it's easier to go to during the night. However, it is recommended that, when you feel sleepy again, you return to bed. You want to avoid sleeping anywhere else other than bed, as this will weaken the bed-sleep association. If there are only 15 mins before you need to wake up, you may not wish to go back to bed, however even if there are only 30 mins left before rise time, I would still recommend heading back to bed.

  • Sleepio Member

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    Expert

    Hello – thanks for raising this as it's a very common occurrence and I'm sure many people will recognise this within themselves.

    It tends to be due to the fact that a negative association has built up over time between bed and sleep due to a period of poor sleep. The body starts to learn that the bed is associated, instead, with tossing and turning, restlessness and wakefulness. So, when we approach bed after this association has developed, we start to feel anxious (even if this is outwith consciousness) and our minds become alert to the perceived 'threat' of bed.

    The quarter hour rule is designed to combat this and force any wakeful time out of the bedroom, to another space. And, over time, the bed-sleep connection can be rebuilt with a positive association.

    Hope that helps.

  • Sleepio Member

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    Expert

    Thanks for getting in touch. First of all, this sounds like a very positive step in that the wakenings are no longer lasting as long as they used to. I can understand that it is frustrating that the wakenings still occur – it sounds as if this is the body still adjusting to a new pattern and recovering from the old one. Often sleep recovery takes a while – old habits need to be unlearned and new ones need to be consolidated. By maintaining the techniques you have learned, it is likely that, over time, this will continue to improve. The other thing I would say is that good sleepers usually wake twice a night – what is important is that one can get back to sleep fairly quickly after these wakenings.

    Sleep restriction is exhausting. Caffeine, although not recommended after lunchtime, can be used in the morning to help waken up, as can getting fresh air soon after wakening. Light exercise can also help to feel more refreshed during the day.

  • Sleepio Member

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    Expert

    Hello and welcome to Sleepio. It sounds as if this broken pattern of sleep is one of the main difficulties for you. You may have heard people talking about a technique known as sleep restriction during this evening's session. This is something that helps people who have quite a fragmented sleep profile. It is designed to squeeze all the bits of broken sleep into one longer chunk. You will come across this in the next few weeks within the programme, but in the meantime, it sounds as if you are doing many helpful things to help your sleep and I hope that Sleepio can add to these in the coming sessions by introducing you to techniques such as relaxation and tips to optimise your sleep as much as possible.

  • Sleepio Member

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    Graduate

    Thank you for your reply. How does sleep restriction work?

  • Sleepio Member

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    Expert

    Hi and thanks for your question this evening. If you are keen to wean off this technique, I wonder if you could start by thinking it through yourself (without the use of the audio itself – if it's used every night it is likely you know it well?) – it won't matter if you don't recall it all – just the jist of it. Then you could gradually shorten it as you see fit – until you're left with the part you like the most (or even the very last part before you usually fall asleep). The other thing to contemplate is whether doing this audio every night is actually a problem. If it helps you fall asleep, it may not be something you need/wish to wean off at all? Many of us have things that can help us fall asleep after a wakening. The main thing is that you can get back to sleep quickly after waking up through the night.

  • Sleepio Member

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    Expert

    It adds pressure to your need for sleep, so typically you work out (on average) how much time you have actually been sleeping each night and then reduce your sleep time to this per night. It usually means you go to bed for less time initially and the increased sleep pressure that builds as bedtime approaches helps you sleep better – in more of a solid chunk. As time progresses and sleep becomes less fragmented, the sleep time can be increased gradually, until a longer chunk is achieved.

  • Sleepio Member

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    Graduate

    To David G. From my point of view, I would worry about weaning off sleep medications which have many side effects. But the audio is not a medication and, possibly, the only side effect is a benefit to your body. Why not continue to use it?

  • Sleepio Member

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    Graduate

    Does it matter if I reduce the sleep at the beginning or the end of the night?

  • Sleepio Member

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    Graduate

    Does it matter if I reduce the sleep at the beginning or the end of the night?

  • Sleepio Member

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    Expert

    Hi there – you will not be expected to do this until you have reached this point in the course, where it will all be explained to you to help you implement it properly. But when you come to this, you can sleep at any time you choose, as long as it is consistent each night.

  • Sleepio Member

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    Expert

    That's all for this evening's session – thank you for all the questions and posts! Speak to you again soon.

  • Sleepio Member

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    Graduate

    Thank you

  • Sleepio Member

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    Session 1

    Thanks for the reply, unfortunately I wasn't able to attend the session 'live' but I'll add this comment for completeness:

    My point was really, if you ARE experiencing side effects from medication (starting or otherwise) then perhaps this would derail the progress of the Sleepio course.

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