Live discussion with Dr Vicki Creanor - 22nd November 2017

Dr Creanor will be hosting a live online discussion here on Wednesday 22nd November, 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, 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.

To keep up with new comments as they are posted you will need to refresh this discussion page.

To do this

On PC hit CTRL and R keys or the F5 key
On Mac hit CMD and R

Posted 16 Nov 2017 at 12:40 PM
  • 32 comments
  • 2 helped

Comments

Show older comments
  • Sleepio Member

    • 26 comments
    • 2 helped
    Graduate

    Hi Dr. Creanor
    I am now having just 1 sleepless night at week. My main problem is adhering to the quarter of an hour rule. The problem is when I get up I set out with the intention of not going back to bed until I'm sleepy tired but that very often just leaves me with 1-2 hours of sleep which is dangerous because I have to drive 1 hour to work every day. Sometimes on the drive back I do feel very sleepy. Would you recommend that when that happens I just pull over somewhere and take a nap even though napping is not recommended.

    Thanks

    Sag

  • Sleepio Member

    • 2510 comments
    • 383 helped
    Expert

    Hello and welcome to the Sleepio live session. Feel free to ask any questions here about the psychology of sleep or the programme and I will answer in a way that will benefit the majority. As always, questions about medication or individual medical concerns should always be directed to a known medical professional who has access to your personal medical history.

    Let's begin…

  • Sleepio Member

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

    Thanks for your question. It can be very difficult for people living with chronic pain to get a good night's sleep. Pain and anxiety – sometimes in equal measures – are known to prevent a good quality sleep. There is some evidence that CBT-type interventions (upon which Sleepio is based) can help sleep in those with chronic pain – please see the article on Fibromyalgia in the library fro more info that may relate to those in this situation.

    Another thing to think about, though, is the use of relaxation methods during the day, before bed and when awakening through the night, to help with sleep. A good type of relaxation for those living with pain is autogenic training – there is a download available on Sleepio for this – have a look at the article in the library called “Autogenic Training” – there is a link to the download section there, too.

  • Sleepio Member

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

    HI there,
    Hopefully people in this situation are putting the quarter hour rule into place to further set-back so this will go some way to tackle the problem. By session 5 as well, people should be using sleep restriction to try and squeeze out middle-of-the-night wakenings. Challenging the anxiety behind the sleeplessness is vital – using relaxation methods, targeting the thoughts that fuel the anxiety and making sure a good bedtime routine is consistently put in place each night are all part of the recovery programme. Looking at daytime factors as well can help reduce the time awake at night (caffeine/alcohol/exercise/stress).

  • Sleepio Member

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

    Sorry that should say “to PREVENT further set-back”!

  • Sleepio Member

    • 5 comments
    • 2 helped
    Session 4

    Hi Doctor could the menopause be causing my insomnia at all?

  • Sleepio Member

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

    Thanks for your post. As for the position when doing the QHR, that is completely fine. The aim is to get out the bedroom, but there is no real hard and fast rule regarding sitting/lying positions, as long as people do not start to fall asleep outwith the bed.

    As for the setback, if the early wakening and reduced sleep has been going on for more than a couple weeks, I would say that people should be looking at their sleep window again and re-calculating how long on average they're sleeping per night and how long they're in bed in total to look at sleep efficiency – if it is less than 90% then reducing the sleep window until it gets back on track may be a good idea. This, along with all other techniques should help make it a quicker turnaround.

  • Sleepio Member

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

    Hi there – yes, menopause has a significant impact on sleep…have a look at the articles in the library about this…“menopause and sleep” and “hormones and sleep: a two-way street”

  • Sleepio Member

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

    Hi – you may be interested in the article “deep sleep” which talks a little about cortisol production?

    The main aim of the QHR (quarter hour rule – once awake in bed for approx 15 mins, we should leave bedroom and go elsewhere until sleepy again) is to weaken the association between bed and poor sleep. Or from another angle…strengthen the association between the bed/bedroom and good sleep. If we lie in bed getting anxious, it teaches the brain that bed is where we feel anxious, thus causing anxiety any time we go into our bedroom or go to bed. This is why we put the QHR into practice.

    If relaxation does not work so well, distraction methods can be useful for people during the day and also as bedtime approaches. It is our racing thoughts that cause the body sensations, so if we can distract the mind, the body will calm. Things such as caffeine intake and underlying stress need to be addressed as well as these all cause increase physiological arousal.

  • Sleepio Member

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

    I'm unsure what this is replying to? However if the room people are going into for the QHR is too cold, it would be a good idea to heat it up so as not to stimulate the sense too much upon using it for the QHR time – or another room could be used? Or if space is limited, people have used a hallway with a blanket and beanbag/cushion in the past.

  • Sleepio Member

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

    Hi and thanks for the questions.

    First of all, like any treatment, sometimes it is not as effective as it is for others. It could be, however, that there are underlying factors such as stress/depression/pain that are causing the sleep problems (or keeping them going) that do not allow for progress. The other things is, though, that sometimes it takes longer for some people to see success but yet success does still come. It's always hard to say how long recovery will take given the varied personal factors at play.

    In terms of sleep restriction, it is very common for this phase of the programme to be very hard and often there is sleep disruption, yes. But it is usually in the short term, before progress is seen in the medium to longer-term.

  • Sleepio Member

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

    Hi – I've never come across this before, but it looks interesting?

  • Sleepio Member

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

    Thanks for getting touch. When we wake up unrefreshed, it is likely due to either the number of hours we have slept (or not slept) or the quality of our sleep, but often a combination of both. We have to also look at what we have been doing during the day/evening…is our day full of stress/consumption of sugar/caffeine/alcohol/nicotine? Are we depressed or low in mood? Have we napped during the day? All these factors can lead us to feel unrefreshed upon wakening, irrespective of when we go to bed.

    During the Sleepio programme, people are guided on how to calculate when best to go to bed and wake up – this what is called the sleep window and is based on a person's own sleep data. This will be explained as people reach this point in the programme. Hope this helps?

  • Sleepio Member

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

    I have heard of some people who find this very relaxing at night time, however it's not to say this is for everyone. I don't know of any research into the benefits of this for sleep, so can't comment officially in any way in terms of whether it is recommended, however as with many relaxation methods, what works for some doesn't always work for others. So my advice to anyone experiencing any negative effects of any type of relaxation would be to stop it and look for alternatives.

  • Sleepio Member

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

    I am wondering if you are referring to using the computer (pc) when you are tired? Sorry if I have picked this up incorrectly. Sometimes we notice that things we did in the past did not affect our sleep, but if our sleep suddenly goes off track for some reason, then these same things can affect our sleep. Using the computer before bed usually has a stimulatory effect – it wakes up our mind for a number of reasons and we often are still thinking about what we have done online (chatting to others, shopping, gaming, searching the web etc) when we are suppose to be winding down. Sleepio will help people look at things to do in the evening that helps them sleep better, so hopefully this will offer some new ideas as to how to fill the evening. I hope I have understood the question here correctly.

  • Sleepio Member

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

    Thanks for your questions….

    Some people have found it helpful to make recordings of the noises they hear at night time so that they can listen to them during the day/evening while using relaxation methods to stay calm, with the aim of adjusting to them at night.

    All the techniques within Sleepio are designed to come together to help people learn how to get a better quality sleep, which in turn means more wakefulness during the day and a more refreshed feel upon wakening. Sleepio also aims to help people learn how to help themselves sleep for longer, too.

  • Sleepio Member

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

    Well done with the progress so far!

    I understand that naps are not recommended, HOWEVER....if people are driving and feeling sleepy at the wheel it is essential that they take a nap somewhere safe, or incorporate a nap elsewhere in their day. Safety comes first!

  • Sleepio Member

    • 29 comments
    • 0 helped
    Graduate

    Thanks for your answer Dr. Creanor

    How can one recalculate the sleep window?

  • Sleepio Member

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

    This is done via the sleep diary, but essentially it is the
    average time asleep in the night divided by average total time in bed over the night x 100 to get a percentage. If this is recorded over, say, a week, the average can be used for the calculation.

  • Sleepio Member

    • 2510 comments
    • 383 helped
    Expert

    That's all for today – thanks for the questions and speak to you again next week!

Return to top