Live discussion with Dr Vicki Creanor - 16th May 2018

Dr Creanor will be hosting a live online discussion here on Wednesday 16th May, from 8:15 to 9:45pm British Time or 3:15 to 5:45pm 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.

Please do note that, as per our guidelines, Dr Creanor will not be able to give personal medical advice, including that concerning 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. 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.

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Posted 10 May 2018 at 5:18 PM
  • 17 comments
  • 1 helped

Comments

  • Sleepio Member

    • 5 comments
    • 1 helped
    Graduate

    Is it common to feel worse with this program than you ever have? I am in the middle of week 5 and I feel terrible. The sleep restriction is making it so I can't drive, read or watch a movie without falling asleep during the day. I am barely coping and not sure how much of this I can endure before I see some positive results.

  • Sleepio Member

    • 2 comments
    • 0 helped
    Graduate

    I find myself waking up before my alarm every single weekday no matter how long I plan to sleep. I have a few questions regarding that:

    1. I've been advised not to check the clock when I wake up, but I'm not sure it's helping. When I wake up I know it's close to my waking time (usually one hour or so) but not by how much, so I'm “watching the clock” in my head anyway waiting for the alarm to go off, so I rarely get back to sleep. What should I do?

    2. The days I do check the clock, I've found that I wake up the earliest the days I have the least time to sleep. How can this be possible?

    I must add I am going through some anxiety disorder issues. The doctor gave me sleeping pills that were supposed to prolong my sleeping time, but I don't feel like they're doing much.

    Thank you very much,
    Elena

  • Sleepio Member

    • 1 comments
    • 0 helped
    Graduate

    Hi i’m at week 5 of the programme and making progress but still don’t feel confident about my sleep – how best to boos this more..?

  • Sleepio Member

    • 2 comments
    • 0 helped
    Graduate

    What is the best way to handle waking up after 4hrs of sleep feeling confused/anxious? Thanks!

  • Sleepio Member

    • 2 comments
    • 0 helped
    in reply to Sleepio Member
    Graduate

    Wanted to add, but there's no edit functionality: also waking up with a racing mind making it ~impossible to fall back asleep for hours.

  • Sleepio Member

    • 3 comments
    • 0 helped
    Session 5

    My nightly sleep goes through a cyclic pattern: one night I would get high quality sleep, and wake up rested; the next night, I won't have as much sleep drive, and wake up tired.
    This pattern always starts with the first day of working week, and has been going on for many weeks now.

    I've been following sleepio program for five weeks, and practicing restricted sleep window, but unable to break that pattern.

    Would you have any suggestions for me?

  • Sleepio Member

    • 3 comments
    • 0 helped
    Session 5

    My sleep cycle/bedtime routine was disturbed in the beginning of April (forced bedtime routine going to bed earlier than my norm, no relaxation of any sort). I developed a sensitivity to noise at the same time. We have tried 3 different sleeping pills eg zolpidem, but only got 2-3 hrs sleep from them, so we stopped after 4 nights for each pills. Prior to this I always woke up at 2 am, but managed to go back to sleep with Atarax, but since my insomnia got triggered by something in April this doesn't work. Even with sleeping pills I woke at 2am, without them I only sleep max 1 hr between 12-2, then up until dawn 4/5/6 am and then I could sleep but I have to get up 7am the latest because of my son and once I am back at work because of that. Basically only getting 1hr or nothing at night, then 1-2 hrs before I have to get up. If I didn't have any commitments eg my son or work it looks like I could sleep or rest longer in the morning (almost like night shift worker pattern). It's been too long and my body as getting weaker by the day, my limbs are aching and weak, I can't do much until lunchtime and need to rest (not sleep, just rest my body), walking is difficult. By 2-3pm I have more energy and can go for a walk or do something. This is my 3rd week signed off work and worried without any help I will lose my job, my son will lose our childminder as we won't be able to pay her if I lose my job, it's having a huge impact on our family. Everybody says different things about how my sleep could be improved, but nothing worked so far, main worry that my sleep cycle has got worse in the past week or so, comparing to beginning of April when the insomnia was triggered. Sleep Clinic or psychiatrist I won't see for weeks or months, because of the slow nhs and not sure what I can do to help. I have been falling asleep on tv since I was a little girl and it had never failed, I dosed off, switched it off and slept until the morning. They advise me to change my bedtime routine to the usual sleep hygiene which I don't believe would work in my case as it did not for 30+ years and in April that is exactly what triggered the insomnia.
    Question: how can I break the cycle of sleep (between 1-2am then 4/5/6 to 6/7/8 am.? I get in total 2/3 hrs sleep which is not even a block of 2/3 hrs.

  • Sleepio Member

    • 2510 comments
    • 383 helped
    Expert

    Hi everyone and welcome to the live Sleepio session. I'll start answering the posts already left but if anyone else has any questions, please join us! Let's get started…

  • Sleepio Member

    • 2510 comments
    • 383 helped
    in reply to Sleepio Member
    Expert

    Hi and thanks for getting in touch. Sorry to hear you're finding things difficult just now. It is pretty common to feel more tired for a time at the start of the programme because patterns are changing and you're trying to alter various aspects of sleep. Alongside lots of changes, there is the sleep restriction, which is often very tricky at the start, despite the long-term benefits. So yes – it is fairly normal to feel this way.

    You mentioned driving – what we would always say is that, if people are really struggling with the sleep restriction and having to drive, please put safety first. Although naps are not recommended, sometimes if long car journeys are unavoidable, short naps may be neccessary.

  • Sleepio Member

    • 2510 comments
    • 383 helped
    in reply to Sleepio Member
    Expert

    Hi and thanks for getting in touch. Sorry to hear you're finding things difficult just now. It is pretty common to feel more tired for a time at the start of the programme because patterns are changing and you're trying to alter various aspects of sleep. Alongside lots of changes, there is the sleep restriction, which is often very tricky at the start, despite the long-term benefits. So yes – it is fairly normal to feel this way.

    You mentioned driving – what we would always say is that, if people are really struggling with the sleep restriction and having to drive, please put safety first. Although naps are not recommended, sometimes if long car journeys are unavoidable, short naps may be neccessary.

  • Sleepio Member

    • 2510 comments
    • 383 helped
    in reply to Sleepio Member
    Expert

    Hi there,
    Thanks for getting in touch. What you describe is early morning wakening and it is, in fact, a very common symptom of anxiety disorders, so it's interesting you mentioned this as being part of the ongoing context. In terms of what to do here, it is recommended that people in this situation use the quarter hour rule – if approx 15 mins has passed and you're still awake, get out of bed and sit somewhere else until you feel sleepy. If the time for the alarm comes before then, refrain from climbing back into bed as it helps to stick to a single wake time. For some people, shifting the bedtime earlier to compensate for early wakening may help but if people do this, it should be made the new consistent bedtime each night, rather than moving it around. However, often therapy for anxiety helps to reduce early morning wakening, so this may be worth looking into…

  • Sleepio Member

    • 2510 comments
    • 383 helped
    in reply to Sleepio Member
    Expert

    Hi there thanks for your question. Confidence is something that tends to come with a mixture of good experiences as evidence and positive thinking. It may be helpful to note down how you used to feel about your sleep and how it used to look, compared to how you feel about it now and how it looks now. Basically, noting down the positive changes you have noticed. Sometimes when positive change is gradual, we miss it, so making notes of it may force you to think about it a bit more. Some people find it helpful to then post these notes of change on their fridge, in their diaries, in their cars etc to remind themselves of how much they have improved. And with this, we can build on our belief systems and, ultimately, our confidence.

  • Sleepio Member

    • 2510 comments
    • 383 helped
    in reply to Sleepio Member
    Expert

    Thanks for your question. When we wake suddenly with a racing mind, it's usually due to an underlying anxiety – perhaps triggered by a dream. It is worth thinking about anything that is making us anxious to see if we can work on this. If it means it is hard to get back to sleep at this point, I would be advising anyone in this situation to implement the quarter hour rule – getting out of bed after 15 mins of trying to get back to sleep and sitting somewhere other than the bedroom until feeling sleepy again. If waking in an anxious state, doing some relaxation or slow breathing or imagining a relaxing place can help the body settle enough to feel sleepy again. Avoid eating/drinking/activities that are stimulating (including watching TV) at this point as it may wake up the body too much and sleep will not be as easy to achieve again. Relaxation before bed may also help and pre-bed anxieties that may carry over into the night.

  • Sleepio Member

    • 2510 comments
    • 383 helped
    in reply to Sleepio Member
    Expert

    We see this pattern mentioned quite often in the live session so you're not alone here! It may be what's happening is that, after someone has had this pattern for a while and noticed it, they may start keeping the cycle going subconsciously…after a good night's sleep, they automatically think “well – tonight won't be great then!” ...leading to increased anxiety and thus poorer sleep. It may help those in this situation to look at their thoughts and see if this occurs and, if so, challenge these thoughts. Trying thoughts such as “well I know I can sleep well – I did it last night!” instead man break the pattern. But the other thing is, 5 weeks is still early days to reverse sleep patterns – they can take a while to change, so being compassionate with oneself and knowing that progress will be made, even if it slower than we want, can be important.

  • Sleepio Member

    • 2510 comments
    • 383 helped
    in reply to Sleepio Member
    Expert

    Hi there and thanks for getting in touch. It certainly seems as if this is a difficult time for you just now. I am unclear if what triggered the sleep problem was the fact you started going to bed earlier and had a set bedtime routine or whether there was something else difficult going on that made this necessary? Either way, it may be helpful to ask your doctor for some support here too given the sleep deprivation sounds quite severe, causing pain. I am aware that NHS wait times are long for certain services, but the GP may be able to help in some way if there are physical symptoms there. You also express a great deal of worry, which may be important to tell them about.

    I will say that, at the start of the Sleepio course, it is common to feel overwhelmed. Many people join Sleepio when they are really struggling. Over the next few weeks you will be shown various techniques that help target different aspects of poor sleep – including those you mention. Taking these one by one often helps people feel more in control of their sleep and of their lives. But if people are feeling very overwhelmed, it may also be important to get support from local health professionals alongside these techniques.

  • Sleepio Member

    • 2510 comments
    • 383 helped
    Expert

    It's rather quiet tonight – still 15 mins left of this session if anyone has any more questions?

  • Sleepio Member

    • 2510 comments
    • 383 helped
    Expert

    That's all for this evening's session. Thanks for the questions and speak to you again soon.

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