Live discussion with Dr Vicki Creanor - 26th July 2017

Dr Creanor will be hosting a live online discussion here on Wednesday 26th July, 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. If there are a lot of questions, she may not be able to answer all in the time available, but will try to answer as many as she can.

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Posted 20 Jul 2017 at 11:33 AM
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  • Sleepio Member

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    Graduate

    Thank you.

  • Sleepio Member

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    Expert

    Hi and welcome to the live Sleepio session. I'm aware there are several questions waiting so I will wait a few minutes to see if anyone is on live before starting these replies…

  • Sleepio Member

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    Expert

    HI there and thanks for your question. I'm curious as to whether, upon wakening early in the morning, there are any thoughts such as “I won't be able to get back to sleep now” etc as sometimes these types of thoughts, although sometimes not viewed as 'anxious' thoughts, can keep people awake. In these circumstances, relaxation in various forms can help. The techniques you will have covered by now including regular bedtimes, good sleep hygiene, the quarter hour rule and sleep restriction all apply when someone has early morning wakenings, but it may also be that the body clock is set in a particular way. When people feel very tired early in the evening and easily sleep then, but wake up very early too, it sometimes (not in all cases) is a body clock problem. In these circumstances, the Sleepio techniques can help regulate sleep and it can be helpful to get some bright light exposure in the early evening, too.

  • Sleepio Member

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    Expert

    Hi there,
    This is often a tricky subject as sometimes it's not so clear-cut. We recommend that people do not watch TV in their bedrooms, as this is part of making sure the bedroom is used purely for sleep (and sexual activity) to strengthen the bed-sleep connection in the brain. As for watching TV just before bed (in a different room), it really depends on what people watch and how it affects them – so it's different for everyone. We want to avoid people being too stimulated emotionally before bed as this won't help sleep. So this is why we recommend being careful about this activity. From there, it's a bit of a personal decision and sometimes trial and error. I hope that makes sense.

  • Sleepio Member

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    Expert

    Hello and welcome to Sleepio. This is a very, very common experience with people who don't sleep well. These feelings of resentment, anger and frustration upon wakening are known to many insomniacs! The Sleepio course takes people through a number of techniques that help to challenge the racing thoughts, calm the physical feelings relating to anxiety/anger and help alter the behavioural elements to sleep that cause us to wake after such a short period of time. It's normal to feel so frustrated at the start of the course, however once these techniques are practised, often people see significant changes in their sleep and also their emotions.

  • Sleepio Member

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    Graduate

    Hi,
    I was wondering how long I should stick to the quarter hour getting out of bed program?
    I've been doing it for over six months and not much hasn't changed.
    Should I just plan on always getting out of bed once a night? Or is there's a point where I stop and be just lay in bed until I fall asleep?
    Thanks.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Welcome to Sleepio, I see you have just started the course, too. Again, this is very common in those who come to Sleepio for help. It's an interesting point to raise and the reason for this odd 'second wind' as some people call it is, in fact, simple science. It will be explained in the next week or so by the Prof, but as a quick summary, it's anxiety that suddenly makes us get that adrenaline rush as we get closer to bedtime/see our bedroom/bed. This is because the connection, for poor sleepers, between bed and sleep is a negative one. Bed is a place where people lie awake and wish they were asleep and cannot get to sleep. So, over time, the brain learns this and starts to panic when bedtime draws closer.

    Sleepio will target a few things here to help:
    – negative thinking about bed
    – the rush of anxiety (using relaxation techniques)
    – the amount and quality of sleep occurring in bed (so the connection becomes more positive)

  • Sleepio Member

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    Expert

    Hi there,
    Thanks for your question. There isn't a set time, as such, on when people should aim to do this technique and actually what is more important is consistency. So I personally would recommend sticking with the QHR whenever required, as to lie in bed awake for longer than 15 mins will affect the bed-sleep connection. It often takes some people longer to regain better sleep quality and this taking months is not unheard of. What would be important to mention, though, is that it's normal to wake once or twice a night. This is just how humans tend to behave during sleep, so what also may help is to remember this upon wakening so that the dreaded negative thoughts don't kick in about these wakenings (“here we go again – why am I awake?!”) and keep you awake. Ensuring that all the other techniques are firmly in place is important, too – a good, consistent bed and rise time and wind down period, as well as watching caffeine and alcohol intake during the day. Hope that helps?

  • Sleepio Member

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    Graduate

    It does. Thanks so much!

  • Sleepio Member

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    Expert

    Hello – welcome to Sleepio, I see you are in the first week. Often when people join Sleepio, they ask us for the one magic technique that will just make them sleep through the night. The bad news is, there isn't one technique, but the good news is, doing the various techniques you will learn with Sleepio has been proven to greatly improve sleep problems. So, taking one technique at a time and implementing this into one's sleep routine is the best way to combat various sleep problems, including sleeping longer.

  • Sleepio Member

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    Expert

    You're very welcome

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there, thanks for your post. If people are struggling to stay asleep past a certain point in the morning and they have tried all the other techniques to no avail, they can try shifting their sleep window, so that they go to bed slightly later and often this means they wake a bit later, too. It's important to make sure all other techniques are being followed, though, to ensure good sleep quality. I would also recommend that shifting the sleep window should not be done on a regular basis, as this risks setting the body clock off again.

  • Sleepio Member

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    Expert

    Thanks for your question. Without knowing a little more, it's hard to pinpoint exactly what is causing this, but generally there are a couple of possible reasons. I'm not sure if naps are happening during the day (although we recommend cutting these out, I know some people still find this hard to do) but if they are, this will lessen any sleep pressure that should be happening at night to make people sleepy. Another possible reason, though, is an underlying anxiety or stress. These conditions often make us feel exhausted but also less sleepy, as there is a huge level of energy used up in anxiety, leading to exhaustion, yet the adrenaline rush or state of alert involved in anxiety does hamper the sleepy state. Another reason still may be due to caffeine intake – this tends to lessen the sleepy feelings in the evenings, too.

  • Sleepio Member

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    Expert

    Thanks for your question. What I think is happening here is that, as you point out, there is a mismatch between time going to bed and time aiming to sleep. What is recommended, though, in sleep treatment is that only sleep and sexual activity takes place in bed, as any other activities that mean you are in bed but not sleeping (including reading) will weaken the all-important sleep-bed connection in the brain. So, to combat this, we would recommend reading outwith the bedroom, then going to bed at the set bedtime (without the book and with the aim of sleeping). This way, I think the calculations should look better and it will also improve the bed-sleep association which is vital in the long run. Hope this helps.

  • Sleepio Member

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    Expert

    Hi there,
    Lack of sleep bring along with it many different symptoms. It's always wise to get new physical symptoms checked out by a medical doctor, so it sounds as if you were wise to do so. What I would say, though, is that I have come across many people with insomnia but also with anxiety/stress conditions who have had very similar symptoms as described here. Tension in the neck can be caused by stress/anxiety (which often co-exists alongside insomnia) and can be so severe that it leads to significant, long-term pain. There are also common complaints from those who experience sleep problems (and, I should add, depression) of a spaced out, disconnected feeling that often comes with exhaustion. Hope this helps explain another route these feelings may originate from.

  • Sleepio Member

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    Expert

    Hello and thanks for your post. To answer the first question, it is a good idea to start the new sleep window when it is more likely to be followed consistently, so yes, pausing the programme may be a good move here. If you need to pause the programme for travel/illness, people can email hello@sleepio.com to request this.

    On the second point, it may be that sleep efficiency would be different without sleep aids, however it's a personal decision whether people use these during the programme or not. There can still be gains in terms of better sleep even when people take sleep aids. It's always necessary to speak to the relevant professional before changing any type of medication, however. As for entering the sleep diary info, people should still stick to what is actually happening (even when on sleeping aids) rather than guessing what would be more accurate without them. Hope that helps.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Thank you Dr Vickie Creanor

  • Sleepio Member

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    Expert

    That's all for this session – thanks for the posts and I will speak to you again soon.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    You're welcome

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    I have been following SR seriously. No naps, no caffeine, no anxiety. I am a nurse and work shift-work for 30 years. I have always struggled with nights, but have managed. Last Dec. I just stopped sleeping for days at a time. I was exhausted but never sleepy. No yawning, no nodding off, nothing. That lasted for 5 weeks and then has gradually gotten better as I have figured out ways to get sleepy. A warm bath, yoga, guided meditation and forcing myself to yawn are required every night to get sleepy enough to fall asleep. If I don't do this routine, I won't sleep, just feel sick. Sleeping pills didn't work, so now I take magnesium, HRT, Vit. B, C, D and fish oil. I am no longer working nights but after 8 months I am still struggling to get sleepy. Any thoughts on why this is happening would be great as I am perplexed.

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