Live discussion with Dr Vicki Creanor - 31st August 2016

Dr Creanor will be hosting a live online discussion here on Wednesday 31st August, 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 25 Aug 2016 at 7:20 PM
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  • Sleepio Member

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    Expert

    Hi there,
    It is sometimes very difficult to imagine a life without sleep problems if they've been going on for so long. This feeling occurs especially at the start of the SLeepio course, before any real changes have had the chance to occur. During the course, there will be techniques taught to help with people's difficulties in getting to sleep and staying asleep. But it's hard when we start this programme to wait for the next part of the work, when people are desperate to sleep better. The techniques have been designed to help with various sleep problems and are effective for those using medication and those not using medication. When people are thinking about weaning off meds, it's always important to do this with a professional who can advise on how best to reduce them.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    It's daunting starting a new treatment programme and what we hear is a real desire for those just starting to use Sleepio to just sort their sleep, ASAP. And no wonder – living with poor sleep is very debilitating and a great source of distress. The Sleepio programme is designed to target many things, including sleep quality. The various techniques covered in the programme all work together to increase the overall sleep experience.

  • Sleepio Member

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    Graduate

    Hello Dr. Creanor,
    I usually fall asleep very quickly, but my problem is that once, for some reasons I wake up in the middle of the night I am not able to fall asleep anymore. I start thinking obsessively about several things and even silly thoughts become huge in mind.
    Could you please give me your opinion on this issue?
    Thanks very much.

    Cinzia

  • Sleepio Member

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    Expert

    Hello and thanks for your post. It's very normal to experience more disturbed sleep at the beginning. Just like any psychological treatment, tings are usually a bit unsettled at the start as the problem takes more focus than before.

    In terms of what people starting out may read about getting out of bed when they can't sleep, this is incredibly daunting and seems completely counterintuitive. The science behind this technique is aimed at increasing the time spent in bed sleeping and reducing the time spent in bed awake, as this will increase sleep efficiency – a key component behind good quality sleep. This is explained when the technique is first explored, but it still terrifies many people. However, the evidence shows that it's one of the most effective parts of cognitive behavioural therapy for people with insomnia in aiding their recovery.

  • Sleepio Member

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    Expert

    Hello – thanks for this question. Having thoughts buzzing around our heads is common in many people who wake during the night and is likely a sign of stress/anxiety. There are several techniques in the course that help this issue – look out for challenging negative thoughts, scheduled worry time and thought blocking techniques – all of these will help target the middle of the night wakenings when the mind becomes full of worries/thoughts.

  • Sleepio Member

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    In reply to a deleted comment
    Expert

    Hi there,
    Sleep efficiciency and length of sleep per night are related in that, once sleep efficicency is improved at around 90%, the sleep window can be extended by 15 mins. So the first aim is to increase the sleep efficiency. Usually this is done using sleep restriction and the quarter hour rule but also by avoiding naps during the day. Sometimes, if even after following these techniques by the book, sleep efficiency is still not great (nor length of sleep), it's worth looking at other factors. Caffeine intake, smoking, use of alcohol, lack of exercise, physical health problems, mental health problems, stress can all play a part in maintaining a sleep problem, so it's important to explore these things too to see if these can be altered to improve sleep. As we get older, or go through the menopause for example in women, our sleep can be negatively affected too, so these things are also worth considering.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    It's hard at the start of the programme to know what lies ahead, but rest assured, the techniques included will target the common problem of not being able to stay asleep throughout the night.

  • Sleepio Member

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    Expert

    Hi – thanks for your question. I haven't heard of this problem of dehydration but that's not to say there's not a link! Always good to get these things tested medically. Perhaps others from the community have similar experiences?

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi – people can have poor sleep for a number of reasons. Sometimes it is that their bodies prefer to sleep at certain times that aren't conducive to their lifestyle (circadian rhythm problems) but sometimes it's that they've gotten into bad habits. The Sleepio programme aims to target these patterns and helps people get back on track with more helpful sleeping patterns that work better for them.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there – thanks for your question. I'm afraid I'm not an expert on this and so not aware of the science behind it but I believe it's about how your brain perceives these beats when played together and, for some, this has a positive effect. The main piece of advice here, however, is that if something make someone feel more relaxed, this is a good thing and worth using if it has a positive effect (as long as there are no risky side effects).

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    1) how helpful can CBTi be with post menopausal women with chronic insomnia?

    2) Should such women also be assessed for sleep apnoea?

    3) If GPs are reluctant to refer for sleep assessment, how helpful is home overnight oximetry and pulse assessment with devices such as the Contec CMS-50E or similar as a screening device?

    4) why do GPs appear to be both woefully ignorant of all of the above, and also astonishingly disinterested in chronic insomnia – or have I just been unlucky?

    5) if my perception above is a common one, how can this be addressed?

    HI and thanks for your post. CBTi has been shown to be effective in many groups of people. If there are patterns of sleep that have proved unhelpful over the years then this is exactly what CBTi targets. Often, menopause can trigger the sleep problems due to the associated night wakenings and physical/emotional changes that accompany this stage of life. \Following the menopause, therefore, some faulty patterns may persist that started during this time of disrupted sleep – CBTi would certainly fit with working with this problem. As for sleep apnoea, people need to be seeing the symptoms of it in order to request an assessment – frequent wakenings caused by obstructed breathing. I'm afraid apnoea isn't something I work with clinically as this usually takes the medical route so I can't comment on the evidence behind use of the oximetry machines. We would always advise people who aren't satisfied with opinions from GPs to request to see a different GP to see if they can offer something different.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    Sorry a reply has not yet been sent to you. I contacted the team last Wednesday after your post asking them to get in touch with you. Apologies for the delay in this happening. I will chase this up on your behalf.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there – thanks for this comment – always nice to hear when people are improving with the programme.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there – there is a good resource in the library regarding this – if people search for jetlag they should find this.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there – best way to stop using technology at nighttime is to do so gradually rather than stop it completely as sometimes it becomes a bit addictive for people. With all addictions, or strong behavioural patterns, it's more effective when we wean ourselves off the behaviour gradually.

  • Sleepio Member

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    Expert

    that's all for tonight – thanks for all the posts – speak to you all again soon.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Thank you for this. I am finding it useful. I am also using techniques from Sleepio very good. Progressive Relaxation is most helpful. I am managing to adjust negative thoughts. It is good to have a toolbox to use for different problems. I have suffered with this problem for over 20 years but I am really beginning to think that Sleepio is something that will help me. Thanks again

  • Sleepio Member

    • 30 comments
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    Graduate

    I'm going on holiday. Long haul… I'm a bit worried about jet lag. There's a five hour time difference and my flight home is a night flight and I'm back in work the next day… Any tips on how I get myself straight back to UK time??

  • Sleepio Member

    • 11 comments
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    in reply to Sleepio Member
    Session 5

    I have been for sleep study they told me to use the sleeping pills for the study.i thought that was not correct any way the result was i woke up hundreds of times and they put me back on meds.
    I do not know if you read that i tried not taking meds some time ago did not sleep for one week then only a few hrs(the week was hell i dont think i could do that again) that natural sleep ended up with about 5 hrs but
    as soon as anything changed (like vacation) i was back to not sleeping.So i take meds some nights are ok others not so brilliant but better than the alternative.
    I sleep with ear plugs ,eye mask,dark quiet room no tv
    no caffeine after lunch ,i do listen to radio real low seems to help.I do not worry about it i just take something.

  • Sleepio Member

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    in reply to Sleepio Member
    Session 5

    I feel the same way i think we have a weak sleep system
    I the brain some how.I take different meds to sleep some time its good other time not so,So i change the med so as not to get addicted to one.
    Its funny having this problem i think most people dont understand what its like,its not like having a broken leg
    where people can see it .

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