Live discussion with Dr Vicki Creanor - 21st September 2016

Dr Creanor will be hosting a live online discussion here on Wednesday 21st 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.

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Posted 16 Sep 2016 at 12:34 PM
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  • Sleepio Member

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    Expert

    Hi there,
    Often with such vivid dreams, if they are recurring, they are related to an underlying anxiety. Many people find that getting support for their anxiety – alongside a good sleeping pattern – can help reduce these negative dreams. The first line of support would come from one's GP/family doctor to discuss available support.

  • Sleepio Member

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    Expert

    Hi there,
    Interesting question. We all ave within us a built-in drive that helps us sleep, however the 'switch' that gets us from wakefulness to sleep needs an extra push as other factors are making it a bit sticky. Often, it's anxiety that makes this switch stick, along with bad sleep habits learned/repeated over the years. The good news is, these can be unlearned and the anxiety can be targeted using the techniques in the programme so that the switch is more effective in the future and sleep becomes more automatic again.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi again,
    In response to this question, it's perfectly OK to pause the programme – people can do this when they know that travel/changes of environment/illness is going to disrupt the regularity of sleep. For those requiring to do so, please contact hello@sleepio.com to let the team know that a pause is requested and this can be done by the administrators so it doesn't cause disruption to people's diaries etc.

  • Sleepio Member

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    Expert

    Hi there and thanks for your post. When people wake up through the night with panic attacks, it's important to seek help for this as it's likely an underlying anxiety causing them. Treatment for anxiety can be done alongside Sleepio techniques and, in fact, some techniques even overlap.

  • Sleepio Member

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    Expert

    Thanks for your post. The directions I'd point people in when there's a persistent problem with falling asleep are:
    – make sure to do relaxation – not only at bedtime but throughout the day
    – schedule in worry time but not too closely before bed
    – look carefully at challenging the negative thoughts and write these records of the thought processes out
    – if all the above is being done with no effect on falling asleep, look at the time at which the sleep window starts…could this be extended to a bit later so that there is more sleep pressure when one goes to bed? remember it's really important to feel sleepy when it's bedtime so it's more likely that sleep will occur more quickly

  • Sleepio Member

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    Graduate

    Hi again Dr C
    In thinking about establishing my sleep window I discussed this with my partner and we agreed that if I started it at our normal bedtime this would be the least disruptive for her. I now see from the library that it is recommended that you finish the window at the time when you want to wake up and get up. Is there any reason why I can't start it at my normal bedtime and in due course gradually expand it until it reaches the time when I want to get up?

  • Sleepio Member

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    Expert

    Hi there, good question. Essentially, waking is waking, whether it be for a physical reason or otherwise. However, what is crucial is how this waking is interpreted/viewed. For good sleepers, they may wake to go to the loo or they may wake due to a loud noise outside. Either way, they (being good sleepers) place little worry on this wakening and just roll over and fall asleep again. On the other hand, those who have had sleep problems before may interpret this wakening as a real disruption to the solid sleep they were trying so hard to achieve that night.

    Assuming all the common sense approaches have been taken with regards to wakening to go to the loo (reducing fluids before bed, going to the loo before bed), it's more about viewing the wakening as normal, OK and nothing to worry about that will help reduce its impact on sleep quality.

  • Sleepio Member

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    Expert

    Hi there – this is a good question. It's often anchored on wake time as people have more pressures on them as to having to get up for work/their kids' school day etc, but it shouldn't matter whether you anchor it by bedtime or wake time, as long as it's regular and it's extended alongside increasing efficiency in some form.

  • Sleepio Member

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    Expert

    Hi and thanks for your question. For those who have had anxiety/depression in the past, they'll know that disrupted sleep is a very common symptom. Sometimes it's hard to work out what causes what, because poor sleep also causes anxiety and depression.

    In terms of general advice for those in the first couple weeks of the programme, it's important to know that, with increased focus on their sleep (due to thinking about it for the programme), sleep can get a bit worse for a while/ This is true for other treatment programmes too. But it's important to know it's normal for this to happen – even expected.

    Once people are employing the techniques further into the programme, they'll get a better sense of whether the sleep improvements are aiding their feelings of anxiety/depression or whether there is still a potential underlying problem of anxiety/depression that requires treatment too.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    Similar to a previous post I replied to earlier, if people feel they need to pause the programme due to illness or travel, please contact hello@sleepio.com to let the administrators know as this will help make sure diaries are all in sync with actual practice.

  • Sleepio Member

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    Expert

    Sorry I pressed enter too early – it's also important to listen to our bodies when we're not well as sleep can really aid physical recovery, so it's perfectly OK to pause the programme for this reason.

  • Sleepio Member

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    Expert

    Hi there,
    There will be techniques you will come across in the next couple weeks to specifically target these ruminations and distracting thoughts.

    In terms of life being on hold, many people do find this when they are working on various difficulties. Sleep work does restrict activities given that regularity is required, but remember it's a short term requirement – many people can get back to a less regimented sleep pattern once they have broken the bad patterns associated with insomnia.

  • Sleepio Member

    • 4 comments
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    in reply to Sleepio Member
    Graduate

    Thank you that is helpful I will try to change my attitude. Are you saying that the number of times you wake doesn't matter?

  • Sleepio Member

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    Expert

    It's horrible to have dreams like this. Often they feel so real and with such emotional content, many of us struggle to process it for a while. It's likely this will setlle with time, but techniques such as the challenging thoughts and relaxation are likely to help. As I mentioned previously in this discussion, recurring anxiety-provoking dreams usually indicate underlying anxiety so it's worth speaking to the GP/family doctor about this if it continues.

  • Sleepio Member

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    Expert

    The number of times one wakes often reduces with all the techniques used on the Sleepio course but good sleepers tend to wake twice a night in any case…it's just not affecting them as they don't worry about them.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    It might be worth doing a relaxation technique before bed but also in bed if people find themselves figeting. Also might be worth looking at a longer wind down period but also lifestyle factors such as caffeine should be monitored.

  • Sleepio Member

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    Expert

    HI there,
    It's hard at the start of the programme to know what's ahead, but rest assured there are many techniques in the next few weeks that will target these racing thoughts and how to manage not getting to sleep. Look out for the quarter hour rule as this will be very important for people spending hours trying to fall asleep.

  • Sleepio Member

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    Expert

    Hi there,
    Meditation and hypnosis are really just deeper forms of relaxation but it's always worth experimenting to see what works best for people. Sometimes different types of mindfulness are worth looking into to enable one to focus on something in particular. The 'the the' technique is often effective but another tip may be to play some relaxing sounds (nature sounds/white noise) so this can be focussed on and used for mindful focus when getting back to bed. Challenging the thoughts around what it means to get up for the toilet may help as previously discussed in order to take the worry out of it and see it as normal rather than a huge disruption to sleep.

  • Sleepio Member

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    Expert

    that's all for today – thanks for a good, busy session with lots of great questions. see you next time.

  • Sleepio Member

    • 4 comments
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    in reply to Sleepio Member
    Graduate

    Thanks Dr. C. I'll keep trying things, e.g. playing nature sounds. I really need to find a way to get over this hill!

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