Live discussion with Dr Vicki Creanor - 24th June

Dr Creanor will be hosting a live online discussion here on Wednesday 24th June 8.15pm-9.45pm BST.

She will discuss as many topics as possible in the hour and a half and, as always, you’re welcome to ask any questions at all about sleep or the Sleepio program. Please do note however that, as per our guidelines, Dr Creanor won’t be able to give highly specific medical advice. She will however try to help as best as she can!

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Posted 20 Jun 2015 at 1:34 PM
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  • Sleepio Member

    • 10 comments
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    Graduate

    Hi Dr Creanor,
    I have a question about my sleep window. I have found Sleepio hugely helpful. I struggle, however, to sleep for the duration of my sleep window. After making steady progress with sleep efficiency up until graduation, I am now on a SW of 7 hours 15 minutes. I struggle every night to meet this, however. I am fastidious about having a proper wind down and, due to the fact that I hate having to observe the QHR, I wait until I can't keep my eyes open before I go to bed. This is an effective strategy in one sense in that I usually meet my 90 per cent sleep efficiency target and avoid having to get out of bed during the night. However, I am going way past my threshold bed time most nights and 'only' getting 6 hours sleep, occasionally less. I get the extra 15 minutes awarded each week but it no longer holds any value for me as I don't feel that there is any natural expansion of my sleeping time.

    Should I just try going to bed earlier some nights, and try to use my full sleep window on those nights? Or should I keep going to bed only when I can no longer keep my eyes open? Is it possible that my body is telling me that I actually don't need as much as 7 plus hours sleep? I actually feel really quite good on 6 hours sleep now that my sleep-related anxiety has been largely put to rest through Sleepio. Ideally I would like to find a way to have a bit more though. 7 hours would be great and was my average pre-sleep problems. Thanks!

  • Sleepio Member

    • 1389 comments
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    Expert

    Good evening/afternoon everyone and welcome to the live Sleepio session. In the next 90 mins, I will take questions regarding the Sleepio programme or the psychology of sleep and answer them to the best of my ability. I am a clinical psychologist, so if there are any queries about medical conditions or medications, these are best taken to your GP/family doctor.

    Shall we begin?

  • Sleepio Member

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    Expert

    I will start answering the questions already posted by some community members, however if you are joining us live and have a question, please post it and we can discuss what's going on and how to help.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi Peony,

    Thanks for your post. First of all, congratulations on your improvements so far – it's great to hear some of the previous problems you had with sleep have been getting easier for you!

    I'll go through your Qs one by one so it's clearer….

    - one specific day of the week I anticipate that I'm not going to sleep well and then I don't. The next day is a day when I particularly need to be alert!! I think I have a little bit of anxiety about the day's activities too. I know this sort of thing is covered in the course but I'd appreciate some more guidance

    I think what would help best here is working on the anxious thoughts you are having about the certain day you feel anxious about. There seems to be a link between what you do that day and how worried you are about it and thus the impact it has on your sleep. All unhelpful behaviours/symptoms are triggered by negative thoughts, so it's an important place to start challenging. You might want to visualise the day you fear going well. Often, when we visualise success rather than worry about the worst case scenarios, it turns out better as we have mentally practised for that outcome. It makes you feel positive about it too, rather than worried.

    - do you have any tips for when I can't follow the wind-down routine/timings? for example, when I have to go to work in the evening

    We all have days when the routine can't go to plan because life gets in the way. That's normal and expected. I would say to try and get back to whatever bit of the routine you can when you get home – you could pick up half way through, or you could even do the whole routine but just condensed in time. You might also want to listen to relaxing music on the way home from work to start the wind down during your journey (as long as it's safe to do so).

    - it seems to me that often when I wake up in the night (or perceive I'm awake) I'm not awake enough to put into practice anything that I have learnt on the course! I just seem to be tossing and turning and restless and worrying about things. Have you any ideas how I can address this?

    This is quite common too – you don't feel you are alert enough to know what to do. The main thing when you wake is to make sure you don't toss and turn for too long. You might want to put a bit of paper on your bedside table saying “quarter hour rule” on it to remind you to get out of bed if you are tossing and turning for 15 mins or more?

    Hope these make sense….

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi SunnyFrodo,

    Thanks for your post. I'm sorry to hear you have felt the topic of non-restorative sleep has not been addressed as much as the focus on improving sleep efficiency. There are a few articles in the library which you may be interested in that do explain it a little more. A very helpful one is:

    “How to Get a Good Night's Sleep” by Dr Kyle.

    The good news is that research has found that the techniques covered in Sleepio (cognitive behavioural techniques) also improve sleep quality over time as well as sleep efficiency.

    I can hear it's really frustrating for you, being able to sleep better but not feeling the benefit. You also asked if there were others who share this problem – may I point you to a community discussion that was started in this area?

    https://www.sleepio.com/community/discussion/dealing-with-non-restorative-sleep/

    Vicki

  • Sleepio Member

    • 1389 comments
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    in reply to Sleepio Member
    Expert

    HI Blodwen,
    I'm sorry to hear you are struggling with poor quality sleep – it sounds very frustrating. You are right, recovery is usually gradual and there will be ups and downs along the route, too.

    As for your question, if I've understood you correctly, you are asking how someone achieves restorative sleep if you're waking up shortly after falling asleep and throughout the night?

    The technique known as the quarter hour rule is important here to try and squeeze together all the bits and pieces of sleep you usually get, fragmented across the night. It's important to get out of bed if you wake up and lie there for more than 15 mins, unable to get back to sleep. This strengthens the association between bed and sleep and makes it more likely – in the long run – that you will sleep for longer lengths of time. Although there is not a complete guarantee that this will increase your restorative sleep (we are still learning about exactly what improves this type of sleep problem), it will increase your chances if you have less fragmented sleep periods.

    Hope this helps?

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi Jenny B,

    It sounds as if you have a lot of insight into what works for you and also that you understand the Sleepio techniques really well.

    I would say you're absolutely right in waiting til you are sleepy tired to go to bed. If you were to go earlier, there's a danger that it will worsen things for you as you may spend more time awake in bed, weakening the strong connection between bed and sleep that you've worked hard to build.

    What you can do, however, is try shifting the sleep window, so that your threshold for going to bed matches when you feel sleepy tired. You may find that you sleep longer. You may find that you don't! If you don't, then perhaps your natural time for sleep is shorter than you were hoping for. It's interesting that you feel good on 6 hours' sleep.

    I would try shifting the window first and see how that goes. Have a look at the library article called How To: Shift Your Sleep Window by Peter – it will help you on how to do this within the programme.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Here's the link, Jenny B…

    https://www.sleepio.com/library/article/how-to-shift-your-sleep-window/

  • Sleepio Member

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

    Thank you for pointing me to the article, which was interesting to read. I have been using CBT techniques for a long while (prior to starting this course) and I don't feel stressed when I go to bed but during the night I wake often and dream a lot. I'm not usually awake for more than 15 minutes and so do not need to get out of bed. So I'm struggling to know what I should be doing to tackling the sleep difficulties that I'm experiencing. Any advice? Many thanks for your help,

    Sunny

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there,
    It sounds as if you have really worked on lots of the techniques, SunnyFrodo – I'm sorry to hear you are still struggling despite clearly having worked hard on it. The research into what specifically will help non-restorative sleep is still emerging. However, when we discussed this within our team of experts at Sleepio, we thought it was important to suggest that people with this condition visit their GP to discuss whether there are any underlying medical conditions, which can sometimes cause non-restorative sleep. If there are no underlying conditions, other things that may help include changing the timing of your sleep window, so that it fits better with your clock or circadian phase – or extending your window in order to receive more sleep. Have you tried any of these things before?

  • Sleepio Member

    • 6 comments
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    in reply to Sleepio Member
    Graduate

    Thanks very much for your reply and help. I have discussed my difficulties with my GP and had the usual blood tests etc and everything was normal. She did mention the possibility of a sleep study but there is nothing that would point to me having an underlying medical condition. I have tried both going to sleep earlier/later and also extending the sleep window but unfortunately neither have worked in terms of getting better quality sleep.

    Thanks,

    Sunny

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    It sounds like you've been pretty proactive, SunnyFrodo. I'm sorry if it seems as if you have tried everything suggested. The only other thing I'm wondering about is lifestyle – do you smoke/drink/take recreational drugs/consume a lot of caffeine/take regular medication?

  • Sleepio Member

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

    Thanks for your support. I don't smoke, drink or take drugs. I drink one coffee a day in the morning. I'm not on any medication.

  • Sleepio Member

    • 1389 comments
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    in reply to Sleepio Member
    Expert

    Thanks, SunnyFrodo. Would it be OK with you if I took your queries back to the team to see if anyone else has further suggestions for you?

  • Sleepio Member

    • 6 comments
    • 0 helped
    Graduate

    Yes that would be very helpful please. In particular it would be useful to know whether it would be worth going back to my GP to discuss a sleep study or whether there are any other avenues that I should be exploring. Meanwhile, should I continue with the sleep restriction or should I extend my sleep window again as I don't feel that the restriction is improving the sleep quality? Many thanks again for your help.

  • Sleepio Member

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

    I would try increasing your sleep window and monitor the effects – positive or negative – to see if this has any effect. I will contact the team tonight and let you know as soon as I have responses.

  • Sleepio Member

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

    Thank you very much for all your help.

  • Sleepio Member

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

    You're welcome, SunnyFrodo.

  • Sleepio Member

    • 1389 comments
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    Expert

    That's all for tonight folks – thanks for the posts and I will see you soon.

    Vicki

  • Sleepio Member

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

    Many thanks for your response. Unfortunately, the quarter hour rule is'nt relevant in this instance. I have been interested to read your advice to SunnyFrodo. My situation is very similar and I too have had blood tests which have been normal. It is good to hear that research into 'restorative sleep' is being done and that it appears to be a separate aspect of sleep problems. B

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