Live discussion with Dr Vicki Creanor - 27th July 2016

Dr Creanor will be hosting a live online discussion here on Wednesday 27th 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.

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Posted 21 Jul 2016 at 1:39 PM
  • 24 comments
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  • Sleepio Member

    • 25 comments
    • 4 helped
    Graduate

    When I've been awake for a while what should I do? Is meditating on the bedroom floor with a blanket allowed (or on the sofa)? I sometimes doze off outside of bed if I leave my bed at night. Is this ok to do?

  • Sleepio Member

    • 1 comments
    • 0 helped
    Graduate

    I wake up 1-2 times a night and board the Hamster Wheel of going over the same problems over and over. They are things in my life that I cannot change. I take a half of a mild sleeping pill and I'm able to back to sleep. I do not feel groggy after as little as a couple more hours sleep. Is that Okay ?

  • Sleepio Member

    • 2 comments
    • 0 helped
    Session 5

    Hi Dr Creanor,

    I've just completed session 3 and have thus started working on my sleep restriction. However, I don't have problems with waking up during the night, but rather with falling asleep. If I understand correctly, sleep restriction is most beneficial/important to people whose sleep is fragmented. Is it paramount that I stick to my sleep restriction? Could I allow myself to sleep longer than the allocated 7 hours?

    Additionally, I've found that I worry about going to bed at the correct time, which in turn makes it even harder to fall asleep than usual, and means that I sleep less than I would if my sleep weren't restricted. I woke up feeling tired and groggy this morning because of that. Do you have any advice for dealing with that?

    Your help is much appreciated!

  • Sleepio Member

    • 9 comments
    • 0 helped
    Graduate

    I am struggling to get off to sleep my S/R j is 2315 -0515 I have been getting in bed at 2300 and listen to PR but cannot get to sleep after this , so I ended up getting up doing my wake up plan and sometimes it's is 0200 before actually get to sleep and then I am awake at 0515 so tired this is happening most nights how do I break this cycle

  • Sleepio Member

    • 7 comments
    • 1 helped
    Graduate

    Despite no day time naps and a busy life either working or looking after grandchildren the most continuous sleep I ever have now is 4 hours. Is there a cycle of 4 hours?
    How can I tell what type of sleep I am having, I only seem to be in a deep sleep if I am woken by the alarm or by grandchildren?

  • Sleepio Member

    • 28 comments
    • 0 helped
    Graduate

    I find I am waking up early--about an hour, I do not feel rested. Is it a good idea to do progressive relaxation or ? I sure don't feel like getting out of bed when the alarm goes off. I find myself nodding off during the day.

    I just was able to add 15 minutes to my sleep 2 days ago.

    thank you for your assistance.

  • Sleepio Member

    • 1389 comments
    • 225 helped
    Expert

    Hi everyone,
    Welcome to the live sleepio session. Any burning questions about the psychology of sleep or the programme, please post away…

  • Sleepio Member

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

    Hi there,
    When people are doing the programme, they might notice changes in their sleep patterns now and again. This is normal and what we'd expect. When it has just been a few says of waking up, we would recommend people keep going with their plan and, if the sleep efficiency gets worse and worse over a week or two, then they can look at their sleep period for sleep restriction. Most good sleepers wake up once or twice a night but they do not worry about it. We also recommend people target the thoughts that come out of the fact they wake up during the night. One can help themselves to stay asleep during the night by putting all techniques into place, having a good diet and little alcohol/caffeine and by exercising well. Avoiding naps is important too as this increases sleep pressure whihc helps us stay asleep all night.

  • Sleepio Member

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    • 225 helped
    in reply to Sleepio Member
    Expert

    Hi there,
    Yes – we would recommend that people avoid all naps (even short ones) as this interrupts the ability to sleep well at night.

  • Sleepio Member

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

    Many people believe they are going 'back to the start' with their sleep after a period of poor sleep again. However, we recommend that people see this as a blip (good sleepers have blips too) and that they focus their efforts on sticking to the techniques including the quarter hour rule when they wake up during the night. When one wakes during the night, they might do relaxation or some activity that is quite passive so as not to stimulate the body but to get it ready again for sleep. In terms of anxiety, this will come from worrying about not sleeping. Relaxation is helpful, as is scheduling in worry time during the day so that worries are dealt with away from the sleep period. One might try the paradoxical intention technique when trying to get back to sleep – this helps focus effort away from sleep and instead, one says to themselves, “don't fall asleep”...the brain hears the sleep bit but it takes pressure of the person in terms of trying to fall asleep as you are saying the opposite. Thoughts at night that make us feel anxious and are not yet successfully challenged during the day can also be blocked by repeating the word “the” over and over.

  • Sleepio Member

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

    HI there,
    This is to be expected with sleep restriction. Its main purpose is to increase sleep pressure and increase the likelihood of sleeping in one continuous block rather than having fragmented sleep over a longer period across the night. People will feel very tired throughout this process, so this is normal and what we expect. Ways to get through this are different for everyone, however many say that keeping busy through the day, using some (but not too much) caffeine in the early hours of the day, exercise, doing stimulating activities and getting fresh air are all helpful in this tricky early period of sleep restriction.

    It's helpful for those going through this to remember that it's a short-term plan but the sleep window, following improvements, will increase as time goes on.

  • Sleepio Member

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

    We want to make it clear to people that it's really important to avoid nodding off anywhere that's not bed as this interrupts the progress one will see in nighttime sleep. I posted a few ideas in my last response just a minute ago to keep people awake during the day but at night, options include reading, relaxation, watching mild TV…I would recommend doing this outside of the bedroom however as this strengthens the connection between the bedroom and sleep. we recommend all activities other than sleep (and sex) are kept outwith the bedroom for this reason. Blankets can be used, but make sure this does not mean falling asleep outwith the bedroom too easily.

  • Sleepio Member

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

    HI there,

    What people can do when they find their worry creeps into bedtime (which occurs with us all at various times in our lives) is schedule in some worry time during the day for things we know will worry us at nighttime. Make it earlier in the day – not too close to bedtime.

    In terms of the course, it will teach people to challenge their thoughts, block their thoughts at bedtime and schedule in sleep into regular blocks with regular wake and sleep times.

    In terms of sleeping pills, many people use sleep aids but any question about them or how to use them effectively should be directed towards a medical doctor. They can be used in conjunction with the Sleepio course, however.

  • Sleepio Member

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

    Hi,

    Sleep restriction is what many people struggle with concept-wise and in practice. It's counter-intuitive for most people. However, even when the problem is mainly onset insomnia (difficulties falling asleep) there is a likely benefit in the technique in terms of increasing sleep pressure/sleep drive. Often we struggle to fall asleep in the first place because our sleep drive (the body's need to sleep that increases with time spent awake) is too weak. Sleep restriction aims to increase this.

    In terms of going to bed at a regular time, this is helpful in terms of getting the body into a routine. The body loves routine, so it helps create a pattern that the body and mind start to understand and adhere to when it's time for bed.

    In terms of dealing with anxiety around any aspect of sleep, the relaxation techniques are helpful but also the challenging negative thoughts section can help turn irrational thoughts into more balanced, helpful thoughts that do not interfere with falling asleep. Scheduled daytime worry time can help remove certain thoughts building up at bedtime.

  • Sleepio Member

    • 9 comments
    • 0 helped
    Graduate

    This question is in regard to couples who over time develop different sleep requirements as well as my partner, spouse, who goes to bed late. Due to my sleep issues feel that they have adjusted to sleep in a different room and made their adjustments. Since it takes me an hour to sleep once in bed the partner does not want to be responsible for waking me once a sleep, turning on the little book light previously used for their sleep routine or moving around in bed. These dynamics do change a long time great relationship over time. Question is to your findings in evaluating the sleep program in overall couple situations. Have your professionals evaluated these type of sleep scenarios in the long run. The issue of insomnia is not a singular or solo mission within a structure of living with other people. I'm assuming the program has research on this. What have you evaluated from your sleep clients?

  • Sleepio Member

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

    Hi there,
    When people are struggling to get to sleep initially, it might be an idea to do any relaxation as part of the wind-down routine (which should be standard every night), outwith the bedroom. Scheduled worry time should be set aside in the daytime to avoid thoughts creeping in at night when trying to get to sleep. The thought blocking technique can be used as well if thoughts start to creep in in bed.Thoughts should be noted and challenged using the technique within the programme. All naps should be avoided to make sure sleep pressure builds up. With a regular sleep time and wake time, implementing the quarter hour rule and sticking with it as close to the programme as possible, changes should start to be seen. If it has been months without change, we might suggest people speak to their GP/family doctor to check if there is any underlying reason for poor sleep. Lifestyle factors and mental wellbeing should also be looked at in case an underlying condition is causing the sleep problem not to shift with the techniques within the programme.

  • Sleepio Member

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

    Hi there,
    As far as I know the research so far has looked at individual outcomes, but let me double check this. It's absolutely true that sleep problems affect more than one person in a family, especially those with bed partners. We do often recommend that people work on their sleep individually if their bed partner's movements/sleep habits interrupt their own recovery, but we are by no means unaware of the tensions this may cause in otherwise good relationships.

  • Sleepio Member

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

    Hi there,
    During the course of a night, we do go through a number of different sleep stages/phases. What is interesting, however, is that sleep manages to adjust itself pretty well. So, if the body feels we are lacking in deep sleep, it will go into deep sleep quicker than usual after we fall asleep so that we catch up with it.

  • Sleepio Member

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

    If people have a consistent problem of waking up an hour earlier than their sleep window ends, they might want to shift their sleep window back an hour so they go to bed earlier to wake at the time they have been waking at naturally. It may be that they are early wakers by nature. If it's sporadic, however, we recommend trying to get back to sleep if early waking…relaxation can be used outwith the bedroom if one cannot get back to sleep after 15 minutes as per the quarter hour rule, or other passive activities to bring on sleepiness. Bedtimes and wake times should be stuck to and one should always avoid the temptation to sleep through the alarm through choice. And of course, all naps should be completely avoided.

  • Sleepio Member

    • 1389 comments
    • 225 helped
    Expert

    That's all for now – thanks for the questions today – speak to you again soon.

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