Live discussion with Dr Vicki Creanor - 31st January 2018

Dr Creanor will be hosting a live online discussion here on Wednesday 31st January 2018, 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, including that concerning medication. 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 25 Jan 2018 at 2:54 PM
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  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    I'm sorry this is a difficult patch for you. What you will cover soon in the programme is something called the quarter hour rule. This helps people to remove themselves from the bedroom if they have been lying in their beds awake for more than 15 minutes. The reason behind this is that we don't want to associate our bed with being awake/anxious, so we move the wakefulness away from this location altogether. It is also a good idea for many people if they keep reading to another room so that bed is purely for sleeping and sex. These sessions will be covered for you soon so look out for the quarter hour rule. Early morning wakening is a common problem so there are techniques built in to the programme to hep with this throughout.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Sorry you didn't find it helpful. It's still very much being studied as a concept, but I would say to go on one's judgement about whether they area wake or not – if they can wake up to note a wakening, they are not asleep – if not, they are asleep. Much of our measurement of sleep is very subjective given it is a personal experience.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there and congratulations on the progress so far. In order to deal with thoughts at bedtime/during the night, I would recommend that people dedicate some time during the day – morning or early afternoon – to note down the thoughts that are worrying them. This is often called 'scheduled worry time'. The theory is that, if people dedicate some time to do this early in the day and process the thoughts, try and problem solve, they are less likely to creep up on people at night time. Keeping everything else regular too – bedtime routine, same bed and rise time – is also helpful, as is avoiding caffeine and alcohol, in making sleep more refreshing.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Thanks for the questions. In terms of temperature, usually the optimal temperature for sleep is a cool bedroom, however everyone is different and feels more comfortable in various temperatures. Perhaps layering of bedsheets is a helpful way forward and having a blanket next to the bed to avoid getting up would help.

    It is very tricky when questions about bed partners' behaviours come up, as it is so hard to control another person's factors. I wonder if he could have earphones for his alarm or you could wear earplugs to block out noise? Some couples sleep separately until the sleep work is complete, but this is not for everyone.

  • Sleepio Member

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    Session 5

    Hello
    This is the first time I have taken part in anything like this.
    I have been trying Sleepio for the last 9-12 months but I have to admit that I have not been using the service since the beginning of August. I tried for approximately three months but saw no improvement in my insomnia. I have suffered with it for over 20 years now and struggle every night to achieve a good rest. I usually take 1-2 hours to fall asleep and/or wake up throughout the night and am sometimes unable to get back to sleep, some nights resulting in getting 2-3 hours at best. I cannot concentrate on anything anymore, my work is suffering and I can almost feel my memory getting worse as the months go on. It's so bad that I can remember with clarity the last time I had a good night's sleep and woke up feeling rested – 4/9/2007. I would give anything to wake up feeling like I did the following morning.
    I'm fairly healthy and not overweight. I try to exercise a couple of times a week (cycle about 5 miles each way to and from work). I had a sleep apnoea study carried out at home and it showed mild sleep apnoea but only while on my back. The consultant said the level would not affect the quality of my sleep. He said we could try a mandibular advancement device to see if it made any improvement, but after a few months of wearing that I did not see any improvement. I then hired privately an APAP machine for two weeks, but it was so alien that I was unable to get any sleep whatsoever while wearing the mask.
    In desperation I went to the doctors two weeks ago to ask for sleeping pills. I have never done this before and have generally been against taking any medication for the issue as I do not want to become hooked or, even worse, for the pills to work for a few weeks or months only to then stop due to developing a tolerance for them.
    The GP asked me some questions and before I knew it he was suggesting some antidepressants based on my questions to general mood and feeling. I lost my mum suddenly and unexpectedly late 2016 and I probably haven't dealt with it properly, but I was keen to stress that my sleep problem has been severe for many, many years before that. I cannot say that it has got significantly worse after losing my mum. Anyhow, I am about to start taking these tablets (Escitalopram), but I was also prescribed sleeping/anxiety tablets (Lorazepam) to try and help me sleep. I thought I'd try the Lorazepam first, because I know the Escitalopram can actually make insomnia worse. The Lorazepam do have some effect, but the last few nights have still seen me take over an hour to fall asleep and I have woken numerous times throughout the night.
    I'm not even sure why I've written all of the above, but I feel I'm at the end of my tether. I do not know what else there is left to try and I feel that my life is wasting away due to a lack of sleep and being able to concentrate. I can be reading a book only to realise that I have absolutely no idea what the last three pages have had on them. I'm 36 and I really do not know what I can try next. I will carry on with the pills and follow up with the GP in a week's time, but I am open to any and every suggestion.
    Desperately yours,

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Thanks for getting in touch. It can be particularly difficult when women go through the menopause as the frequency of hot flashes increases, leading to disturbed sleep. There are methods I have come across such as having a fan in the room behind a bowl of ice, which blows icy air into the room. So having a blanket on at the start of the night and having the fan may help when too cold and too hot. Reducing the need to get out of bed is worth thinking about so you're not waking up too much. It may also be worth asking the GP/family doctor if there is anything medication-wise that could help the hot flashes. Using relaxation methods upon awakening may be helpful but also following the quarter hour rule, as discussed above, if awake for more than 15 mins will help sleep in the long run.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Thank you for the honesty of your post. I can tell that it really has been a difficult time for you.

    I cannot comment on the medications but I'm glad that you are seeing the GP again next week to discuss these.

    When reading your post, and particularly the part about memory suffering, I wonder whether it would be helpful to have a friend or family member help you through the programme and help you implement the techniques? Sometimes when our mood is lower, memory is weaker and energy levels are low, it is hard to stay motivated. Having someone help recall the techniques and provide prompts may help to target the sleep problem more effectively?

  • Sleepio Member

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    Session 2

    Dear Dr Creanor
    Do you think my mind is overriding the physical “catching the moment” of falling asleep and waking me up? Seems very weird. I dont get hot flashes at any other time ( during the day) and didnt get them before the start of this severe insomnia in November 2017 as i am way past menopause. Age 58
    Thanks for your thoughts in thus

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Quite often the mind is key to keeping us awake at the start of the night – racing thoughts do override the physical need to sleep. I would always recommend getting something physical such as the hot flashes checked and assessed by a medical doctor who knows your medical history well – they may be best placed to reduce them, too.

  • Sleepio Member

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    Session 2

    I can also add that of the 6 nights of Zopiclone prescribed by my GP i had similar sensation. After one hour of taking the Zopiclone tablet i experienced the sensation of the moment of falling asleep ( heavy drowsy eyelids and sensation that yes this is me falling asleep) , only for my mind to override it by forcing me awake again . and try as i might i could not get the sensation of “ catching the moment” back again so it would be a whole night awake. I know that i am awake the whole night as i can see it getting light outside.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    It is hard to know what's ahead in week 1, but there will be many techniques being offered over the next 5 weeks that will help not only with people not able to fall asleep, but with those who cannot stay asleep all night.

  • Sleepio Member

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    Session 2

    Thank you .
    I dont honestly think i have any racing thoughts though. Ive had enough of the day and achieved what i can do in that day . no problems at all before november 2017. Would fall asleep quite easily.
    Also as its not always a hot flash i think there is something else causing it .

  • Sleepio Member

    • 12 comments
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    Session 2

    Its almost as if im not giving myself the permission to sleep . have you come across that before in your clinical work?
    Thanks

  • Sleepio Member

    • 9 comments
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    Graduate

    Thanks for your reply Dr Creanor, I think it's the so called periods of restlessness (not necessarily awake) that's increasing my awake time as I believe even good sleepers have several brief periods of being awake that they have no recollection of. I will take your advice on board and use my own judgement of when I think I'm awake during the night and adjust the data accordingly that should definitely increase my SE. Thanks again for your time.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    I shall keep an eye out for further work in the area then. The half-sleep episodes I have had have little to do with alcohol or work stress: the last one was when I was off work for two weeks due to proper flu, so no work, and no alcohol. It happens when I don't have a virus as well. I think it would be a good idea if we could add to our diaries when we are unwell: I was just asked to fill in a 3 month graduate survey and review the last two weeks. I had the flu, I wish I could have mentioned that. My sleep was entirely atypical.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Sorry – I misunderstood about the overriding mind comment and thought you meant thoughts? Trouble falling asleep is one of the most complained about issues regarding sleep so there will be a few things for you to try to help this over the next few weeks. They involve getting a set bedtime routine, letting the mind wind down, relaxation and also getting into good consistent patterns. Often this is all very helpful for the problem of falling asleep.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Sorry I missed this other comment. What you describe truly is the power of thoughts. They can occur without our knowledge at times but have a profound effect on what happens to us. There is a section in the course about challenging these thoughts so I think that part will resonate with you.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Yes I agree – good sleepers will probably show periods of movement on a fitness device too yet will report good sleep upon wakening. Good luck!

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Illness can make us much more drowsy and so I can understand why periods of this phenomenon can occur then. There is an option to pause the programme when people are ill or away travelling, so the diaries aren't too skewed. If anyone wishes to do so, please email your request to hello@sleepio.com

  • Sleepio Member

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    Expert

    Thanks for joining me on this session everyone – speak to you again soon.

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