Live discussion with Dr Vicki Creanor - 21st November 2018

Dr Creanor will be hosting a live online discussion here on Wednesday 21st Nov, 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 15 Nov 2018 at 6:20 PM
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  • Sleepio Member

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    Graduate

    I was given a sleep window of five hours when I signed up with Sleepio two years ago but decided not to engage with SR. Up until recently my average sleep has been around five hours 36 minutes and around six weeks ago I embarked on a six hour sleep restriction.

    Does this new sleep window sound okay to you? Since starting it my sleep hasn't been too bad, though I have tended to lay in bed another 15 to 30 minutes most mornings. Should I get up on the dot each morning at 7 (my prescribed time).

    Finally, how do I cope with being 'overtired'? Two nights ago I just wasn't relaxed and went to bed, hardly getting any sleep that night. What tends to happen is the next night is bad as well as a result and last night I was wide awake throughout the whole of the night.

    What should I do in such circumstances and is the latter regarded as 'adrenal fatigue', i.e my body being to stressed to let me sleep?

    Thanks.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    I am unfamiliar with the book sleepio is based on. could you please share the title?

  • Sleepio Member

    • 44 comments
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    Graduate

    Hi, thanks for doing this, v helpful. My question is about screen time, specifically computers, specifically iPads and smartphones. Being shortsighted, I hold them close to my face – I have glasses but have become accustomed to screen use and reading this way too. I stop using both early, about 7 pm but am wondering if high daily cumulative use, esp later in the day may also have a negative effect on sleep. I read admittedly just one paper indicating this to be the case in teenagers though with v high usage- would appreciate your comments, thanks.

  • Sleepio Member

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    Graduate

    Hi again, wondering if sitting in the dark before bed – is it necessary to keep my eyes open? It’s hard as I’m often drowsy – don’t fall asleep – I’ve read nightlights in bedrooms can negatively affect melatonin production even with closed eyes so, wondering if the reverse is true? Thanks.

  • Sleepio Member

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    Graduate

    Hello again! Reading the expert session, I came across the idea that using cbt-I increases our ‘internal locus of control’ ( hope I’ve got that right!) regarding insomnia. Although I’m still in v early days – tho v grateful for 2 good/1 pretty good night in a row! – I’m beginning to feel some positive distance/ less tied up with being insomniac/ less controlled by it – think this is what’s meant by the phrase …? Would appreciate if you would write a little more about this aspect of recovering from insomnia, thank you!

  • Sleepio Member

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    Graduate

    Hello again. Following your advice I re-started SR, it’s going well and during the week I’m regularly achieving high levels of SE. Thanks again for nudging me in that direction. The problem is I live on my own Mon to Fri but stay with my partner at their place on a Saturday evening and while I never really think about sleep during the week, it just happens, the situation different at the w/e. As soon as Saturday arrives I start thinking will I/wont I. I’ve tried using the DARE response to deal with these random thoughts as in Diffusing the thought (so what if I don’t sleep) then Accepting it (as in I accept this thought) when it comes back. But sure enough when I get into bed on a Saturday night, despite all the pre-bed prep etc I fall asleep but am then awake again and back up practising QHR. I almost wonder if using the DARE advice to respond in specific ways is fuelling the anxiety and frequency of thoughts. Incidentally, my partner is hugely supportive so I’ve no problems on that front.

    Two questions really: I’m confident I can conquer the Saturday night issue but what’s the best way to deal with these random worries that start popping into my head on a Saturday morning and keep recurring throughout the day? And secondly, are there other strategies I could try to help improve things on the w/end? Thank you. I did wonder if counselling might be the answer? Thanks again for all your help.

  • Sleepio Member

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    Graduate

    Hello
    I'm in the first week of the programme so at present just recording my daily sleep routine. I have a question regarding the use of sleeping tablets whilst doing the course. I was on zoplicone for 4 weeks, then stopped and have been put on Lorazepam short term, 1 mg daily. I have taken Lorazepam for 4 nights, then decided not to take it on night 5 which meant a terrible night sleep, and last night I decided to split the tablet in half effectively taking 0.5 mg; that seemd to be enough to give me a better night sleep. My target is to improve my sleep without the need of sleeping pills, hence getting involved with Sleepio, amongst other resoources such as hypnosis and magnesium. I'm also on HRT for the menopause.

    My question is specific to the use and weaning of the sleeping pills whilst on the Sleepio programme. How should I go about it? Can you advise?

    Thanks
    Marta

  • Sleepio Member

    • 2622 comments
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    Expert

    Hi and welcome to the live Sleepio session! I see there are some great questions waiting already, so let's get started. If anyone has any further questions about sleep or the programme, please get in touch over the next 90 mins…

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there. The book to which you are referring is called “Overcoming Insomnia and Sleep Problems: A Self-Help Guide Using Cognitive Behavioural Techniques” by Colin A. Espie. The Sleepio programme was developed from this book, so many of the techniques will be the same as they have their origins in CBT (cognitive behavioural therapy) however Sleepio is obviously different in a few ways – it is interactive, it allows people to connect with others going through similar difficulties and it has several add-ons such as relaxation exercises to listen to etc. So it's personal choice whether to follow the book or the programme. Essentially they have the same goal of targeting poor sleep!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there! I'm not sure if you saw my reply to this post last week? If you go to last week's session via the community tab you will see my reply :)

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi and thanks for getting in touch.

    There are a few questions in there, so first of all, re the sleep window – this should reflect the average sleep time you're getting. So if it's still 5.5 hours, this should really be the sleep window to work from initially. A 6 hour sleep window is for those sleeping on average 6 hours each night.

    In terms of laying in bed in the morning, we recommend that this is avoided as it weakens the bed-sleep association in our brains. It is best to get up at the prescribed time to help the brain associate bed with sleep rather than lying awake.

    In terms of getting oneself ready for bed and avoiding going to bed stressed, it's important to think about a wind-down routine that is done in the same way every night. Do something relaxing and fairly passive, so the brain knows it's relaxation time and nearly bed time. This will help the body relax as well as the mind.

    Hope this helps.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi – please see my first post tonight for title :)

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Thanks for this interesting question. This is a new area of research so there are lots of studies emerging about it. We always need to be careful, though, of taking the results at face value, as some studies may not be too robust in terms of the way they were conducted. What I would say is that the most important time to be vigilant about blue light coming from screens such as tablets and phones is nearer bedtime. This affects the melatonin release (the hormone that makes us sleepy at night) and so can suppress sleepiness. In terms of use during the day, we're still learning about the effect on night time wakefulness, but what we do know is that having lots of daytime screen-time usually means getting less sunlight and fresh air during the day too – both of these things are helpful in terms of reminding the body and mind that it is daytime and we should be alert and awake. So, I think it's important to think about the wider context of what lots of screen time means and how else it could impact on good sleep at night.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    I think certainly dimmer lighting can be helpful before bedtime as it's less stimulating. Usually we have lamps on in the evening rather than harsh overhead lighting for this reason. It could certainly be attempted, however I would be slightly wary that one might accidentally fall asleep in a dark room and this may impact on later sleep in bed.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi – when we talk about our locus of control, it refers to where we place the power source of change, essentially. In several CBT programmes, we are aiming to help people feel more in control of their difficulties – rather than feeling their problems are being controlled by something outwith their power (an external locus of control). An external locus of control can make us feel helpless, so we do nothing to help ourselves, making the problem worse. However when we learn we can make a change, it often feels empowering and can help recovery. Hope this makes sense?

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hello and thanks for getting in touch again. I'm so pleased that the weekdays are improving – well done for sticking to sleep restriction, even although we all agree it's really difficult.

    So, in terms of the thoughts that creep in, something that might help is setting aside some time in the morning/early afternoon (30 mins should do it) to note down any worries that pop into your head. You can then challenge them using the approach mentioned in the programme so that they feel more 'dealt with' before bedtime. This way, there are fewer loose ends at play when you go to bed.

    In terms of how to tackle the wakenings at the weekend, I wonder if a set bedtime routine is being carried out at the weekend, too? Is there any change in terms of diet at weekends? Alcohol/caffeine/sugary foods that can lead to wakenings? It may also be the case that a bed partner's movements (that are not present during the week) are waking you up – some people do try separate beds for a while until sleep is back on track, but this is a very personal decision for couples to make.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi and thanks for getting in touch. Unfortunately as per our guidelines here on Sleepio, we cannot answer questions about medication, given that the way in which they are prescribed and used is very specific to each person, so to give advice without knowing that person would be very risky and irresponsible. The best person to ask is your doctor who knows your medical history well. Thanks for your understanding.

  • Sleepio Member

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    Expert

    15 mins left of this discussion if anyone has any further questions?

  • Sleepio Member

    • 2622 comments
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    Expert

    That's all for this week. Thanks for the questions and speak to you all soon.

  • Sleepio Member

    • 44 comments
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    Graduate

    Thanks very much for your replies – all make good sense.

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