Live discussion with Dr Vicki Creanor - 25th November 2015

Dr Creanor will be hosting a live online discussion here on Wednesday 25th November 8:15pm-9.45pm GMT.

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 that, as per our guidelines, Dr Creanor won’t 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.

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

To do this:

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Posted 20 Nov 2015 at 12:23 AM
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  • Sleepio Member

    • 1389 comments
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    in reply to Sleepio Member
    Expert

    Hi there,

    Thanks for your questions…

    Melatonin is actually a hormone that is released at night time. It varies as to how you obtain melatonin from country to country – in the UK, you need to see a medical doctor to have it prescribed but in the USA you can buy it over the counter. I'm unsure where you live but it's always wise to get advice from medically trained professionals when starting a course of medication.

    As for thyroid problems and trauma, we know that these often do cause sleep problems in many people.

    We know that Cognitive Behavioural Therapy (on which Sleepio is based) is the best evidence-based treatment for sleep problems because many people do recover from it using this treatment.

    As for getting into bed feeling relaxed and calm, yet sleep doesn't happen, this is often due to the negtaive associations built up subconsciously about the bedroom/bed and sleep. This is why the quarter hour rule and sleep restriction are so important to retrain the mind in this respect.

    Hope that helps?

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi Lovebug,
    Thanks for joining us tonight. Yes thanks – just making my way through those already posted but I shall come to yours just now…

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi again,
    Thanks for asking about early morning wakenings. This is a common phenomenon in sleep problems. In terms of what actually causes them, it differs from person to person but some common causes include lifestyle (caffeine consumed, alcohol consumed, smoking, diet etc), mental health difficulties (anxiety, depression, stress) and then there is the sleep environment (uncomfortable bed, too hot, too cold). Hormone changes and age also play a factor…many pregnant women and women going through the menopause complain of early morning wakenings and the older we get, often the more broken our sleep becomes. So, it's worth thinking about all these factors when we find ourselves waking up early.

    In terms of what to do, the Sleepio programme is designed to create the optimal amount and quality of sleep and eradicate things like early morning wakenings as well as other difficulties. Making sure you optimise your environment and look at the factors above is important. Making sure you get help for anxiety/depression etc is also helpful but in terms of specific Sleepio techniques, sleep restriction will help these wakenings in terms of creating more sleep pressure in order to help you stay asleep throughout your sleep window.

    Hope this helps.

  • Sleepio Member

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    Expert

    Hi Trevor,
    Thanks for your post. It's tricky to explain the difference between these two descriptions as sleep is such a subjective experience. So someone might have a bad night's sleep and feel tired, while the next person may feel completely exhausted. Sometimes when we are physically unwell, however, or are feeling depressed, we may feel more overall lethargy as well as tired, but again it's very subjective so it's hard to quantify these categories. Hope that makes sense?

  • Sleepio Member

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    In reply to a deleted comment
    Expert

    Hi there,
    Thanks for your post. I hope the response to Lovebug was of some help to you too. In terms of how the Sleepio course is set up, it is aimed to target many of the most common sleep difficulties (including early morning wakenings) using techniques that have been found to be successful. Although it is not an entirely individualised programme, the techniques you will cover after week 2 will tap into what is needed to treat early morning wakenings.

  • Sleepio Member

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    Graduate

    Hello,
    Thanks for the response. I am not pregnant or in menopause. I have none of the lifestyle or sleep environment issues you mentioned. I do suffer from anxiety which I am working on and I have made a lot of progress with and not sure why it still would be causing the early awakenings. I have followed the Sleepio directions very diligently (i'm in my sixth week) and have no trouble at this time falling asleep initially or with multiple wake ups throughout the night which were problems for me at the beginning and now sleep 4.5-5 hrs straight. However, the last early wake up is persisting. What do you recommend for it as I tried pushing my bedtime later? my sleep window was 11:00-5:00. I've done as late as 12:00-5:00 with some improvement but not always. Should I continue with the shorter window or Should I move the whole sleep window earlier (10:00-4:00)? Also how long will it take to work through the early awakenings? Any specific directions would be appreciated. I have to go back to work shortly (I'm in the US) so thanks again for responding!

  • Sleepio Member

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    Graduate

    Hi Dr Creanor.
    Thank you for the answer I understand where you are coming from it is an awkward situation and your explanation is good so thanks again .
    Trevor.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi Lovebug,
    Thanks for your response too. In terms of anxiety, it's sometimes very subtle and subconscious and can actually wake us up even if we don't feel the typical palpitations or anxious feelings on the surface, so it could be that once the anxiety issues are resolved, the sleep improves. In terms of how long it takes to get through the early morning wakenings, again I'm afraid the variance is wide from person to person so it's not possible to say exactly. The diary you are completing, though, is a good indicator of improvements as sometimes it can feel like nothing is shifting, yet your diary shows you otherwise. As for, shifting the sleep window, you can try this, but make sure you stick to the same number of hours you should be on and try the new sleep window for about 2 weeks before assessing whether it's helping or not. A night here and there with different sleep windows may do more damage than good as you're really aiming for consistency in the long term, but varied sleep patterns can be quite disruptive.

  • Sleepio Member

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

    Hi Lovebug,
    Thanks for your response too. In terms of anxiety, it's sometimes very subtle and subconscious and can actually wake us up even if we don't feel the typical palpitations or anxious feelings on the surface, so it could be that once the anxiety issues are resolved, the sleep improves. In terms of how long it takes to get through the early morning wakenings, again I'm afraid the variance is wide from person to person so it's not possible to say exactly. The diary you are completing, though, is a good indicator of improvements as sometimes it can feel like nothing is shifting, yet your diary shows you otherwise. As for, shifting the sleep window, you can try this, but make sure you stick to the same number of hours you should be on and try the new sleep window for about 2 weeks before assessing whether it's helping or not. A night here and there with different sleep windows may do more damage than good as you're really aiming for consistency in the long term, but varied sleep patterns can be quite disruptive.

  • Sleepio Member

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

    Hi Lovebug,
    Thanks for your response too. In terms of anxiety, it's sometimes very subtle and subconscious and can actually wake us up even if we don't feel the typical palpitations or anxious feelings on the surface, so it could be that once the anxiety issues are resolved, the sleep improves. In terms of how long it takes to get through the early morning wakenings, again I'm afraid the variance is wide from person to person so it's not possible to say exactly. The diary you are completing, though, is a good indicator of improvements as sometimes it can feel like nothing is shifting, yet your diary shows you otherwise. As for, shifting the sleep window, you can try this, but make sure you stick to the same number of hours you should be on and try the new sleep window for about 2 weeks before assessing whether it's helping or not. A night here and there with different sleep windows may do more damage than good as you're really aiming for consistency in the long term, but varied sleep patterns can be quite disruptive.

  • Sleepio Member

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

    Hi Lovebug,
    Thanks for your response too. In terms of anxiety, it's sometimes very subtle and subconscious and can actually wake us up even if we don't feel the typical palpitations or anxious feelings on the surface, so it could be that once the anxiety issues are resolved, the sleep improves. In terms of how long it takes to get through the early morning wakenings, again I'm afraid the variance is wide from person to person so it's not possible to say exactly. The diary you are completing, though, is a good indicator of improvements as sometimes it can feel like nothing is shifting, yet your diary shows you otherwise. As for, shifting the sleep window, you can try this, but make sure you stick to the same number of hours you should be on and try the new sleep window for about 2 weeks before assessing whether it's helping or not. A night here and there with different sleep windows may do more damage than good as you're really aiming for consistency in the long term, but varied sleep patterns can be quite disruptive.

  • Sleepio Member

    • 1389 comments
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    Expert

    ooops sorry for the double (or quadruple!) posting – technical hitch as I thought my reply wasn't posting…!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    I would also say to make sure you implement the quarter hour rule with early morning wakenings – even if it's an hour before you are meant to get up, I would advise all early wakeners to get out of bed after being awake for their guess of 15mins, and making a point of returning to bed when they feel sleepy tired if this happens before their wake-up time.

  • Sleepio Member

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    • 225 helped
    Expert

    It's very quiet out there…any more questions?

  • Sleepio Member

    • 21 comments
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    Graduate

    Hi, I'm not sure if I'm writing this in the right box but here goes. I find it absolutely impossible to not fall asleep if I sit down in the evenings. I ( and my hubby ) have been fighting it for years. Often it is just for a minute or 2 at a time. I have tried sitting on floor, on hard chairs, on stools etc but if I'm watching TV I'm normally gone after 30 mins whatever I am sitting on. Apart from being really annoying is this an issue for the programme? Evening are torture!! It doesn't make any difference whetherI am exhausted or relatively OK. Have been on SR for 4 weeks. I would appreciate some advice

    Thanks

  • Sleepio Member

    • 21 comments
    • 1 helped
    in reply to Sleepio Member
    Graduate

    Hi, I'm not sure if I'm writing this in the right box but here goes. I find it absolutely impossible to not fall asleep if I sit down in the evenings. I ( and my hubby ) have been fighting it for years. Often it is just for a minute or 2 at a time. I have tried sitting on floor, on hard chairs, on stools etc but if I'm watching TV I'm normally gone after 30 mins whatever I am sitting on. Apart from being really annoying is this an issue for the programme? Evening are torture!! It doesn't make any difference whetherI am exhausted or relatively OK. Have been on SR for 4 weeks. I would appreciate some advice

    Thanks

  • Sleepio Member

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

    Hi Juniper.
    Thanks for your post and looks like you wrote it in exactly the right place. It is an important issue for the course, actually, yes – any sleep we get (even accidental!) outside the bedroom can have a negative impact on sleep improvements. So, what's helpful to those finding they drift off when they're not meant to is to have a bit of a trial period in terms of trying activities in the evening that keep them awake (as long as they are safe if you do fall asleep). So light housework can often help, light exercise (a walk), keeping the house (and you) cooler so that you don't get so dosy etc. Perhaps people in the community have good ideas of their own that has helped this problem?

  • Sleepio Member

    • 1389 comments
    • 225 helped
    Expert

    That's all for this session – see you again soon!

  • Sleepio Member

    • 435 comments
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    in reply to Sleepio Member
    Graduate

    Hi juniper,
    I had a real struggle staying awake through the 9pm dozy zone, and found that if I could just keep awake from 9 to 10, I could keep going for another couple hours quite easily. So to get me over the hump, I started baking bread in the evening because that made me have to get up every so often to knead or turn it, and I planned it to be round my dozy time. Then I would just leave the dough somewhere cool overnight and bake fresh bread when I got up early in the morning – the treat of fresh bread was a good reward! Whatever you can think of that forces you to get up and move to another room, or outside, every 20 minutes or so will help. Walking outside for even a few minutes is ideal, but at this time of year that may be a bit difficult!

  • Sleepio Member

    • 21 comments
    • 1 helped
    in reply to Sleepio Member
    Graduate

    Hi and thanks for the suggestions. Baking bread does sound a rewarding thing to do. I tried ironing and a short walk yesterday which helped. One of the great pleasures of my new later time schedule is that I can now go to the cinema in the evening, which is a real treat. I made myself go to bed at 10.30 before which meant a pretty dull or stressful social life if I stayed up 'late'. Now I need to work on how not to nod off in the cinema!!

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