Live discussion with Dr Vicki Creanor - 23rd November 2016

Dr Creanor will be hosting a live online discussion here on Wednesday 23rd 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. 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 Nov 2016 at 9:07 PM
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  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    Sorry to hear things are so tricky just now. There are certain points in the programme when the techniques are particularly difficult – the quarter hour rule being one of these as you have experienced and also sleep restriction. It's the points that most people seem to want to stop the course the most. At the start of the sleep restriction, there is likely to be disruption and little sleep – this is very normal. Although the last attempt at the quarter hour rule was tough, I would recommend trying it again as it may have been a coincidence that the shingles occurred then, although it's clear to see why the link would have been made as it is often stressful at first trying these new techniques. Many people find that even if a certain technique is tried first time without success, they go on to succeed at further attempts. Not what you want to hear I imagine! However it's important to know that most people find these elements very hard indeed and to know you're definitely not alone here.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    Naps have been mentioned a couple times tonight interestingly – it's obviously a topic people are keen to talk about. We do recommend cutting out all naps, even if no sleep was had the previous night…however…if naps are recommended by your medical doctor for physical health reasons, or if you need to drive a long distance or if you need to operate machinery for example, then naps are sometimes needed for safety. But in pure CBT treatment, they do interfere with night time sleep, so they should be cut out altogether, all the time.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    Thanks for your question however I'm afraid you're right-I can't really endorse any particular resources on mindfulness, however there are a number of apps for phones now available to engage in mindfulness as well as many books. What is more important than the book/app one chooses is the results one gets from it…ultimately, one is aiming for a sense of relaxation and stillness that reduces the amount of worrying that goes on in terms of thinking ahead to the future too much. It's about learning to just be in the here and now. Hope that helps!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there,
    in terms of treatment for insomnia, it's often best to stick to routines for sleep. This is when it works best. Unfortunately, this can require sacrificing a social life (!) for a while during treatment. To get sleep back on track, consistency is essential for success. Travelling can be tricky if it can't be avoided, but maintaining as much consistency and routine as possible is key to improving sleep in general. Hope that helps.

  • Sleepio Member

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    Expert

    HI there,
    I see you are at session 3 so there are many more techniques to cover that will tackle this particular issue. It's a very common problem so the course is tailored to targeting it. These are cognitive and behavioural approaches so there is a good combination to tackle all parts of this problem of middle of the night wakenings. Hope that reassures you about what's to come…

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there,
    Sleep restriction (SR) is probably the hardest part of the programme for most people…then it's probably the quarter hour rule! SO, they are definitley not easy and sleep usually gets worse before better…however…they are also the most important parts of the programme and likely the most effective in terms of getting sleep back on track.

    Some tips for making these easier…. – Using the ''the the' technique to stop thinking about any thing one used to do when trying to get to sleep (I'm not sure where this is covered in the course but it involves the repetition of the word 'the' over and over to keep negative thoughts out)
    – make the room one goes into for the quarter hour rule cosy and not too bright, avoid eating, drinking and stimulating activities at this time – try and sit and do nothing til sleepy again
    – do not clock watch …it is simply your estimation of 15 mins, it's not completely rigid…don't have a clock near you or visible when in bed

    My advice would be to try these tips and stick with the SR as it's very very effective.

    Good luck!

  • Sleepio Member

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    Expert

    HI there,
    As a short term fix, a caffeine boost can really help with this issue in the morning and is important if one needs to drive. However it does sound as if taking the course again, one technique at a time would be helpful in terms of helping with the other issues mentioned…it may also be that it then helps the unrefreshed feeling upon wakening.

  • Sleepio Member

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    Session 4

    I am wondering about discontinuing my use of sleeping pill while on the program. It's one of the reasons I'm here. I know, from my doctor, that I have to gradually reduce my dosage over time. I think it will take me some months to taper off because I've been on them so long. When I tried before I had rebound insomnia. So I'm wondering if any reduction or discontinuance is not going to skew my results from the Sleepio program quite a bit.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there,
    Often we do hear about menopausal women struggling with sleep. It's sometimes linked to the reduced levels of progesterone (which helps sleep) but can also be to do with wakenings caused by hot flashes etc. There can still be improvement in sleep using the CBT approach depending on which area is impaired at the moment but it is often one of the transitional times in life that sleep becomes poorer/different (puberty and pregnancy are also linked to poorer or altered sleep)

  • Sleepio Member

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    Session 3

    Hi
    Im really hoping this programme works for me as i have been an insomniac for over 20 years and im looking forward to learning new techniques. I have only been on the programme for a few days. It feels like im running on auto pilot at times and i just keep going until i drop. I also have an eating disorder and have done for over 30 years and suffer from depression. i know negative thinking can affect your sleep behaviour but is there also a link to poor sleep and anorexia. I have had cbt before in therapy and i know it can help, but ive never been taken seriously regarding my sleep. Drs either dismiss it, tell me not to worry about things too much or try to prescribe medication which i do not want to take as i feel in the long term they make you worse.
    Thanks for taking the time to answer my questions

  • Sleepio Member

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    Expert

    It's always essential to talk through any medication changes with your medical doctor, however there are people using this programme on meds, tapering off meds and not on any meds who see benefits, so it's possible to improve in all situations.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there thanks for your question. Poor sleep is actually linked to most (possibly all) mental health problems in some way. I have worked with people with eating disorders in the past and sleep has been affected, yes. CBT approaches are often similar and will target the thinking and behaviours, which are crucial to recovery for eating disorders and sleep. All the best with the programme.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    hi there,
    in terms of dreams waking people up, usually it's because there is an anxiety-provoking element, which comes from an underlying anxiety, so it would be worth people speaking to their medical doctor/GP if this is the case to get support for anxiety. As for tinnitus, some people have tried having a white noise playing in the background to provide a different focus other than the tinnitus-related sound.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there – avoid having a clock at all nearby as this increases anxiety, but some people have taken screen shots on their phones (if a smart phone) when awake just briefly to record times, so there is a record in the morning of number of wakenings and times.

  • Sleepio Member

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    Session 3

    Thank you Dr
    I am committed to this programme and any techniques that may help i am willing to try out. Looking forward to the next stage of the programme.

  • Sleepio Member

    • 1389 comments
    • 225 helped
    in reply to Sleepio Member
    Expert

    hi there,
    Sleep restriction is the hardest part of the course for most but yes, sleep will be disrupted for a while and will eventually even out for most people. We would try and recommend avoiding drifting off on sofas (albeit difficult) but engage in lightly stimulating activities to try and avoid this til bedtime.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    hi there,
    quite a few questions like this which only highlights how hard this part of the course is for most people, but yes, also most effective part in my opinion so sleep will be disrupted for the short term with usually very good longer term outcomes and more routines normal sleep. all the best for this phase of the course…

  • Sleepio Member

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    Expert

    That's all for today – busy wee session with lots of great questions. Thanks for your company…speak to you soon.

  • Sleepio Member

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    in reply to Sleepio Member
    Session 2

    Not sure if i'm allowed to recommend this, if not I apologise.
    I have practiced Mindfulness for over 5 years. I would recommend ' Mindfulness a practical guide to Finding Peace in a Frantic World by Danny Williams and Danny Penman. It also has CD's with guided meditations.

  • Sleepio Member

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    in reply to Sleepio Member
    Session 2

    Sorry it's Mark Williams and Danny Penman

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