Live discussion with Dr Vicki Creanor - 3rd December

Dr Creanor will be hosting a live online discussion here on Wednesday 3rd December, 8.15pm-9.45pm GMT.

She will discuss as many topics as possible in the hour and a half, starting with the most popular questions with answers being given in a way to give the most benefit to the general Community.

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Posted 27 Nov 2014 at 10:52 AM
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  • Sleepio Member

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    Graduate

    Hello Dr. Creanor,
    I was wondering if you had any insight on the relationship between poor sleep and menopause. At age 52 it seemed like despite worsening night sweats and hot flashes I was able to fall asleep again fairly well after waking up in the night, but when the hot flashes stopped in response to a fresh sputtering hormonal surge, the worst of my insomnia began. All I can say is bring back the hot flashes! For I can deal with those much better than poor, fragmented sleep.
    If there is a relationship between hormonal changes and sleep, is there hope that it can resolve when the hormones finally reach their new low levels and stay there?
    Thank you for your thoughts!
    Flick

  • Sleepio Member

    • 49 comments
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    Graduate

    Hi Vicki,
    Sorry I can't be at the discussion tomorrow as it's work time here, but if you have a chance I'd be interested in your thoughts on a couple of topics.
    First, I wondered if you'd had chance to follow up on the research that went into BBC article about segmented sleep that we talked about three weeks ago.
    Second, is there any evidence that women post child-bearing are lighter sleepers because of some epigenetic factor that turns on when they have to look out for their kids? Are moms bad sleepers because they got into a bad pattern during the nursing period (which for me lasted 3 years) or are they bad sleepers because of an evolutionary pressure to wake easily?
    I'm also interested in Flick's menopause question (which could be related to my second question).
    And finally, a question about my progress--what is stopping me sleep when I'm comfortable and relaxed, my mind is not racing and I'm not worried? I'm too tired to be able to read doing QHR--so it's not lack of sleepiness.
    Thanks for your help, I'll check in at the end of the day.
    Karen

  • Sleepio Member

    • 213 comments
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    Graduate

    Hi Dr Creanor, I'm nearing the end of week 4 and last night barely slept. I keep waking up throughout the night and up to an hour or two before my alarm, even though I am absolutely and complete exhausted. I have no idea as to what i actually slept last night as my Up24 tracking device showed it as my waking up once, when in fact I constantly woke up through out the night. I didn't do the QHR last night as my body felt achey and like lead and I don't even know the times or how long I was awake as I was absolutely sick w/exhaustion. I drifted off a few times on the sofa last night before my bedtime as I could not keep my eyes open but kept catching myself and waking up startled. I went to drive to a friend's yesterday and was scared I was going to get in a wreck and am basically petrified to drive at all. My sleep dr had told me this program was worth a shot but that there was a good chance it would not work as he believes I am simply wired wrong. I have tried to remain positive but feel broken. I am so scared. I live alone and support myself and want to take care of my mother who lives over an hour away and is battling her own health problems alone- but I can't even function myself, so I can't. I feel like my life has been a series of bad choices and now I feel on the verge of losing my mind. If I can't get myself together, I won't have a job (I have already been out on medical leave over a month due to extreme sleep deprivation), which means no income, which puts me where? This is exactly why I took all the pills to sleep previously- as i was desperate to function and support myself in society and I'm starting to feel hopeless. I'm off the pills now which is huge but I still am not functioning at all well. I just want to believe things will get better, but I feel like I'm losing it and wondering if maybe the dr was right – I'm just wired wrong and I'm a fool to think differently.

  • Sleepio Member

    • 585 comments
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    Graduate

    Oh dear. Poor gin-gin makes my question seem insignificant. I'm so sorry for this Sleepio member and I'm sure you will give an encouraging answer.

    For myself, I'm wondering what your opinion is.
    I've been 'addicted' to Nitrazepam for many years and joined Sleepio to see if it would help me get off them.

    It's taken a very very long time but I'm now down 50% (ie one tablet instead of two). Would it be advisable to now start slowly tapering this last tablet. I have Amitriptyline 25 mgs at night which has definitely helped the tapering process. I did find another suggested regime by T.R.A.P. combining titrated doses of Diazepam with Nitrazepam but am uncertain whether this would be a good route to use.

    I shall appreciate your advice Vicky, please?

    Marigold

  • Sleepio Member

    • 49 comments
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    in reply to Sleepio Member
    Graduate

    Dear gin-gin, your question has to be top priority with Vicki.
    I'm not sure of the etiquette of posting here, but I wanted to offer a story about rewiring from my life--so I hope I'm forgiven. My son had major mental health (and physical health) issues. With cognitive-behavioural therapy (similar to sleepio), he changed from a suicidal, non-functioning kid (at 8 years old) to a confident, happy, pretty-much-normal, productive teenager. Our family saw the therapy “rewire” his brain. It took two years and he'll always have to work at it--but after that experience (and reading--and particularly seeing brain scans of people before and after CBT), I strongly believe that CBT can change our brains given time and work. I'm no sleep expert, just a mom, but I do remember very well the deep hole we struggled in for months before he improved, wondering if it would ever work and if we could be strong enough to keep at it. I wish you all the best.

  • Sleepio Member

    • 1389 comments
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    Expert

    Hi everyone, let's start the session. Any and all questions welcome.

  • Sleepio Member

    • 585 comments
    • 139 helped
    Graduate

    Good evening Vicki.

    Do hope you have some helpful tips for gin-gin.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi gin-gin,

    Along with your fellow Sleepio colleagues, I am also concerned about your current distress.

    Although I know little of your background, apart from what you have helpfully shared with the community, from this post alone, I would encourage you to speak to your family doctor or any healthcare provider that you feel comfortable talking to, about the way you are feeling. It sounds as if your mood is pretty low at present. Of course, most people will agree that lack of sleep can be very damaging to our mood, however I am concerned about your distress levels and would recommend seeking face to face support.

    Is there someone you can speak to?

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there pemmling uw sleep,
    Thanks for your post. It sounds as if this is a question for your GP or whoever prescribes your medications. It'd be worth checking this issue out with someone who is trained in medicine – I'm afraid I am not a medical doctor. I hope you find the help you need.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi Dibby,
    That's a good question, thank you. Although I can't speak a great deal about medication itself as I am not a medically trained doctor, I can answer the other half of your question. It sounds like you answered the question yourself going on your past experience, actually.

    In order to build up sleep pressure, we need to engage in make sure that all the little bits and pieces of fragmented sleep we get during the night are squeezed together to give us the best opportunity to get the most continuous period of sleep. We do this through sleep restriction (SR), as you alluded to. So, if you avoid sleep restriction by taking medication earlier than you're meant to go to bed using SR, you will likely lose sleep pressure, which usually has an overall negative effect on our sleep.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi 18Years,
    Thanks for your question. Parasomnias are often linked to insomnia and come in various forms, like those you mentioned. And yes, they can affect the quality of your sleep. Sorry to hear the meds made things tricky. There may be behavioural support out there though, such as habit reversal techniques…I would speak to your family doctor about this option?

  • Sleepio Member

    • 213 comments
    • 73 helped
    in reply to Sleepio Member
    Graduate

    Hi Vicki, I've been going to a psychiatrist which is how I ended up on Sleepio. My GP sent me to the sleep specialist. He is who thinks my wiring is off and had me on up to 3 ambien a night w/gabapentin and up to 3 klonopin a night. I was still waking up every few hours on this mix. The psychiatrist then threw in mood stabilizers and the such. I had to get off of those because my GP said that the meds prescribed by the psychiatrist were dangerous and hardcore and I was fainting, blood pressure extremely low. I've gone to 3 therapists this year. 2 sleep specialists in the past few months (1 of whom I have been seeing for over 4 years) I was initially trying to find someone to help me w CBT for insomnia but nobody in my insurance network does this specifically. I haven't been in to the therapist in the past month due to the fear of driving w/so little rest. The drs (therapists included) seem to think that my lack of sleep is my biggest problem – that I am so exhausted, and therefore, it's hard to determine how much my lack of sleep is causing my mood to be this way (previously, I always wanted to work out, be with friends, go out and do things – I was very active). I've been struggling for ages w/sleep but the past few years have been just trying to get by – I simply have no energy. I feel on the verge of collapse. I appreciate everyones help. I really want the CBT to work. I'm sure trying.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi Flick,
    Yes there is a link between hormones and poorer sleep – it is very common during teenage years, pregnancy and the menopause for sleep to change. The Sleepio techniques are important at these times to ensure you are making your life as optimal as possible for sleep, so stick with it. Often sleep settles down after these events, however it is good practice to engage with these techniques to prevent bad habits occurring during these trickier times.
    Hope this helps?

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    It sounds like you are trying very hard, gin-gin. I'm so sorry to hear you've had such a tricky time of it lately. That sounds like a difficult cocktail of medications, too, so I'm glad your GP is looking out for this. I wonder if you could get to your therapist's another way/get a lift or ask of they could see you at home perhaps (not everyone does this but some do) as it sounds as if you haven't been able to keep up with therapy recently. If the sleep problem is the main problem that, in turn, causes mood changes, we do recommend treating the sleep first, so it sounds as if this is the case. I'm glad you have people you can share your thoughts and feelings with. You may find that your colleagues on here are a great support – and actually they already have said some helpful things tonight- to help you see that there is light at the end of the tunnel.

    As for being 'wired' differently, I can't really comment without knowing you more, but I do know that CBT techniques are the gold standard for sleep problems and come with a huge amount of research and evidence behind them, which is why we base our techniques on CBT.

    I hope that provides some hope and reassurance for you, gin-gin.

  • Sleepio Member

    • 1389 comments
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    in reply to Sleepio Member
    Expert

    Hi Karen,
    Thanks for your questions – I will answer them one by one…

    I'm afraid I haven't had the chance to look at the research since we spoke, so I'm unable to comment on it.

    Many things can cause an episode of poor sleep – and there is no doubt that having a child can kick start such an episode. Having such broken sleep and having to be more alert for your children can lead to sustained poor sleep, even when your child begins to sleep well. And, as I've spoken about tonight with Flick, there are hormonal changes when women are pregnant and for a while post-birth, which can have an influence on sleep. Although I'm not aware of the research in this particular area, it makes sense that women in particular (but perhaps dads too) are programmed to sleep less deeply once they have a child to listen out for and certainly anecdotally, we hear this a lot.

    Regarding your last question, it may be that you have built up a negative association between your bed and sleeping, which means that, due to an extended period of time finding it hard to sleep and trying to sleep while in bed, your body has learned not to sleep when it sees – and is in – bed, despite feeling relaxed and tired. This is why the QHR is essential to implement as it reverses this learned behaviour.

    Hope these help.

  • Sleepio Member

    • 1389 comments
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    in reply to Sleepio Member
    Expert

    Hi Marigold1942. Thanks for your question. I would love to offer advice, however I am a psychological doctor and am not trained in psychiatric medication, so it is important to speak to your psychiatrist/GP about this. I would always strongly recommend talking through the weaning off process with medically trained professionals as it can be more complex than some may think and therefore important to get the best advice. Apologies I can't help in this instance.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Karen P – thank you so much for sharing this personal story. It's so helpful for other members to hear real, positive stories about true recovery as it is often a stronger message than what professionals can offer. I am so pleased to hear the turnaround your family has experienced with your son's health.

    Thank you.

  • Sleepio Member

    • 213 comments
    • 73 helped
    in reply to Sleepio Member
    Graduate

    Hi Karen, I really appreciate your kind words and your sharing your experience. I'm sorry to post such negative feelings on here. I am always trying to be more positive about things but the lack of sleeping is really getting to me. I'm so happy that your son and family found such success w/CBT and are doing so well. It sounds amazing the way things things turned around for you and that's absolutely wonderful :) Thank you for giving me some hope. Wishing you all the best on your journey to better sleep. Thank you.

  • Sleepio Member

    • 1389 comments
    • 225 helped
    Expert

    It's gone a little quieter on here…anyone have any more questions?

  • Sleepio Member

    • 1389 comments
    • 225 helped
    Expert

    Thanks for all your questions and support for colleagues today. Take care and see you soon.

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