Live discussion with Dr Vicki Creanor - 4th March

Dr Creanor will be hosting a live online discussion here on Wednesday 4th March, 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 2 Mar 2015 at 11:20 AM
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  • Sleepio Member

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    Expert

    Hi everyone and welcome to the live session. Here, you can ask any questions about the psychology of sleep or about specific techniques within the Sleepio programme. If there are no live questions, I will go through those already posted to answer them first…let's get started…

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI kt80rep,
    Thanks for your question. It's a very personal thing choosing the activities that keep you going til bedtime – a lot of it is trial and error. Some people do find going for a walk is helpful, some people do things like ironing or reading or baking to keep them awake. Try to avoid taking caffeine, alcohol or smoking. In fact eating in general too close to bed is a no-no. As for the wind down routine to get sleepy, this has to ensure that you feel relaxed before bed – often people like to read, take a bath, listen to music to unwind.

    It may be worth asking for examples from your fellow Sleepio users in the community…

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi Josh,
    Thanks for your question. It is a mixed picture as to whether people prefer using CBT-I with meds or without. It is very much an individual choice and I've known people to improve in both circumstances. Some feel they need meds to kick start therapeutic gain; others do not want to confuse psychological improvement with medical effects. So my opinion really is that if it works for you, that's OK – whatever you feel helps you get the improvements you're looking for is helpful to you. You can do CBT-I using sleep meds or without.

  • Sleepio Member

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    Expert

    Hi Marko,
    Thanks for your post. For the 1st question, yes – I would still continue to do the low-stimulus approach as if it's the middle of the night, frustrating as it may be. If you do find you consistently wake up 30 mins ealry, you could also try to make that time (30 mins before end of sleep window) your new wake up time and shift the window accordingly?

    Your second question is trickier to answer as I can't see how you fill in your diary, however it doesn't sound right – that less time asleep in bed increases the efficiency? I would contact the technical team and check this out and explain how you're filling in your diary etc.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi RichardC – I am going to alert those in the clinical team about this issue as it's obviously happening to multiple users…thanks for highlighting it.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Marko – I will contact the clinical team about this as you and RichardC are experiencing the same problem.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi gamerx – can you describe your sleep pattern in a bit more detail? Just curious to know whether you have trouble getting to sleep, staying asleep and how many nights a week it troubles you? That will help me understand whether SR is likely to help. THanks

  • Sleepio Member

    • 8 comments
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    in reply to Sleepio Member
    Graduate

    Hi Dr Vicki

    Thanks for that.
    Re my second question – the final question in filling in the sleep diary is “what time did you get out of bed for the day”. I'm getting out of bed up to 1 hour before the end of the sleep window under the QHR. If I don't get back to feeling sleepy that's my final getting up time. But the programme seems to identify this as progress – my sleep efficiency score is boosted by the shorter time in bed – resulting in the SW being extended.
    Hope you can clarify. Thanks

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Less time in bed increases efficiency. If your sleep window is 1 AM to 6 AM and you go to bed at 1 AM, fall asleep quickly, wake up at 5 AM & get out of bed within a few minutes, you've slept less than 80% of the hours you were allowed (<4 hours out of 5 hours) but your sleep efficiency, by Sleepio's calculation, is over 90% (almost 4 hours out of 4 hours in bed). Looks great and gets you a bigger sleep window, but more time in bed is not what you need.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    My last post crossed with yours. Thanks for looking into this.

  • Sleepio Member

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    Expert

    Hi biddyp – you're not the first person (and will not be the last!) to question the need for (the dreaded) sleep restriction. It sounds awful and lots of people struggle with the concept of it as it sounds counterintuitive.

    Here's the rationale for it…

    Many people with insomnia experience broken sleep – lots of little bits of sleep throughout the night, which are unrefreshing. Many people also take naps/sleep in after they are meant to get up etc and so SR intends to get people sleeping in a solid block of sleep – like good sleepers' patterns – to increase their sleep efficiency (time in bed being spent asleep rather than awake). A block of sleep is much more beneficial than bits of sleep, as most people will agree. So SR does this by squeezing all the bits of sleep you get into one block. By restricting it to the amount of sleep you are getting anyway at the start, you create sleep pressure – a drive by your body to want – and need – to sleep, making it more likely to happen.

    Does this make sense?

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hmm – I see what you mean. I will take this further on your behalf, Marko.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi kt80rep – has this happened to you? You are right it is more like 80% efficiency than 90%. Again, I will take this to the clinical/technical team to look into.

  • Sleepio Member

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    Expert

    Hi Allich,
    You're right – at the start of the programme and until your sleep is back on track, we would recommend that relaxation exercises are done out of the bedroom (not just the bed) to avoid non-sleep/bed associations.

  • Sleepio Member

    • 15 comments
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    in reply to Sleepio Member
    Graduate

    Many – maybe most – sleep restriction therapy programs use actual time in bed rather than sleep window time to calculate sleep efficiency. It's my pet peeve with the program – I've posted more about this near the bottom of the list of today's questions.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi denised,
    Thanks for your question – similar themes going on tonight! I would recommend shifting your window so you don't need to go to bed til later (if you can do this at the other end) as you may just naturally not be sleepy til later. Is this a possibility? If not, I would actually go to bed when you are supposed to, and think about your wind down activities – or daytime activities (increased activity or exercise, reduced caffeine if these are relevant) – to help you feel sleepier when your window starts. You may find that you are doing the QHR a lot at the start, but it may help to train your body into going to bed at that earlier time.

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    kt80rep I think you might have meant the opposite in your last comment.

  • Sleepio Member

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    Expert

    It's gone very quiet…any other questions?

  • Sleepio Member

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    Expert

    That's us for tonight – thanks for all the questions and I look forward to speaking to again you soon.

  • Sleepio Member

    • 4 comments
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    in reply to Sleepio Member
    Session 5

    My problem is with going to sleep only. When it happens, it usually starts on Sunday night all the way until Wed before I am able to go back to normal. Sometimes I lose sleep for the entire work week until the weekends(Friday night)

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