Live Discussion with Dr Vicki Creanor - 25th March 2020

Dr Creanor will be hosting a live online discussion here on Wednesday 25th March, from 8.15pm to 9.45pm British Time or 3.15pm to 4.45pm US Eastern Time.

They 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, they may not be able to answer all in the time available, but will try to answer as many as they can.

Please do note that, as per our guidelines, Dr Creanor will not be able to give personal medical advice including those about medication. Their 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 20 Mar 2020 at 4:52 PM
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  • Sleepio Member

    • 5 comments
    • 6 helped
    Graduate

    Good “Morning” from America-
    Quick Question:
    Do we still implement the QHR protocols (moving to a passive activity) if we wake up 30 minutes before our scheduled alarm? (Or is it okay to just get up?)

  • Sleepio Member

    • 3 comments
    • 1 helped
    Session 5

    Hi Dr Creanor,

    I am struggling with sleep onset anxiety. I have a found that if I read a book for 5 minutes when I get into bed it distracts me and I fall asleep. The book just drops from my hands. If i don't, and I can start to worry, which if it builds can stop me getting any sleep at all.

    Is this an issue? I am on a 5 hr sleep window and I do get really tired but my anxiety is strong enough to override even this.

    Thanks

    Paul

  • Sleepio Member

    • 2 comments
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    Graduate

    I already had decent sleep efficiency as this isn't my first try at sleep improvement so much of what I am being told to do I already do. However, I still only get 5 hours or so of sleep with 1 or 2 wakings for short times, and often due to need to use the bathroom. I don't see how these methods will allow me to get more sleep when efficiency is the goal not sufficient sleep. It is expensive to pay to heat my home all night so I can get up for over 2 hours and multiple times a night, which increases my efficiency since I'm not awake in bed, but I'm still awake just cold and up.

  • Sleepio Member

    • 2 comments
    • 1 helped
    Graduate

    If we sometimes sleep later than our given wake up time, are we supposed to set an alarm every day? The session just suggested setting an alarm on weekends.

  • Sleepio Member

    • 4 comments
    • 3 helped
    Graduate

    Hi Dr Creanor,

    My issue with sleep had always been staying asleep, not falling asleep.

    Now that I am adhering to my sleep window, I find that I often fall asleep in the early evenings while watching TV or sitting up reading. Sometimes I have slept for as long as half an hour or 45 minutes. When this happens should I adjust my sleep window in any way?

  • Sleepio Member

    • 3131 comments
    • 555 helped
    Expert

    Good evening and welcome to the live Sleepio session. I'm Dr Vicki Creanor, a clinical psychologist with a special interest in sleep behaviour. I'll be here for the next hour and a half to answer any Qs on sleep behaviour/the Sleepio course. Let's get started…

  • Sleepio Member

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    Expert

    Hi and thanks for getting in touch. First of all, I'm pleased to hear the early wakenings have reduced now! My first question is – how long has this remained at 85% efficiency? If it's been a number of months, and you have seen other gains in sleep, I would say you can alter the sleep window by 15 mins – sometimes it's a bit of trial and error if we get stuck. But 85% efficiency is OK – 90% is considered good but you're close to this. If it was any less I'd suggest persevering a bit longer. Keep an eye on the impact of this and if efficiency increases again, you can add to the sleep window once again. If it drops, I'd suggest sticking with a shorter window for a while longer.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there – thanks for your questions. First of all, I would agree with all the things Kurly has suggested in their reponsse to you – thank you Kurly, all good advice!

    I would wonder if you have been sticking to a set sleep window and what this is? Is it supposed to be 10-5.15?

    It sounds as if you don't have enough sleep pressure built up when you actually go to bed, meaning that the body isn't ready for sleep yet. Increasing activity/exercise/fresh air/daylight (all challenging in the current climate, however we will speak in general terms for the moment) will all help you feel more tired when you retire to bed. Avoiding naps is also important. Having a good wind down period as has been suggested is important and making sure that you have 'put the day to rest' by noting any anxieties that may pop into your head at night can also help. Avoiding caffeine and alcohol is important too – make sure no caffeine is taken after lunchtime as this will impact on sleep onset insomnia (not being able to fall asleep). Remember that decaf drinks contain caffeine too, as does hot chocolate and energy drinks.

    It may be that after a period of being able to get a longer sleep, you can shift the sleep window to an earlier time and sleep later, but sleep quality and building sleep pressure may have to be worked on before this is possible.

    Hope this helps…

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hello – thanks for your post. This sounds frustrating! So it sounds as if this is likely a habit, if it even predates the other sleep issues. What you could do, is to gradually reduce what you do when you need to get up. For instance, over a week or tow, you could start to reduce the distance you travel at these wakenings. So night one, you might go to the bathroom but not actually use it and stay for one minute. Night two you could go to the bathroom, not use it, and stay for 30 seconds (don't time these as this will wake your brain up too much – just a rough guess is fine). Night three, go to the bathroom door, hover, then back to bed. Night five, halfway to the bathroom, hover, back to bed. Night six, a quarter way….night seven sit up in bed for 10 seconds or so….night eight sit up for a few seconds…night nine open eyes, then go back to sleep. Worth a try….? I'd be keen to hear how this goes.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    PS not sure where night four went but you get the idea!!

  • Sleepio Member

    • 3131 comments
    • 555 helped
    in reply to Sleepio Member
    Expert

    Hi there – good question and thanks for raising it. As we are all aware, Covid-19 is a real problem for us all just now. As with any illness, though, the advice for Sleepio if someone falls ill is – sleep when you need to to fight the illness. Don't worry about the programme at that point, do what you feel you need to do – sleep is much needed (even during the day) to heal the body when we are ill and fighting a virus especially. In terms of the programme, this can be simply paused and returned to from where you left off. If you feel the sleep window is too small initially and you are still working on the impact of illness, you can widen the window initially if required and get back to where you left off as soon as you're able.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hello from across the pond! Thanks for your question. It's the most frustrating time to wake early isn't it? I think when the time is 30 mins before the alarm, it makes most common sense to get up at that time. QHR may be more disruptive if you get back to bed then have to wake so quickly. If it is an hour before the alarm, though, I'd still try the QHR.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there. If your question is about whether it's Ok to continue reading, then yes I think it is. There is debate about this amongst sleep experts – some are stricter and say absolutely no reading in bed and there is good evidence for this too. However if it works for you and you are asleep in 5 mins I see this as a good strategy to help you get to sleep quickly. Good sleepers often do the same. The problem mainly arises when people get so engrossed in books and they are reading for an hour in bed before they get to sleep. This means that the brain associates the bed with quite a bit of awake time instead of purely sleep. 5 mins in my view is absolutely fine.

  • Sleepio Member

    • 3131 comments
    • 555 helped
    in reply to Sleepio Member
    Expert

    Hello and thanks for getting in touch. Sorry to hear you're still struggling with the amount of sleep per night and wakenings. In practical terms re the use of the QHR and being up in a cold house, leaving blankets and a hot water bottle/small heater in your chosen area of the house may help. But I'm wondering if there is an underlying reason for the struggle to sleep longer/more soundly. Sometimes, if there is an underlying stress/anxiety/low mood it can have a real impact on sleep. Health problems may also play a part, as does napping during the day, caffeine/alcohol use and medication. Are any of these relevant to you at all?

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    yes – consistent bedtimes and rise times are important to the treatment plan. It helps the body get used to certain patterns and helps the internal body clock. Even at the weekends. Sleeping past our set rise times is not recommended.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there. I would flip this around…instead of adjusting the sleep window (not recommended), I would concentrate on ways to avoid napping early in the evening as this will have an impact on your sleep later in the night – even if it's 15 mins worth of a nap. You can do this by getting up and being more active to avoid falling asleep, having a window open near you for fresh air and even setting alarms on your phone every few minutes to stop you falling asleep. Hope this helps…

  • Sleepio Member

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    Expert

    That's all for this evening – thanks for the posts and I will speak to you all next time. Stay safe.

  • Sleepio Member

    • 3131 comments
    • 555 helped
    Expert

    That's all for this evening – thanks for the posts and I will speak to you all next time. Stay safe.

  • Sleepio Member

    • 3 comments
    • 1 helped
    Graduate

    How do I post to suggestions? Or respond to the doctor? I'm not able to respond! :-(

  • Sleepio Member

    • 453 comments
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    in reply to Sleepio Member
    Graduate

    You can post a new question for next week – just go to the community page and scroll down to the Live
    Doctor session and post your question there. These sessions take place every Wednesday evening (UK time)
    If you need help before then, click on my name or post to your profile page and it will appear on the rolling banner for all to see. There will be plenty of help forthcoming!
    Kurly :)

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