Live discussion with Dr Vicki Creanor - 5th December 2018

Dr Creanor will be hosting a live online discussion here on Wednesday 5th Dec, from 8:15 to 9:45pm British Time or 3:15 to 5:45pm US Eastern 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 30 Nov 2018 at 5:26 PM
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  • Sleepio Member

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    Expert

    Hi and thanks for your question – I see you've asked another further down the thread but I'll answer them separately so people can follow the questions and answers better…

    In terms of what is 'better' relaxation-wise, it is always personal preference – what relaxes one person may not relax the next, however the autogenic training is a more passive exercise than progressive muscle relaxation, so we sometimes hear that people with limited mobility or physical problems can engage better in autogenic training.

  • Sleepio Member

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    Graduate

    Hi,

    Is the bedtime threshold time before you lay down to sleep? I do progressive relaxation before I sleep and this takes about 10 minutes or so. Thanks!

  • Sleepio Member

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    Expert

    Hi thanks for getting in touch! The threshold time is when we should be going to bed to sleep. During the Sleepio programme, we recommend that all other activities (including relaxation) are done before one goes to bed. This strengthens the association between bed and sleep. Having said this, some people do a little relaxation prior to sleep in bed…as long as this does not go beyond 10-15 mins this should not affect the bed-sleep association too much, however if it goes on for too long it should be done outwith the bed (and bedroom).

  • Sleepio Member

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    Expert

    Hi there – this is similar to the answer I've given above actually…when doing the Sleepio course, we recommend that people do all activities (excluding sexual) outwith the bed to strengthen the positive association between bed and sleep. So if someone was in bed, awake, doing something other than sleeping for 35 mins, this could actually weaken the positive association we're aiming for as it's more time awake in bed. If the relaxation only lasts 10 mins before one falls asleep, this should be OK to do in bed, however if longer this is not recommended.

  • Sleepio Member

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    Expert

    Hi – in terms of the use of sleeping pills, it is a personal choice. People have used sleeping pills on the course and have found success, as have others who have stopped using them. The important thing is to take advice from an appropriate professional (doctor/pharmacist/psychiatrist) who prescribes the medication for you as to how best to wean off it if this is the preferred option, as doing so without advice can be risky.

  • Sleepio Member

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    Graduate

    Thanks for the earlier response!

    Another question. I have been logging in my sleep hours manually over the past weeks, although I have a fitbit. When I reconcile the 2, they are vastly different with the tracker showing that I have had much more sleep. Is this because trackers are not so effective in measuring sleep or that I think I am awake for longer than I actually am (its difficult to assess this). Thanks!

  • Sleepio Member

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    Expert

    Hi – so what people should be looking for as to when to increase the sleep window is that their sleep efficiency across the week is approx 90%. If it is increased before this is reached, people run the risk of spending more time in their beds awake, which is unhelpful in terms of that bed-sleep association. Does that make sense?

  • Sleepio Member

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    Expert

    Hi! It might be both! Sometimes trackers go by movement, so if someone is awake, but lying very still, the data is recorded as 'asleep'. The advice tends to be to go with what you believe is more accurate based on your subjective experience of the night. Hope that helps?

  • Sleepio Member

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    Expert

    Hello and thanks for getting in touch. If there is no way around being in your room for long periods during the day (which will be the case for some people like yourself), what might be helpful is to ensure that your room in the daytime is very different to your room at night time. So keep the curtains open, music on perhaps during the day, but at night make it a very different-feeling space – dark, quiet and calm. It would also be a good idea to set limits on when work is done, keeping a good few hours before bed work-free and using this time to be away from the bedroom altogether. This separation might help compartmentalise work-time bedroom and sleep-time bedroom.

  • Sleepio Member

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    Expert

    Hi and thanks for getting in touch for the discussion. So it can be very difficult to keep going when we're so tired, can't it? However sticking to the sleep window is a really good way to help get sleep back on track and create that positive link between sleep and bed once again. Some ideas are to sit by a window and get fresh air when sleepy, do some light exercise or housework or engage in a more stimulating activity such as a crossword (often if we engage in passive activities like watching TV, we fall asleep on the sofa!) In the morning, it can be very hard to get out of bed, especially on the darker winter days. Something that can help is to set the alarm and put it out of reach, to force us out of bed and then go for a shower straight away or plan for something we enjoy as soon as we're up. A strong coffee can also help first thing!

  • Sleepio Member

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    Expert

    Hi again – so, my thoughts would be that it would be worth still doing the techniques as we can never be 100% sure what is causing the sleep problem. Hormonal factors may be contributing, but may not be the full cause. Tackling the problem with behavioural strategies and HRT seems a good approach to target all possible roots. Even although a sleep problem might start with hormone changes, it might also be maintained via unhelpful behaviours, which Sleepio would target. Hope that makes sense?

  • Sleepio Member

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    Expert

    Thanks for your questions. Firstly, the Sleepio strategies are mainly short-to mid-term techniques to help get sleep back on track. Once it is, then certain things tend to be OK to relax. If things ever slip a little again (as we all go through periods of poorer sleep once in a while – as is the case with good sleepers too), things can be tweaked as and when needed.

    Secondly, there is a normality in terms of the variability in how refreshed we feel after a night's sleep. That feeling is influenced by so many factors – how that person's mood is, how stressed they are, what they ate that day, what they're thinking about, whether they had any alcohol, how much sleep they got across the week etc etc. So, aiming for total refreshment each morning may be unrealistic, but it is often a good indicator on how well we slept. If every morning carries a feeling of being unrefreshed, however, it would be important to look at lifestyle factors as well as sleep quality.

  • Sleepio Member

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    Graduate

    Thanks Vicki,
    so on my sleep diary, if I'm not hitting the bottle, eating late, relaxed etc etc I should be reasonably refreshed if my sleep is of good length and quality. Is there sleep quality scale I could use track or is the one in my sleep diary 1-5 as good as any other?

  • Sleepio Member

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    Expert

    It can be a little more complex than this at times – just to mix things up a but for us – as previous nights' sleep can also have an influence on that night's sleep. And the list of influential factors is much longer than the examples I gave as I'm sure you've guessed. In terms of rating sleep quality, a simple subjective scale is a good measure as a lot of it depends on how we feel within ourselves in the morning.

  • Sleepio Member

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    Graduate

    Of course. The last time I felt super refreshed after a nights sleep I'd been trecking the Annapurna sanctuary route. It'd be great to have that feeling again without needing the preceding 8 hour mountain trail hike….

  • Sleepio Member

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    Expert

    Proof though that physical exercise is very good for our sleep!

  • Sleepio Member

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    Graduate

    I'm sure that was part of it. Sense of calm, at one with nature and super mountain scenery probably helped as well. Just thought of a good scene to replay for future autogenic relaxation session…..

  • Sleepio Member

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    Expert

    exactly!!

  • Sleepio Member

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    Graduate

    Thanks for the chat, I'm logging off, getting close to my wind down time and trying to avoid the screen time.

  • Sleepio Member

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    Expert

    That's all for this time – thanks for the great questions and I'll speak to you next week…

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