Live discussion with Dr Vicki Creanor - 25th February

Dr Creanor will be hosting a live online discussion here on Wednesday 25th February, 8.15pm-9.45pm GMT.

She will discuss as many topics as possible in the hour and a half, starting with the most popular questions with answers being given in a way to give the most benefit to the general Community.

To have a say in which questions are answered, either:
+ post a question or comment ahead of the discussion, by clicking the blue ‘Add a comment’ button; or
+ vote on other people’s questions, by clicking the blue ‘Yes’ button underneath the relevant comment.

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' or the 'F5' key
- On Mac hit 'Command' or 'Apple' and 'R'

Posted 22 Feb 2015 at 4:32 PM
  • 27 comments
  • 3 helped

Comments

Show older comments
  • Sleepio Member

    • 1426 comments
    • 247 helped
    Expert

    HI everyone and welcome to the live session. Let's get started – fire away with any sleep or programme-related questions…

  • Sleepio Member

    • 12 comments
    • 0 helped
    Graduate

    Hello Dr Creanor,
    I have been on SR for 5 weeks now and while there have been improvements I am still having difficulty. My sleepwindow is from 1:15 to 6:45. I have really tried to keep it as close to that as possible. I try not to nap and if I do it is only for the 15 minutes. My SE is staying between 68 and 75 % and I'm still waking ul between 8 and 10 times a night. I don't fell stessed when I go to bed and usually fall asleep within 10 minutes. Do you have any suggestions on what I could do to improve my SE? I thought about throwing in the towel or restricting my sleep even more but have a hard time wrapping my mind around that as tired as I am.

    Thanks so much!

    Sherri

  • Sleepio Member

    • 1426 comments
    • 247 helped
    in reply to Sleepio Member
    Expert

    Hi zeebee,
    That's a good question and I'm not entirely sure how you go back to sessions as I log on slightly differently. Do any of the other community members know how zeebee can do this? If not, I'll check it out with the technical team.

    What I can advise you about is that active relaxation involves things such as going for a walk, doing mild exercise – things that burn up energy. Passive relaxation activities involve reading, listening to music, having a bath etc. Both are useful and you really have to try a few before you know what works for you as everyone is different.

    Hope that helps?

  • Sleepio Member

    • 1426 comments
    • 247 helped
    in reply to Sleepio Member
    Expert

    Hi mg15,
    Thanks for your question. Most people with insomnia experience poorer concentration, poorer memory after their sleep problems start. This may be the case even after a good night's sleep due to the accumulation of poor sleep in the previous nights. As for medication, this is not my area of expertise, but some drugs do have strong side effects – I would check the side effects information or speak to the person you prescribed them for you to see if this is a possibility.

  • Sleepio Member

    • 1426 comments
    • 247 helped
    in reply to Sleepio Member
    Expert

    Hi Sherri,
    Nice to talk to you again. The only way really to improve sleep efficiency is to stick to sleep restriction closely. This means taking no naps at all (even 15 minutes can set it back significantly) and sticking to the sleep window exactly. Yes, this is very rigid and you will probably not want to hear this, however it's got to be rigid if it is to be effective. In all the evidence we have about the effectiveness of this technique, it's been followed exactly, so this is what we recommend. I do really appreciate that it is really hard. It's the hardest technique of all, especially when you have many responsibilities during the day. However if it is to work, it has to be followed to the letter and naps have to be completely avoided. Hope that helps?

  • Sleepio Member

    • 1426 comments
    • 247 helped
    in reply to Sleepio Member
    Expert

    Hi there,
    Thanks for your post. Sounds like you're having a tough time of it? It sounds as if the physical problems are impacting heavily on the sleep problems just now so I would recommend getting these resolved before working out how best to work on your sleep problems. You will still have all your Sleepio techniques to use when you need to, but it sounds as if your sleep will still be poorly affected by this pain until this is resolved?

  • Sleepio Member

    • 1426 comments
    • 247 helped
    in reply to Sleepio Member
    Expert

    Hi Crafty,
    Sleep restriction is, as I was saying to your fellow community member previously, the hardest part of the programme for most people. It's counterintuitive to restrict sleep you're not usually getting. However, I would say again that it has to be followed exactly, without extending the time in bed to 8 hours and without sleeping on later when tired.

    When you go on holiday, it's up to you whether to halt the programme or keep it going – everyone is different. I believe you'll still have access to the previous weeks' material? As for extending your window to 8 hours, though, this will likely set your sleep efficiency back so this is not recommended.

    Hope that makes sense.

  • Sleepio Member

    • 12 comments
    • 0 helped
    Graduate

    Dr. Creanor
    Thank you! Do you think it would help to restrict my sleep even more? Maybe going from 5:30 minutes to 5 or 5:15 a night. I would like to this moving in the right direction.

  • Sleepio Member

    • 1426 comments
    • 247 helped
    in reply to Sleepio Member
    Expert

    Hi Mary,
    Good question. This is something that people tend to have to do a bit of trial and error with til they find something that works. Avoid drinking and eating, and things that will stimulate you. You could simply sit and so nothing until you feel sleepy again, rather than having to find an activity to do?

  • Sleepio Member

    • 1426 comments
    • 247 helped
    in reply to Sleepio Member
    Expert

    Hi there,
    I wouldn't restrict it further until you're at around 90% efficiency. Try cutting naps entirely and leaving bed when you're meant to, implementing the quarter hour rule and staying awake until you're meant to go to bed (you can ask here for suggestions on what others do to stay awake) and then see how this affects things…

  • Sleepio Member

    • 1426 comments
    • 247 helped
    in reply to Sleepio Member
    Expert

    Hi gamerx,
    Yes it is possible that CBT is not suitable for some people, even although it's the treatment of choice to treat insomnia. If there is an underlying sleep condition such as sleep apnoea, restless leg syndrome, narcolepsy etc then this may have to be treated first. Likewise, if there is another physical or mental health problem that is causing the sleep problems, we would recommend that these are treated first, given that sleep is a symptom of this primary problem. If someone is on medication as well, sometimes this will have a negative impact on their ability to find effect in CBT. So there are a few reasons as to why CBT sometimes doesn't help. Also, it may not help now, but may help in the future, if circumstances change – sometimes the readiness of the person to change, for example, is what's blocking treatment.

    Does that help?

  • Sleepio Member

    • 1426 comments
    • 247 helped
    in reply to Sleepio Member
    Expert

    Sorry to hear this, Gavlaur. A few people have mentioned their struggles with sleep restriction during this chat so far – this shows you that it's the main technique where people struggle. It's a very effective technique but you may feel that now is not a good time to put it into practice. You have to feel ready to commit to restricting your sleep as it is really hard to do. Despite this, it's probably the most effective technique to treat insomnia and get sleep back into a regular, unbroken pattern. It needs to be the right time for you as well, though.

  • Sleepio Member

    • 1426 comments
    • 247 helped
    Expert

    Any more burning questions out there? It's gone a bit quiet…

  • Sleepio Member

    • 12 comments
    • 0 helped
    Graduate

    Is it ok to move your sleep schedule as long as you stay within the number of hours allowed for sleep?

    Thanks,

    Sherri

  • Sleepio Member

    • 1426 comments
    • 247 helped
    in reply to Sleepio Member
    Expert

    Yes you can do this, sherri, as long as your sleep window remains the same length.

  • Sleepio Member

    • 1426 comments
    • 247 helped
    in reply to Sleepio Member
    Expert

    ...and you should also stick to the new window time rather than moving it around all the time…

  • Sleepio Member

    • 12 comments
    • 0 helped
    Graduate

    Ok great, thank you so much for your help! Have a great evening!

    Sherri

  • Sleepio Member

    • 1426 comments
    • 247 helped
    Expert

    Thanks for the posts and questions everyone – speak to you again soon.

  • Sleepio Member

    • 4 comments
    • 0 helped
    in reply to Sleepio Member
    Session 5

    Yes, I used to have rather bad exam anxiety. Thinking bad, this could be why.

  • Sleepio Member

    • 15 comments
    • 8 helped
    Graduate

    I have had insomnia for 4-1/2 months. I do not have any clinical mental health issues or physical sleep disorders (apnea, restless leg, etc.), and I have never taken any sleep medication.
    I started sleep restriction with a CBT-I-trained therapist 3 months ago and just recently quit in frustration. After 3 months I still had not achieved 90% efficiency and had only marginal improvements in night-to-night consistency (only occasional deviations from the 1 “good” night followed by 1 “bad” night pattern). My therapist told me that everyone else she had worked with was back on track in 4-6 weeks.
    I did not adhere well to the bedtime the first two weeks, but since then I have been very conscientious. I do not nap at all during the day, though I occasionally fall asleep on the couch during my “wind-down” hour before bedtime. I have also followed all the sleep hygiene and stimulus control guidelines.
    I suspect that one reason for the ineffectiveness of the therapy was inadequate emphasis on the cognitive piece, especially the thought modification. I am currently looking for another therapist who can help me with that. I'm giving Sleepio a try in the meantime.
    I am currently being a little looser about the restriction – I'm maintaining my prescribed wake time of 6:30 AM but am allowing myself to go to bed any time after midnight. I am averaging about 4 hours of sleep per night, so 6-1/2 hours in bed is probably too much, but I am just so tired of 3 months of fighting off sleepiness every evening, sometimes for as long as 4 hours/evening, in order to stay up until 1:00 or 1:30 AM when I'm seeing so little improvement.
    At last… here's my question: Should I resume the sleep restriction? If it hasn't really helped in 3 months, is it OK to be less restrictive than normal and focus my energy on the cognitive piece? (I haven't done the Sleep Schedule module yet – it's next week in my Sleepio program.) Thanks!

Return to top