Live Discussion with Dr Vicki Creanor - 1st July 2020

Dr Creanor will be hosting a live online discussion here on Wednesday 1st July, 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 25 Jun 2020 at 4:09 PM
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  • Sleepio Member

    • 21 comments
    • 1 helped
    Graduate

    Hello Dr Creanor. Your replies in this discussion forum have been a great source of help and reassurance to me over the years when I have popped back in to Sleepio following a blip. I would be grateful if you could once again offer me some guidance. I used Sleepio to great effect 5 years ago following an acute period of insomnia. I had always been a good sleeper until very suddenly I wasn't, and I find that when I relapse, my sleep gets very bad again very quickly, and get very anxious and preoccupied with fixing it. I convince myself every time that I won't be able to fix things this time and yet every time I have relapsed, I have managed to get back on track. I went for 4 years without any major relapse but have had 3 relapses in the past year alone. I am in one of those relapses at the moment and negative thinking has its hold over me. I am caught in a limbo between wanting to try Sleepio again, or waiting to see if the problem passes of its own accord (but in the meantime I am very agitated and fearful of bed time). If I want to commit to Sleepio again, I know the answer is to spend time relearning the techniques and follow everything to the letter, as I did 5 years ago. However I have been wondering whether it would be better for me to wait it out, not use the techniques and see whether the problem passes on its own. I see myself as an occasional sufferer of extreme sleep disruption rather than a chronic or long-time sufferer. I worry that by focusing on Sleepio and fixing things so soon, I actually make it harder for the problem to go away of its own accord. On the other hand, Sleepio has been a beacon of light for me! Can you recommend whether I should go 'full on Sleepio' or wait it out? Taking a more relaxed approach would be maybe sleeping in when I can, napping, trying not to let it dominate my thoughts. I know that if I embrace Sleepio fully, there will be some bumps in the road ahead and I am a bit scared. Thank you.

  • Sleepio Member

    • 2 comments
    • 0 helped
    Session 1

    Dear Dr Creanor,
    I am new to Sleepio, but have noticed already that when I enter 4hrs sleep for my diary, with no wake up, it marks me as having 90% sleep success … despite going to bed at 3am and getting up at 7am. No wonder I'm exhausted!
    I am interested in hearing about 'going to bed', how to switch off, leave things unfinished, not keep the brain buzzing, I am a terrible one for pottering about late at night, when the rest of the household are asleep.
    Any tips would be most useful. Thank you. KatyLG

  • Sleepio Member

    • 3131 comments
    • 555 helped
    Expert

    Hi all and welcome to the live Sleepio session – I'm Dr Vicki Creanor, a clinical psychologist with an interest in sleep behaviour. I'll be here for the next 90 mins. I see there are some questions waiting so let's get started!

  • Sleepio Member

    • 3131 comments
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    in reply to Sleepio Member
    Expert

    Hi Alex,

    I'm sorry to hear it's a tricky time just now with regards to sleep and that you haven't seen much progress yet.

    Sleepio is a self-help course and, because of this, it has been designed to help the majority of people with the most common sleep problems using evidence-based treatment grounded in Cognitive Behavioural Therapy. As with many treatments, it will not be as useful to some compared to others.

    If this is the case, it may be that a different type of approach may be more beneficial. Which type exactly will be dependent on a thorough, individual assessment of the person's presenting problems.

    So my advice would be to seek one-to-one support from a sleep specialist who can look more closely at your individual sleep patterns and needs and tailor treatment accordingly.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi and thanks for getting in touch with your question.

    There is no easy answer here, as some people prefer to do the course while using sleep medication; others prefer to wean off them (being guided by a health professional to do so safely) before or during the course.

    It is perfectly Ok to do the Sleepio course while taking meds, however you're right – some aspects may be trickier while on meds. You will still likely benefit from other aspects of the course if you choose to stay on meds, though (relaxation, tackling unhelpful thoughts, keeping a consistent routine).

    Whatever option you decide, it is always recommended that you speak to the person who prescribes the medication before tapering it – but they also may be able to guide you in your decision as to what is best for your sleep.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi Elayne and thanks for getting in touch.

    I'm sorry to hear this part has been so tough. Sleep restriction is a difficult process, as many on here will testify to.

    If you choose not to do the sleep restriction part of the course, this is OK and totally up to you. As it's a self-help course, it is each person's choice as to what they wish to engage with.

    It sounds as if you are looking to improve your deep sleep, so other options that will help with this are:
    – cutting out caffeine from lunchtime onwards
    – getting plenty of exercise during the day
    – not drinking too close to bed time
    – regular bed and rise times
    – a consistent bedtime routine
    – relaxation exercises throughout the day

    Hope this helps?

  • Sleepio Member

    • 3131 comments
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    in reply to Sleepio Member
    Expert

    Hi again Lulapop,

    Nice to hear from you – thank you for your kind words :)

    I'm sorry to hear things are tricky again with regards to sleep. Based on what you've said, there seems to be a lot of worry and anxiety going on just now. For many of us, this strange and unsettling period due to Covid-19 is also playing into our anxieties.

    Although I'm sure it is what you are looking for, I feel it would be inappropriate for me to decide whether you do the full programme again or wait and see if the anxieties and sleep issues subside naturally, as I don't have all the information and it is ultimately up to you. However, what I can suggest is that you make a list of pros and cons for doing the full course again vs waiting it out.

    If you choose not to do the full course, I would also recommend sticking to some good basic habits re sleep – no naps, good bedtime routine, regular rise and bed times. It also sounds like it would be important to build in some relaxation time to your day to help with the underlying anxiety.

    I hope this helps?

  • Sleepio Member

    • 3131 comments
    • 555 helped
    in reply to Sleepio Member
    Expert

    Hello KatyLG.

    First of all, welcome to Sleepio! Thanks for your post.

    So although it does seem odd on initial inspection that 4 hours sleep would be seen as successful, what this actually means is that your sleep efficiency is sitting at 90%. This means that, of the time you were in bed between 3am and 7am, you were asleep for 90% of it. This is deemed pretty good and the Sleepio course will aim to help you extend this sleep window over time so it feels more successful overall.

    I hope it reassures you to know that the other things you mention that you are keen to learn about are all included in the programme and you will learn techniques to combat these difficulties as you proceed through it. I hope you find it helpful.

    During your time on the course, please join us any Wednesday if you have any questions for myself or my Sleepio colleagues.

  • Sleepio Member

    • 2 comments
    • 0 helped
    Session 1

    My interest is more about falling asleep at the wrong time. Is it ok to take an afternoon nap? and for how long, before it becomes too long and disturbs your night time sleep?

  • Sleepio Member

    • 3131 comments
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    in reply to Sleepio Member
    Expert

    We tend to recommend that all naps are avoided to help strengthen night time sleep. You'll learn about the rationale behind this too, but even a very short 15 min nap can have an impact on the ability/quality of sleep later on. The only exceptions for taking naps are 1) if it is required for medical/health reasons and 2) if it is required for safety (ie to avoid driving/operating heavy machinery/looking after vulnerable others when dangerously sleepy)

  • Sleepio Member

    • 21 comments
    • 1 helped
    Graduate

    Yes, that does help. Thank you Dr Creanor. I think I'll wait until the weekend and then work out a strategy for myself, but the list of pros and cons sounds a good idea. I like putting pen to paper and it's generally a good way of reaching a solution when presented with a dilemma.

    Relaxation time is also a good idea. I tend to do my relaxation exercises (if I do them at all) just before bed but it may be best for me to do them earlier in the day, when my anxiety levels are generally lower. Thank you.

  • Sleepio Member

    • 28 comments
    • 3 helped
    Graduate

    Hi Doctor
    I have done 8 nights of SR and QHR, my problem is both not falling asleep and staying asleep, each night has been a different experience. But as I dreaded, the last 2 nights was getting in and out of bed all night long without a wink of sleep. That really adds to being anxious to sleep and getting frustrated, not to mention feeling like a zombie during the day.
    Do I continue with this? I don't know how much more I can take of this?

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    It can be reassuring writing things down – helps to simply get the problems out of your head sometimes, too.

    I hope these strategies help you to reach a decision either way.

  • Sleepio Member

    • 3131 comments
    • 555 helped
    in reply to Sleepio Member
    Expert

    Hi and thanks for getting in touch. It's been a horrible couple days for you and I'm sorry to hear this. Sleep restriction is really tough, as we've already touched on tonight. It's the part most people will struggle with because it's the exact opposite of what we want to be doing! It can feel exactly as you have described in the first while of SR, but it tends to be a short term experience before sleep starts to find a new pattern. This is the adjustment phase. Your body is battling with what it thinks it should be doing vs what you're now trying to teach it for the better. If you are able to continue with SR safely, you will likely find that this improves soon.

  • Sleepio Member

    • 28 comments
    • 3 helped
    Graduate

    Thank you Dr Creanor
    Your reply is reassuring. I will continue and truly hope to see improvement very soon.
    On a few nights, I felt very sleepy indeed between 9pm to 11pm, however when I get to bed at 12am my SR time, I am no longer sleepy. Sleepiness is very mysterious to me, it tends to happen sometimes in the afternoon and evening, but rarely at night when it's supposed to. Is there any training for this?

  • Sleepio Member

    • 3131 comments
    • 555 helped
    in reply to Sleepio Member
    Expert

    It feels very strange, doesn't it? There is an explanation to it all, however. Earlier on in the evening, you're starting to feel naturally sleepy due to the sleep pressure that's been building up (time that's gone on without sleep) throughout the day. However, because of the poor relationship between your bed/bedroom and sleep that has built up over the past X amount of time, your body has learned to be alert and feel anxious when you approach this sleeping environment. It now sees it as a threat, so prepares for it as such…which is the opposite to what you want to feel as you climb into bed! There is indeed training for this – many of the strategies you'll learn over the next couple weeks (and have learned already) work together to create a new pattern of sleep and to create a more positive bed-sleep connection (sleep restriction and the quarter hour rule are part of this).

  • Sleepio Member

    • 3131 comments
    • 555 helped
    Expert

    That's all for this evening's session folks – thanks again for the great questions and I will see you again soon.

  • Sleepio Member

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

    Thanks for the advice. Yes, I do think it is the deep sleep I am hoping to achieve. I do a number of the things you mentioned, like avoiding caffeine after lunchtime. I have stopped reading in bed at night and so it is true that I am asleep for a greater percentage of the time that I'm in bed. I do need to exercise more during the day. I will also try relaxation exercises during the day; I never tried that before. My biggest gripe was feeling so sleep-deprived and thinking I was only supposed to “earn” more sleep 15 min/week. With the initial sleep restriction regimen, I really couldn't even sum two three-digit numbers in my head and that's normally easy for me. Thanks for the encouragement!

  • Sleepio Member

    • 1 comments
    • 0 helped
    Graduate

    I was very sorry to be unable to interact with you last night. My problem is similar to Elayne's – I go to sleep very easily but wake up between 1 and 2 hours later. My main problem is that I tend to doze in my chair whilst trying to stay awake till 11.45, which I'm sure is unhelpful to my sleep. I would ordinarily go to bed around 10pm but would then have to wake up at 4.15am to maintain the sleep restriction, which I feel is unrealistic. How do you suggest that I deal with this?

  • Sleepio Member

    • 121 comments
    • 42 helped
    in reply to Sleepio Member
    Graduate

    Hi Jonny
    The session above is now closed but the good news is that next Wednesday’s has already been created and you can post your question anytime.

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