Live discussion with Dr Vicki Creanor - 4th January 2017

Dr Creanor will be hosting a live online discussion here on Wednesday 4th Jan, 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 29 Dec 2016 at 12:18 PM
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  • Sleepio Member

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    Graduate

    Hi, I began sleep restriction over a week ago and my sleep has been erratic since then, someday's okay, others not so good. Twice this week I've been troubled with restless legs syndrome and have had only three hours sleep. This means I am absolutely wrecked the next day along with all the anxiety that comes with it the next night. I am pretty mindful about the thoughts that can keep me awake but have been experiencing hyperarousal as well.

    Should I get up at the assigned time time (7am) every day regardless of how little sleep I have had and what is the best way to deal with hyperarousal? I'm really exhausted and somewhat demoralised from the last three night poor sleep.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,

    Hot flashes (usually a symptom of the menopause) are a very common cause of disturbed sleep in females at this stage in their life. Although it's down to medical professionals to recommend how to control the hot flashes, in terms of sleep, a big part of the problem is often that the flashes wake the person up, but then they lie awake annoyed about it, or worrying that this will reoccur again throughout the night. So this is where the psychology of it comes in. What we can do in these circumstances is to look at how we deal with the hot flashes when they occur. Use the challenging negative thoughts technique within the Sleepio programme to treat these wakenings as nothing to worry about, natural, and something that won't affect you as you're going to learn how to get back to sleep. The relaxation can come in useful here, too, as it can help with calming the mind before bedtime, to help avoid worrying about the possibility of a hot flash. And, as we would always recommend, if it causes one to be awake for more than 15 mins at night, follow the same 15 min rule.

    And on a very practical level, I've also heard that having a cool fan in the room can help cool women down quicker if they wake up with ht flashes.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there,

    Sorry to hear this. Sounds like a tough week. It's actually very normal to see erratic sleep when one starts the programme as the body is getting used to change. This shouldn't last long. Hyperarousal is also common as the body is defending itself against change, but if it lasts longer than expected, it can be a sign of underlying anxiety/panic. The good news is that the relaxation exercises incorporated into Sleepio will really help this, if done regularly. Challenging the negative thoughts is also important.

    In terms of getting up at the regular time, yes, I'm afraid this is pretty important even if it doesn't feel like what one should be doing! The reason for this is that we need to make sure we work towards our sleep being regular if we want to stabilise it, so we use the regular wake time as the anchor for this and work on the sleep using the techniques during the night.

    Hope this helps

  • Sleepio Member

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    Expert

    Hi there,
    This is correct, sleep does change as we get older – it's often lighter sleep and we often need less of it. However it depends on what the current problems are in terms of whether they can be improved – at 75, some changes can still be made.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    First of all, yes it's normal for the sleep to be erratic in the first few weeks, it should be a short term problem, though. Secondly, I would recommend going by one's gut response in terms of how sleep was the night before. What is important when we record sleep data is how the person interprets their sleep – it's a pretty subjective thing, sleep – so it would mean more if the person notes how they feel on that morning, rather than us suggesting how they should respond. I hope that makes sense? We feel differently about our sleep all the time, but this is important to record as there will still be consistency in terms of who is recording the responses.

  • Sleepio Member

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    Expert

    Hi there,
    This may be too late for you to see the response (!) but I'm afraid it's read-only, there is no audio. It can be read at a later date, though, if people are interested in reading the content.

  • Sleepio Member

    • 16 comments
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    Graduate

    How does one avoid sleep anxiety/panicking after not sleeping at all one night? This problem seems to perpetuate itself and create multiple days of not sleeping on end for me.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    What is described here, in terms of the difference in ratings, is pretty common and it's all down to our mood and possibly sleep inertia. If we feel groggy and not yet fully awake, it will affect our mood and we will rate things more negatively than when we are more awake and energised. It's up to people when they want to record the data, however, if huge differences are noted in terms of when the recording is made, just make sure that it is done at the same time each morning (it's up to you when this is – first thing, or after the energy has kicked in!)

    In terms of recording when one goes to bed, this is the time at the start of the sleep window, rather than when one goes back to bed after not being able to sleep when they were scheduled to.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    The best ways to combat anxiety are to use regular relaxation techniques (practise them at least once a day so that even at the first sign of anxiety one is ready to use it to bring anxiety down) and also to target the negative thoughts that are causing it. Thoughts are at the centre of our anxiety, so identifying them and challenging them (using the technique within Sleepio) will be very beneficial. Scheduling in some worry time during the day (not near bedtime) can help to think about what's on the mind, so it's worked out and thought through prior to bedtime. The wind down routine is also very important to get into the right frame of mind for bed. In addition, the 15 min rule/quarter hour rule is very important in terms of breaking the anxiety link between bed and sleep. Hope this helps.

  • Sleepio Member

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    Expert

    Thanks for your question. Although I'm not sure how old you are, it is common for women around menopause age to have disrupted sleep for a number of reasons, including the changes in hormone levels and the physical symptoms (hot flashes etc). I notice there is one wakening noted here at 3am. Often when people have had disrupted sleep in the past, they automatically focus on any wakenings, even after their sleep has improved. If there is only one wakening in the night, it is often helpful to view this as quite normal. Most of us wake up once or twice a night. Good sleepers do. It's really about how we interpret this wakening that will affect the rest of the night. If we view it as normal and just then get back to sleep, then it won't affect us. If we start to ruminate about it/worry about, or see it as abnormal in some way or “part of my sleep problem”, then it will have a negative impact on that night's sleep and probably most nights ahead. So the key here is to challenge any negative associations with that middle of the night wakening and attempt to view it as normal. Over time, this belief will likely become stronger.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there,
    Similar to my last post, it's not actually normal to sleep entirely through the night. Most of us do wake up at least once or twice, but the best thing to do here is to view it as quite normal and, if one can get back to sleep OK after these wakenings, this is good. When people start to view these as abnormal, they tend to be awake longer worrying about it, but it is what most good sleepers do.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi and thanks for your post. What people do during the wind down routine and quarter hour rule period is variable and also quite subjective. There is mention here of the TV being too stimulating, which is true for many (depending on the content) but it can be relaxing for others. Likewise, if reading is relaxing and the book isn't too stimulating, it's fine to do this. Stick to doing it away from the bed, however, if possible. Others might have a warm bath, listen to music, do meditation, relaxation exercises – the list is long, but it's sometimes trial and error to find the right activities for that person.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hello – the techniques within Sleepio mainly aim to combat sleep problems that have been learned. I'm not aware of gene testing in the sleep world as it's not my field of research, but an interesting question! It may be a research area worth watching…

  • Sleepio Member

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    Expert

    Hello thanks for the question. Sometimes people find that they wake early on as their bodies aren't fully relaxed – there's still an element of anxiety there. Relaxation can help this as well as a good wind down routine. Lifestyle factors can play a part too though, so for instance having alcohol/caffeine close to bedtime or doing exercise too late in the day can also keep us stimulated and stops us sleeping well throughout the night. It's always worth looking at such factors one by one to see what might be causing this wakening after an hour.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    Thanks for your posts. Firstly, although it is very very difficult to incorporate a new sleep routine into family life, it is usually a short term plan. Often when couples sleep separately during the course they can and do gradually start sleeping together again after the sleep is back on track. It's an important point to raise though as many bed partners struggle too when sleep is a problem with their spouse.

    As for the question about the relaxation/imagery, I would recommend if it's taking up to 30mins that it is done outside of the sleep window (ie before the sleep window starts) and, if possible, not in the bed. Know this is hard for many people but it optimises the chances of the bed-sleep link being strengthened which really helps improve sleep overall.

  • Sleepio Member

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    Graduate

    Hello Dr Creanor,
    I have had sleep problems for 40 years , the programe is helping me , and at the momement I can hardly stay awake in the evening , I'm having trouble even writing this comment to stay awake, I wonder if one has had problems like this for so long that suddenly one can just switch off and go into a relaxed phase when finding some solution to a sleep problem after such a long time.
    Thanks.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there,
    I have met some people who have had long standing sleep problems and who have managed to see positive changes. A lot of the time, I believe it takes the person to be consistent with the new techniques but also to be patient with themselves and compassionate towards themselves and see even small changes as an achievement. Much of the time it is about the beliefs and behaviours surrounding sleep needing to alter. If they have been built up over a long time, it may take a while for them to be unlearned. It is still effective if the techniques are followed carefully and consistently. All the best.

  • Sleepio Member

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    Expert

    Thanks for everyone's posts before and during this session. That's us finished for now – speak to you again soon.
    Take care,
    Vicki

  • Sleepio Member

    • 20 comments
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    in reply to Sleepio Member
    Graduate

    Thank you for your help. Although it is a struggle I see that perseverance is the only option to break my sleeping problems

  • Sleepio Member

    • 60 comments
    • 2 helped
    in reply to Sleepio Member
    Graduate

    Hello Dr Creanor,
    Thank you for your reply, I agree with your point.

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