Live discussion with Dr Vicki Creanor - 20th September 2017

Dr Creanor will be hosting a live online discussion here on Wednesday 20th September, from 8:15 to 9:45pm British Time or 3:15 to 4:45pm US Eastern Standard 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. 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 15 Sep 2017 at 5:35 PM
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  • Sleepio Member

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    Graduate

    Hi
    I was making pretty good progress getting almost 6 hrs of sleep or so. I exercise a lot so I was still really tired even with that vast improvement.But every time I let myself sleep more I do not sleep well following the better sleep. I feel like I cant get to the next level where I can fall asleep without the feeling of overwhelming tiredness.

  • Sleepio Member

    • 9 comments
    • 3 helped
    Session 2

    Hello Dr Creanor and thank you so much for being here.

    (So sorry I cannot be here 'Live', so here is my enquiry:)

    Similar to -Alex, I have a somewhat similar question but, as things are, I my average sleep pver the last two weeks has been just over 3 hours of sleep. My problem, is that I haven't had any set sleep pattern since I began having problems sleeping back in February. It began, one night back then, in me going a full night without sleeping at all. Since then I've been through so many different patterns:

    Able to fall asleep straight away, but wakening a number of times
    Unable to fall asleep until the wee hours, then sleep until time to get up from bed (only a few hours sleep)
    Falling asleep straight away, awakening in the early hours (unable to get back to sleep)
    Some nights unable to sleep at all.
    These last two weeks have been terrible for me in having difficulty in both getting to sleep, getting back to sleep and not sleeping at all.

    Is it usual to have a 'random' pattern of sleep when suffering with Insomnia? I'm curious to know.

    I'm on week three now, currently staying with our Daughter this week and taking a break the best way I can. I will be totally honest and admit to facing the next bout of Session 3 in regard to sleep restrictions. As things are, I have no chance of falling asleep within 15 minutes of going to bed; sorry if that sounds pessimistic, but for the last month I have been unable to do this. I have tried getting up from bed only to find myself becoming wide awake and not feeling even a need to return back to bed.

    I am suprisingly bright during the day hours, even if feeling a tad down but nothing I cannot cope with. I do not spend my daytime wakened hours worrying about going to bed and I spend the last hour (prior to going to bed) listening to mediational recordings. My eyes are always heavy when going to bed, yet I can lie in bed and find myself immediatly awake and unable to go to sleep. On the nights I do get some sleep I either fall into sleep after a long period of being in bed, or (possibly) a hour or two after getting into bed.

    (Sorry, this is a veritable Epistle ad I read it back to myself sighs)

    Thank you very much
    F

  • Sleepio Member

    • 2622 comments
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    Expert

    Hi all and welcome to the live Sleepio session…let's get started….

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi and thanks for your question. Funnily enough, I would say one of the best subjective measures of your sleep quality is simply how refreshed you fell in the morning. When we wake up and feel as if we have slept well and have little tiredness during that day, this is a good indicator that our sleep was of a good quality the previous night. If we are talking about objective measures, it tends to be that the quality of sleep is best (most accurately) measured in a sleep clinic that can look at the different stages of sleep and how long one spends in these during a night. Hope that answers your question?

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi – good question! We do not actually need a nap during the day if we manage to get good sleep at night. Some people still like naps, often at the natural post-lunch point in the day when we often feel tired again, but it should not be required if sleep quality and quantity is good. Others again might require naps if they are recovering from illnesses, or are on medications that make them sleepier, but in general, it is quite unhelpful to nap if we are trying to maintain good night time sleep patterns as there will be a knock on effect.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    This can be particularly frustrating when this happens, so close to wake time. In theory, people should be treating it a if it was a night-time wakening and seeing if they can get back to sleep again, but if this doesn't happen after 15 mins, they need to get up. If it is regular, though and has been going on for a while, some people shift their sleep window so that they go to bed slightly earlier and shift their sleep window to the time they are waking naturally. This is an option to think about if it persists.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi and thanks for your question. There is not one simple technique to achieve this, but instead what the Sleepio team has done is put together a programme of various techniques which collectively target the various things that may be leading to poor sleep with the aim of 1) achieving better quality sleep and 2) achieving a longer, more solid sleep at night time. So, by following the course, one of the main outcomes people notice is a longer sleep at night time.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hello and thanks for your question. I see you're a graduate, so what you'll have covered previously is the challenging thoughts technique? This is an important one to do for people who have these types of thoughts, but what can be helpful is to schedule in some “worry time” earlier in the day (morning or afternoon – not close to bedtime) to think about anything on your mind, the thoughts that often come up at bedtime, so they can be challenged and dealt with before bedtime. They may still pop into your head in bed, but often they can become weaker if they have been thought through earlier that day.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Just to add as well – the thought blocking technique can also be helpful here when the thoughts continue to pop into one's head in bed…quite a good instant distractor…

  • Sleepio Member

    • 15 comments
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    Graduate

    Thanks Dr Creanor for your response about naps – very helpful

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    Thank you for getting in touch. Firstly I would say that, in the clinic, if the GAD occurred first and the insomnia occurred after this, we would treat the initial problem first, rather than waiting to treat the secondary problem (presuming they are linked?) Such exposure therapy may also help at night if similar symptoms are occurring then.

    One of the most common reasons people's insomnia is kept going is due to the attention they pay to the thoughts in their head, the worry about sleep, the symptoms their body is now showing etc etc….there is a strong theory that acceptance will help if it can be achieved (often quite difficult when people are anxious). If we think about good sleepers – they are used to good sleep. They are passive in sleep (they do not try and sleep – it happens to them). So if they have a bad night's sleep, they often pass it off as annoying, but place no fear in the next night's sleep- they go back to expecting to sleep well, accepting that they can have a bad night but they can sleep well too. So it makes sense that if we view blips just as that – blips, rather than a major setback – then our sleep will get back on track more quickly.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    You're welcome!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hello,

    It's often a tricky time for people to get their own sleep back to a good pattern after a new baby enters their world, as babies tend to set the agenda for the household's sleep! However, it sounds as if you're doing well thinking about how to schedule your sleep.

    In terms of wake time, this is quite a personal decision. Some people are happy to wake for the day at 4am, others would prefer a later start. But deciding on the rise time for anyone is where the sleep window will be calculated from and anchored to. Given you are a graduate, you will presumably know how to calculate the sleep window based on average length of sleep per night (adding up all the bits of broken sleep) then working out when to go to bed based on your chosen rise time.

    In terms of what helps when people wake early, we need to remember to put into place the quarter hour rule and when up in the middle of the night, way before rise time, we recommend no eating/drinking/use of computers in order to help the body stay unstimulated and help it feel sleepy enough to get back to bed for more sleep.

    Hope this helps.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    Thanks for your question. The main aim with sleep restriction is to help people get a more solid night's sleep, rather than a broken pattern as described here. It is more than just making sure people feel sleepy at the point of going to bed…it is also about making the sleep pressure build up more in the evening to ensure that they stay asleep all night but also to help squeeze out the bits of the night when they are in bed but not asleep. So it is restricted to avoid times when people are lying awake with the aim that less time in bed means they are more likely to sleep for most of this window. The other techniques around sleep restriction compliment it too, so it is a wider approach to target broken sleep.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hello – I'm a little unclear about the question here. I'm wondering if you mean each time the extra 15 mins is added onto the sleep window, this is when sleep doesn't seem to improve? If this is the case, it might be worth holding back from adding on the 15 mins for another week or two to consolidate the improvements and help improve sleep quality? Sleep is often up and down when improvements are being made, but if there is a general upward trend this is positive. Also, in terms of feeling exhausted when going to bed, this is actually OK as it means sleep will likely occur more easily.

  • Sleepio Member

    • 7 comments
    • 0 helped
    in reply to Sleepio Member
    Session 5

    Hi, Dr. Creanor. Acceptance is difficult but not unrealistic, correct? I'm afraid to ask. I'm feeling kind of desparate these days--worried that neither my GAD or my insomnia will go away or that they will get worse. I know everyone's experience is different but what's the general time for recovery for both of these issues. What should I expect? Maybe I'm being too impatient as it's only been 3 months--albeit a severe 3 months…

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    Thanks for getting in touch. First of all, it is common to have a bit of a mixed bag when it comes to poor sleep. Some people experience the same problems persistently, but others do find their sleep problems change around a bit. Different things cause different sleep patterns, so it's often useful to target them all using the various techniques set out in the programme.

    Sleep restriction is very daunting for most people – it is probably the scariest part of the programme – probably the most difficult but certainly one of the most effective techniques upon completion.

    It is common to feel exhausted upon going to bed, but then wide awake once in bed – this is anxiety that causes this. Over time, if we lie awake in bed trying to get to sleep and failing, we come to associate the bed with negativity, frustration and fear. So even if we are exhausted, as soon as we approach this environment and see our bed, our brain remembers this association and the anxiety response kicks in, sending adrenaline through our bodies….making us wide awake.

    So, with this in mind, what I would say is to be careful about lying in bed for hours trying to sleep – remember to put into practice the quarter hour rule as this will help break this negative association between bed and sleep.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Absolutely! Definitely possible. Especially with the right help to find acceptance and work on it. As for time-frames, I would love to be able to say but it is not an exact science when it comes to recovery from any mental health problem. It depends on so many factors, such as how long the problem has been going on for, how severe it is and what support/obstacles are present during recovery for that person. I'm glad to hear support is in place, though, that's always a positive factor in recovery.

  • Sleepio Member

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    Expert

    Just a few minutes left of the live session if anyone has any more questions…

  • Sleepio Member

    • 2622 comments
    • 411 helped
    Expert

    That's all for tonight – thanks for the posts and speak to you all again soon….

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