Live discussion with Dr Vicki Creanor - 22nd March 2017

Dr Creanor will be hosting a live online discussion here on Wednesday 22nd March, from 8:15 to 9:45pm British Time or 2:15 to 3:45pm 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 16 Mar 2017 at 1:56 PM
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  • Sleepio Member

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    Expert

    Hi there,
    Thanks for your question…we tend to respond to people on this thread as opposed to personal email addresses, so hopefully this will be received OK. It's perfectly OK to leave a question to be responded to if one cannot make the live session time.

    The diaries are held by the programme in order to calculate the sleep windows and review progress. It's a way of tracking how people are doing throughout the programme and to help make adjustments if required. Hope that helps.

  • Sleepio Member

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    Expert

    That's very kind of you to say – I wish you all the best in your progress with sleep…

  • Sleepio Member

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    Graduate

    Thank you dr creanor .

  • Sleepio Member

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    Expert

    It can be a tricky decision to make, however unfortunately we can't advise on medication for specific people as we don't have access to the important background health info etc needed to help with these decisions. Sorry I can't be more direct about this question.

  • Sleepio Member

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    Expert

    Hi there,
    It can be so frustrating when one good night happens and the next is poor. There are many factors potentially at play:
    – stress during the day
    – how much we're thinking about sleep – diet and lifestyle factors (amount of caffeine/alcohol/sugary foods eaten that day) – health problems that may keep us awake – underlying stress/anxiety/low mood
    – irregular bedtimes
    – lack of a regular wind down routine

    It's worth looking at all of these individually and working out what might have caused the poor night. But the other thing is that, when we are staring to get our sleep back on track using a treatment programme, sleep will not be uniform each night. There will be good night s and bad nights, as the body tries to re-balance itself.

    In terms of the sleep switch not coming on, this is common in poor sleepers – often the body has learned that night time is anxious time, so the signs of evening are interpreted as such and the body starts to get more alert, and thus awake, instead of more sleepy. The techniques within Sleepio are designed to reverse this learned effect over time and with practice.

  • Sleepio Member

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    Graduate

    Thank you Dr Creanor ,
    I quite understand, thanks for replying.
    Anna.

  • Sleepio Member

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    Expert

    Hi there,
    Similarly to the post previously with regards to medication, it's always a personal choice and there's no right answer or perfect advice to give as everyone responds to different medications differently. What I will say is that one-off poor nights are common, even in good sleepers, after stressful days/alcohol-fuelled weekends etc. What is important psychologically is how these one-off nights are interpreted…if they are viewed as the first night of sleep getting poor again, this will increase anxiety and make sleep worse in general. However, if they're passed off as normal (which they are!) then the mind tends not to get too fussed about it and the body will naturally cathch up on any lost types of sleep the following couple of nights.

  • Sleepio Member

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    Expert

    Hi there,
    An interesting question. I have come across a handful of people who have required Melatonin given its under-production at night time, however most people I have worked with who presented with poor sleep have managed to get their sleep back on track through the use of psychological techniques as more often than not it is a learned pattern of poor sleep that has caused the problem. An additional point is that melatonin is often underproduced due to poor behavioural habits too, so it's not so clear cut…

  • Sleepio Member

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    Expert

    Hi Jackie, I'm wondering if this was a library article I perhaps referred to? I can't recall a particular study that was mentioned.

    There may well be research into this area of age and light, however I'm afraid I've not come across it. Certain people, with simply our individual differences, can sleep better when slightly warmer/colder, so perhaps this is a factor in warmer climates? As for the age element, I'm not sure why this may be? It could also be the lifestyle in hotter climates is at a slower, more relaxed pace during the day, which promotes better (more relaxed) sleep at night.

  • Sleepio Member

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    Expert

    Hi there,
    I'm not aware how old you are, however when we get older (noting the retirement comment here!), we tend to sleep more lightly and for fewer hours. It could also be that the rise time is set by the body, so by going to bed earlier, it may increase the amount of sleep achieved overall (provided sleep is still achieved in one good block).

  • Sleepio Member

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    Expert

    Hi there,
    When health problems are at play that are interrupting the sleep pattern, we usually suggest that this is treated first. It would be a case of seeking help from the GP/family doctor to check what can be done for this rather than trying to get the sleep to work around it. Hope that makes sense?

  • Sleepio Member

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    Expert

    Hi there,
    Most drugs (over the counter and prescribed) will carry with them a list of side effects. These are usually printed in an info leaflet inside the box, or can be discussed with the pharmacist/GP/doctor. There are many medications that carry sleep problems as a side effect – too many to list here – but my advice to anyone starting new medication for any type of physical/psychological problem would be to:
    1) check the side effects in order to decide if this is the medication for you and
    2) discuss with the prescriber/pharmacist at the counter any concerns about the possible interference in using that medication while completing a sleep programme.

    Hope that helps?

  • Sleepio Member

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    Expert

    Hi there,
    Thanks for your question. This is very relevant as this will be addressed in (I believe) the next session…we talk about something called the quarter hour rule when people wake in the middle of the night. This involves staying in bed to see if sleep comes within (approx) 15 minutes and, if not, there is a clear technique to engage in which will be explained in due course. The quick answer is that you get out of bed if sleep doesn't come before 15 minutes, but it will be explained fully soon.

  • Sleepio Member

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    Expert

    Hi there,
    Although there will be some differences in sleep in someone with fibromyalgia and someone who does not have this, there is evidence to suggest that cognitive behavioural therapy (CBT – upon which Sleepio is based) does help to reduce night time wakenings and improve insomnia symptoms overall.

  • Sleepio Member

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    Expert

    Hi there,

    Thanks for your question. I suppose it depends when these books are used, whether they are used in bed or outwith the bed and also whether they are so interesting/stimulating/thought-provoking that they keep the brain awake.

    Audio books are a great way to relax for some people, however I would recommend they're listened to outwith the bedroom firstly. They could be used as part of the wind down routing, but anyone using this method of relaxation must give careful consideration to the amount of stimulation caused by the book. If it is scary, graphic, exciting, it could lead to someone going to bed thinking about it so much that they lie awake longer than usual. Food for thought…

  • Sleepio Member

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    Expert

    Hi there,
    I haven't had this question before from an adult, so thank you for raising the awareness of this. Night terror are usually more common in children, however some adults do experience them. Here, it' important to clarify the difference between night terrors and nightmares…night terrors are not generally recalled in the morning as they occur in deep sleep, it's unlikely that the person can be wakened up during them and they usually involve screaming or panic. Nightmares occur in REM sleep, are usually recalled in the morning and the person can be woken up from them.

    Night terrors are usually linked to the amount of deep sleep someone is getting or to anxiety. The right amount of deep sleep can be achieved when following techniques such as those noted in this programme. If they are caused by anxiety, though, this should be treated, too.

  • Sleepio Member

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    Expert

    Ok folks, I ran over a bit there – hopefully I answered all the questions. I'll get back to those I said I would once discussions with the clinical team have taken place…Thanks for the great posts – speak to you again soon.

  • Sleepio Member

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    Graduate

    Thank you so much. You are right on point with the information screaming out loud, I don't wake up from my sleep. My husband or kids will let me know the next day if I had an episode, I do not recall it. I haven't spoken to a medical professional before regarding this matter, so I will, to see if it's linked to anxiety.

  • Sleepio Member

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    Graduate

    Thank you Dr Creanor.

  • Sleepio Member

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    Expert

    Hi everyone. As promised, I took this question to the clinical team. Some of us believe that relaxation should remain part of the wind down routine (outwith bed) given the argument that bed should be used only for sleep and sexual activity, however it was also noted that, should relaxation be used in bed, the quarter hour rule should be followed here (i.e. if sleep does not occur within 15 mins of doing the relaxation, one should get out of bed and return when sleepy tired). Hope that helps!

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