Live Discussion with Dr Vicki Creanor - 22nd May 2019

Dr Creanor will be hosting a live online discussion here on Wednesday 22nd May, from 8:15pm to 9:45pm British Time or 3:15pm to 4:45pm 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. 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.

Please do note that, as per our guidelines, Dr Creanor will not be able to give personal medical advice including those about 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.

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Posted 16 May 2019 at 8:54 PM
  • 22 comments
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  • Sleepio Member

    • 5 comments
    • 0 helped
    Session 4

    Hello: I usually fall asleep very easily (my problem is early waking) and night 2 of sleep restriction my anxiety got totally triggered about the whole requirement to wake up at 4:30 am (alarm and all) and “what would happen if I didn't go to sleep easily” and ended up staying awake, in and out of bed, for a very long time. I tried all sorts of techniques – from thought management to relaxation stuff – and it was just miserable as nothing “worked.” My current instinct is to move more slowly through the program. Just sit for a few weeks with all the other changes: regular bedtime, only use bed to sleep, commitment to long wind-down time, etc. – and check back in with myself and my sleep after I have had more time with all of that. It just feels potentially unnecessary to “go through the torture” of even less sleep and even more anxiety without more practice of the less provocative changes. But I feel concerned that I will mess with the program's data outcomes (never mind myself) and be a “bad patient.” I welcome your thoughts on this.

  • Sleepio Member

    • 3 comments
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    Graduate

    After many weeks my sleep efficiency was improving and I reached over 80 percent then I went on holiday and decided I could not continue with the QHR as there was nowhere to go at night and it would impact too much on my husband so I abandoned Sleepio for a week and slept really well. Then I came back home, resumed the Sleepio programme and I was not able to get to sleep at all. Getting to sleep initially had not been my problem recently, only waking up too early, so it came as an unpleasant shock. Is this normal? I feel I have gone backwards by having a week off.

    A second question, on waking after only a few hours sleep after a quarter of an hour I still feel sleepy and don’t want to get up but when I do get up for the QHR I become wide awake and do not become sleepy again at all . The option then is to (1) stay up for a couple of hours not feeling sleepy, or (2) stay in bed with a sleep mp3, or (3) go back to bed after a quartet of an hour with the “sleep“ mp3 and often drift off to sleep again . The trouble is with the mp3 that when when I wake up again I don’t remember how long I have been listening, but don’t remember much about it, or how long I have just been dozing or actually asleep. So it is pure guesswork for filling the sleep diary. So which option would you recommend?

  • Sleepio Member

    • 1 comments
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    Session 3

    To establish and maintain the bed-sleep connection we are advised to do nothing in bed except sleep (apart from sex). I was wondering whether listening to the radio in bed is a permissible activity? Thanks>

  • Sleepio Member

    • 1 comments
    • 0 helped
    Session 4

    I'm keen to get some direction as to how I should be recording the sleep diary with respect to the quarter hour rule. It's not clear if getting out of bed is time that should be included or if somehow I should adjust the times to account for the fact that I wasn't in bed?

    There seem to be two slightly contrasting goals in mind when I consider the sleep diary – Bed/sleep association (the reason for QHR), and sleep efficiency. By getting out of bed, I'm destroying my sleep efficiency if I record that time.

  • Sleepio Member

    • 2 comments
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    Graduate

    Hi. I have ME/CFS. How can I adapt this programme especially the restricted sleep to help my condition and not make me feel more tired and unwell. Thanks.

  • Sleepio Member

    • 4 comments
    • 0 helped
    Session 3

    Hi, I am on week 2 but have a question in advance about the sleep restriction. From what I've read in the Community, one of sleep restriction's aims to make sure you're exhausted by the time you go to bed. What if my SE averages between 95% and 99% every week but most of the time I wake up feeling unrefreshed. How does sleep restriction help with unrefreshing sleep? I'm exhausted nearly all the time going to bed because of unrefreshing sleep.

  • Sleepio Member

    • 2510 comments
    • 384 helped
    Expert

    Hi all and welcome to the live Sleepio discussion. My name is Dr Vicki Creanor and I'm a clinical psychologist who has an special interest in sleep behaviour. I'll be here for the next 90 mins to answer any questions about sleep or the Sleepio course, so let's get started….

  • Sleepio Member

    • 2510 comments
    • 384 helped
    in reply to Sleepio Member
    Expert

    Hello and thank you for getting in touch. Your question has a few points I'd like to address that may also help the wider group…

    First of all, the accuracy of these devices varies greatly and something to be careful of is paying too much attention to the information they're claiming to record. If we focus too much on the concern that we are getting too much or too little of one type of sleep, it will increase our anxiety and reduce the quality of our sleep. It is much healthier to simply focus on how refreshed we feel in the morning – a more subjective measure of sleep – and then work on how to improve this.

    Secondly, the amount of REM and non-REM sleep we each require varies from person to person, from night to night, based on a number of things – how much sleep we got the night before, whether our bodies are needing repaired etc etc. So again, it's better to focus on maintaining a consistent sleep, because your brain will sort out the rest – it has an inbuilt system that will keep the amounts of sleep each person requires balanced out as required.

    Lastly, with regards to broken sleep/frequent wakenings, the most helpful and effective strategy we would recommend for this is the sleep restriction – I see you're a graduate so if you go back to the work you did before on this and use your average sleep times across the week to work out your sleep window and when you'd like to set your consistent bed/rise times.

    Hope this helps.

  • Sleepio Member

    • 2510 comments
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    in reply to Sleepio Member
    Expert

    Hi and thanks for raising this issue – it's the first time I've been asked about it on Sleepio, but will be very helpful for others to recognise this as a difficulty if they, too, experience this.

    EHS is an emerging area in sleep science, so there is a lot of catching up required about the phenomenon, but it's thought more people experience it than we think, perhaps because people don't tend to understand it or don't know what to call it if it happens to them.

    In terms of what causes it, there are several theories out there, but one thing that may cause it – or make it worse after onset – is stress/anxiety. Therefore, something that may help is to allow for a longer wind down period that is consistent each night, engage in relaxation before bed and throughout the day. A reduction in alcohol consumption may also help.

    I believe that the concern this phenomenon causes may actually be part of the main reason people can't sleep when it happens, so, using the thought challenging techniques within Sleepio, it may also be helpful to challenge any beliefs that cause worry about it, instead replacing these thoughts with ones such as, “this is unusual but completely harmless”.

    I hope this offers some reassurance that there are things that might help.

  • Sleepio Member

    • 2510 comments
    • 384 helped
    in reply to Sleepio Member
    Expert

    Hello and thanks for getting in touch. It's a good point you raise. We need to sometimes be a bit more flexible with treatment and it's often a helpful tactic to take things at a slower pace if anxiety is a factor. I think as long as the bed-sleep connection is kept as a focus (ie using bed only for sleep and sex) and if more time is being spent on relaxation, then this may increase your confidence in approaching the next steps a little later. Sleep restriction is very effective, however is known to be very difficult and if the delay in engaging in it is spent specifically on building confidence and reducing anxiety, I think it's a good idea – it may just not be the right time to engage in this element. The best idea is to get in touch with the technical team at hello@sleepio.com and explain your plans so they can pause this element of the programme for you.

  • Sleepio Member

    • 2510 comments
    • 384 helped
    in reply to Sleepio Member
    Expert

    Hello – thanks for your post and sorry to hear you're struggling.

    In response to your first question, it is very normal for sleep to be thrown out when we return from travel. Jet lag can be an issue if it is long haul, but simply the change of routines/environments is also a common trigger to a bit of a blip. I wonder if what happened was that the association between poor sleep and bed that is present for your own bed was not present for the holiday bed, hence a reduction in anxiety and an increase in sleep quality when away.

    With regards to your second question, try not to worry too much about the accuracy of the sleep diary if it is causing anxiety – this will simply reduce sleep even more! Instead, guess your best estimate or take a brief screenshot when awake so the time is captured on your camera roll in the morning. If you are feeling sleepy and 15 mins has passed, 5 more mins seeing if sleep happens is OK. The 15 min rule is based on an average of when good sleepers fall asleep, not a hard and fast rigid measurement.

  • Sleepio Member

    • 2510 comments
    • 384 helped
    in reply to Sleepio Member
    Expert

    Hi there, thanks for getting in touch with this question. The reason we recommend using the bed only for sleep (and sex) is to ensure the association between sleep and bed remains strong; any other activities done in the bedroom will (especially amongst poor sleepers) weaken this link and reduce the liklihood of swift sleep at night time.

    The Sleepio programme is, however, a guide, rather than prescriptive. In terms of using the radio, it is a passive experience, so for some it may help induce sleep and may even block out thoughts, however it is always important to monitor whether it is extending the length of time to fall asleep – or even wakening people throughout the night if left on.

  • Sleepio Member

    • 2510 comments
    • 384 helped
    in reply to Sleepio Member
    Expert

    Thanks for getting in touch with this. It's a common question – I wonder if this article is helpful? It sometimes comes down to personal preference about what you feel should be entered:

    https://www.sleepio.com/library/article/how-should-i-record-brief-nighttime-wakings-in-my-/

  • Sleepio Member

    • 2510 comments
    • 384 helped
    in reply to Sleepio Member
    Expert

    Hello there. As with all medical conditions, we would recommend that guidance is sought from your doctor before engaging in sleep restriction to explore whether it is appropriate, so they are able to take your personal medical history and current symptoms into account.

  • Sleepio Member

    • 2510 comments
    • 384 helped
    in reply to Sleepio Member
    Expert

    Hi – this is a good question that I'm sure many others will be pondering, too. Sleep restriction's aim is to help people consolidate all bits of broken sleep into one long chunk. It also helps to improve people's sleep drive as they approach night time. Over the course of Sleepio, however, various aspects of the programme also aim to help people's sleep feel more qualitative. It takes a while sometimes for sleep quality to improve – even if sleep quantity has, so don't worry – this will eventually come.

  • Sleepio Member

    • 24 comments
    • 2 helped
    Session 4

    Thanks for answering my question Doctor.

  • Sleepio Member

    • 2510 comments
    • 384 helped
    in reply to Sleepio Member
    Expert

    You're welcome.

  • Sleepio Member

    • 2510 comments
    • 384 helped
    Expert

    That's all for this evening – thanks for the great posts and I'l speak to you again soon.

  • Sleepio Member

    • 4 comments
    • 0 helped
    in reply to Sleepio Member
    Session 3

    Thank you.

  • Sleepio Member

    • 2 comments
    • 0 helped
    in reply to Sleepio Member
    Graduate

    The link did not work as well as searching in the library for that subject

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