Live discussion with Dr Vicki Creanor - 18th May 2016

Dr Creanor will be hosting a live online discussion here on Wednesday 18th May, from 8:15pm until 9.45pm BST.

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. 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 12 May 2016 at 10:10 AM
  • 24 comments
  • 8 helped

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  • Sleepio Member

    • 1 comments
    • 1 helped
    Graduate

    I fall asleep fine but wake up in the middle of the night and am usually unable to fall back asleep. I tried deep breathing, being present in my body, counting backwards, and my brain just won't drift off. What ACTUALLY works?? Please, I'm super miserable :(

  • Sleepio Member

    • 11 comments
    • 4 helped
    Graduate

    Hi Dr Creanor,
    I graduated the course over a month a go and I believe my sleep has got worse. I have improved greatly on managing my thoughts (especially 'putting the day to rest') and the other techniques but I feel like that may have made me extra sensitive to things keeping me up. I do have a fear of not sleeping, which I am working on, but I am very scared I have nothing left that can work for me as most nights I fall asleep between 3 and 5 am and then have a poor quality sleep for approximately 3 hours. Is there anything else I can do to combat this, especially the fear of not sleeping and the emotional and physical exhaustion while I'm awake? I'd appreciate even the most obscure idea. Thank you.

  • Sleepio Member

    • 1 comments
    • 1 helped
    Session 3

    Hi Dr. Creanor,
    I just started my first week on the Sleepio Program. I hear that CBT is the best therapy for insomnia but I fear that it takes a long time to see results and I'm desperate for a solid night of continuous deep and restorative sleep hopefully without the use of OTC pills. I was diagnosed several months ago with Severe Obstructive Sleep Apnea and have been struggling to get used to a Cpap machine.I have little trouble falling asleep first thing at night. However when I awaken at night to go to the bathroom I finally give up without putting the machine back on because of air escaping and an uncomfortable fit.I'm concerned that the C-Pap to help my Sleep Apnea would be fighting with use of any CBT techniques I would need to implement from Sleepio. Can the Sleepio Program be successfully implemented at the same time as C-Pap therapy and can the two programs be complementary to one another? C-Pap might be enabling my Insomnia.

    Also is awakening at night and then dozing on and off and in and out of restless light sleep for 3 1/2 hrs considered to be awakenings or going back to sleep for purposes of sleep diary entries.

  • Sleepio Member

    • 13 comments
    • 0 helped
    Graduate

    Hello Dr Creanor.
    I am 3 months post Graduation and have just completed the questionnaire, getting a result of 7.5 and 'Good'. The most valuable thing I have learned from the Sleepio Course is that when I have a disturbed night it is because of troubling thoughts or even exciting happy ones. I have yet to find the best way of controlling these thoughts and realise that 'taming the mind' is difficult. So like Luke above, any additional ideas would be welcome, please. Thanks.

  • Sleepio Member

    • 1323 comments
    • 214 helped
    Expert

    Hi and welcome to the live Sleepio session. I'll be here for the next 90 mins to answer questions on sleep and the psychology behind it as well as the Sleepio techniques. Let's begin!

  • Sleepio Member

    • 1323 comments
    • 214 helped
    in reply to Sleepio Member
    Expert

    HI there,
    It sounds as if you have identified the underlying issue as anxiety-based. if this is the case, we would recommend that people look at this as well as their sleep. The Sleepio techniques can also help anxiety – for instance, the relaxation techniques done throughout the day when anxious but also nearer bedtime. Challenging the negative thoughts is also important to get to the thoughts that are underlying the anxiety – all emotions and behaviours and physical feelings associated with anxiety are driven by the anxious thoughts, so getting these under control is important.

  • Sleepio Member

    • 1323 comments
    • 214 helped
    in reply to Sleepio Member
    Expert

    Hi there,
    It sounds as if you were getting on top of the sleep problem, and then hit a stressful time, which set it off track again. When good sleepers hit times of distress, they often go through periods of poor sleep but the difference is, most of them acknowledge that this is just temporary, which helps their sleep get back on track again. It is possible to get your sleep back on track again as you already had done. It's important to see this as a blip that can be managed, rather than getting frustrated and worried that this is back to square one. It's probably not back to square one, even though it feels like it to those who have hit blips. So, thinking about blips as just blips is a good start. Dealing with the issue at hand is also important as life events will impact on sleep and they need dealt with so that the impact can be contained. Again, like I'd mentioned earlier, challenge the negative thoughts and use more balanced thoughts that help you to be compassionate to yourself and to tell yourself that you will get through this and get your sleep back on track again. Using the relaxation techniques can also help and making sure, despite family chaos, that regular bedtime routines are stuck to and regular sleep windows are too.

  • Sleepio Member

    • 1323 comments
    • 214 helped
    in reply to Sleepio Member
    Expert

    Hi there,
    We're asked this question a lot so it's common to have this query. There's no straight forward answer, however – people do the course with medication and without. Some stay on full meds during the course while some taper them off.

    What is important is that anyone in this situation considering reducing their meds speaks to their medical doctor/pharmacist (whomever prescribed the meds) to let them know they are on the Sleepio course and to discuss the options of reducing meds. This must be done with medical advice as it can be dangerous to do it alone.

  • Sleepio Member

    • 1323 comments
    • 214 helped
    in reply to Sleepio Member
    Expert

    Hi there,
    Thanks for your post. Continuous Positive Airway Pressure (CPAP) machines have been known to be effective in helping with the symptoms of apnoea, however it's not an intervention I work with as I work with the psychology of sleep as opposed to the medical side of things. My guess would be, like any treatments, that the length of time you require it will vary from person to person and that this will be monitored by health professionals with whom you will be working.

  • Sleepio Member

    • 9 comments
    • 2 helped
    Graduate

    Hello Dr. Creanor,
    I am in my second session with the Sleepio Program.
    During the night I wake up several times, and
    generally check the time I do wake up. What is the
    recommendation in regard to this? Would it be better
    not to check the time?

    Thank-you.

  • Sleepio Member

    • 9 comments
    • 0 helped
    Graduate

    I finished one round of the course, which has helped somewhat. Problem with panic episodes in the early hours (5-7 AM) that wake me up persist. This leaves me fatigued and almost non-functional the next day. Otherwise sleep pattern appears relatively uneventful, aside for light and insufficient sleep (<5 hrs). Been working with my doctor trying to control this pesky issue, but so far with no success. Any thoughts on this?

  • Sleepio Member

    • 1323 comments
    • 214 helped
    in reply to Sleepio Member
    Expert

    Hi there,
    I see from your details that you are in session 2 of the course, so you won't have come across all the techniques quite yet. The good news is that you will learn other ways of reducing night time wakenings to help this problem. When one wakes in the middle of the night, it's important to get out of bed after approx 15 mins of trying to get back to sleep (you will soon come across this 'quarter hour rule'!) but in the lead up to bed, look at challenging your thoughts and focussing on relaxation in case it's anxiety that wakes you up in the night. When you are out of bed after the quarter hour rule, you can continue relaxation techniques to help get back to feeling sleepy before returning to bed. Regular bedtime routines quite often help night time wakenings associated with anxiety as do keeping a comfortable bedroom environment, to prevent waking due to heat/noise/light etc.

  • Sleepio Member

    • 1323 comments
    • 214 helped
    in reply to Sleepio Member
    Expert

    Hi there,
    Yes, tempting as it is to have a clock by your bedside to check the time when you're awake, it's best not to have a clock near you and to only guess how long you are awake for. if you're up (for the quarter hour rule that you will come across ini the course soon), you can look at clocks then but try to avoid staring at clocks in the bedroom. For the same reason, it's best to keep phones out of reach as they are also tempting to check, then the light coming off them wakes us up even more. The reason we advise against clock checking in the bedroom is because of the anxiety is causes within us if we constantly time-check. Hope that helps.

  • Sleepio Member

    • 1323 comments
    • 214 helped
    in reply to Sleepio Member
    Expert

    Hi there,
    If there is an underlying anxiety/panic disorder there, it's a good idea to do as you are doing and tackle this alongside the sleep work. Sounds as if you are talking to your doctor about this. In terms of sleep treatment-wise, those who wake early in the morning should implement the quarter hour rule if their sleep window is not yet over. Again, regularity and consistency are key in reducing events such as this – regular bedtimes and bedtime routines tend to help this problem as well as the relaxation techniques you will have covered.

  • Sleepio Member

    • 1323 comments
    • 214 helped
    in reply to Sleepio Member
    Expert

    Hi there,
    Although this sounds quite basic and common sense-like, I often recommend those in similar positions to yourself that they take a bit of pressure off themselves (because this usually maintains the anxiety around sleep) and then start the course again using the techniques one by one, going through them all one at a time again. Sometimes when graduates reach a blip, they get stressed and use everything they have learned at once and get overwhelmed by things. So, by taking it one step at a time again and consolidating the techniques in their own right, people often feel more in control again. Might be worth a shot? In terms of emotional and physical exhaustion, regular exercise is actually very helpful in boosting mood and exhaustion (although is sounds counter intuitive, exercise does help exhaustion). Avoiding alcohol and eating well is also important basic advice to help deal with the emotional and physical side of things.

  • Sleepio Member

    • 1323 comments
    • 214 helped
    in reply to Sleepio Member
    Expert

    Hi there,
    Would it be OK if I checked this out with the rest of the team? Sleep apnoea and insomnia do require separate treatments as you are aware and are receiving, however I would like to check the advice about doing the course while using the CPAP machine. Will get back to you!

    As for wakenings and light sleep thereafter, this is very subjective and depends if you think you are asleep (regardless of depth of sleep)...if you believe you have been asleep after a wakening, record it as sleep.

  • Sleepio Member

    • 1323 comments
    • 214 helped
    in reply to Sleepio Member
    Expert

    As well as the ideas talked about tonight (challenging our thoughts, relaxation, worry time during the day, putting the day to rest), some people like the 'the the' technique (not a typo!)...basically when you have intruding thoughts, you say the word 'the' (or any other neutral word or number) over and over to focus on that and block out thoughts. Paradoxical intention can also be very effective, repeating to yourself “don't fall asleep” as it takes the pressure of trying to fall asleep by saying the opposite, yet the brain only hears the “fall asleep” bit…and it can help to do just that.

  • Sleepio Member

    • 1323 comments
    • 214 helped
    Expert

    Only a few more minutes left of the session – any more questions?

  • Sleepio Member

    • 1323 comments
    • 214 helped
    Expert

    That's all for today – thanks for the questions and I will speak to you again soon….

  • Sleepio Member

    • 11 comments
    • 4 helped
    in reply to Sleepio Member
    Graduate

    Thank you Dr Creanor, I will start again by reconsidering the timings of my sleep window (as well as length) and then the techniques one by one again.
    Thank you for your help.

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