Live Discussion with Dr Vicki Creanor - 6th April 2016

Dr Creanor will be hosting a live online discussion here on Wednesday 6th April, from 8:15pm until 9.45pm BST.

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 31 Mar 2016 at 9:58 AM
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  • Sleepio Member

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    Expert

    HI there,
    Of course, I'll answer you just now…many people have this difficulty in falling asleep in other places than their beds pretty easily. The cinema, the sofa…both comfy places and when you're sleep deprived, your body wants to settle down there and then! However, this has a pretty unhelpful effect if you're trying to sleep better in your bed, so you're right to want to avoid this happening. There are several techniques to try and keep yourself awake – sometimes it's trial and error (and I'm sure fellow community members will have some good ideas for you!) but quite often if you're at home, it's about staying on your feet or keeping relatively active so that you don't flop on the sofa and snooze. Getting fresh air is always good and making sure you're not too warm helps. If at the cinema, it's harder as it's dark, which tends to promote sleepiness, but even getting a bit of sunlight (season permitting) beforehand can help, or drinking an energy drink/caffeine before hand (as long as it's not to close to bedtime!).

  • Sleepio Member

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    Expert

    HI Irena,
    Many people ask about this and it's OK to take medication while doing the Sleepio programme. We would always recommend talking to your medical doctor (or whoever is involved in your healthcare) before starting the Sleepio programme but they are the best people to talk to about medication advice.

  • Sleepio Member

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    Expert

    Hi there,
    Thanks for your question. Many people take medication while doing the Sleepio programme and you are able to use the techniques exactly as you would with or without such sleep aids. When people start to wean off them, they tend to continue to use the techniques as they have been doing all along – I think it's good to stay consistent with the Sleepio techniques even when medications alter, so you keep that bit of the treatment constant.

  • Sleepio Member

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    Expert

    Hi there,
    Thanks for your question. Many people take medication while doing the Sleepio programme and you are able to use the techniques exactly as you would with or without such sleep aids. When people start to wean off them, they tend to continue to use the techniques as they have been doing all along – I think it's good to stay consistent with the Sleepio techniques even when medications alter, so you keep that bit of the treatment constant.

  • Sleepio Member

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    Expert

    Hi Sturan,
    First of all, well done on your sleep improvements – efficiency of 81% is pretty good. You asked about the reason for setting efficiency at 90% and yes, it is because good sleepers tend to achieve this on average. Sleepio aims to get your sleep as close to a good sleeper's again so this is the figure we have as a goal. It's quite a standard figure in other sleep treatments outside Sleepio, too as it's based on the research into good sleepers' sleep. It will be hard to achieve straight away, though. Poor sleep habits build over a long time and so they have to be unlearned, which is a gradual thing and takes time. Hope this helps make the 90% bit more clear.

  • Sleepio Member

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    Hi there Katew,
    I'm a little confused about the question but I think it sounds as if you are engaging in the sleep restriction part of the programme? This involves squeezing all the bits of broekn sleep that people experience during the night into one block that is more likely to be solid. THis promotes sleeping in one solid period in a night and is gradually extended the better sleep quality becomes over time. Broken sleep is unrefreshing and being in bed when you are struggling to sleep is very psychologically unhelpful for sleep, hence why this technique is carried out. It will usually mean sleeping for a shorter window than you're used to, but it is because it's trying to squeeze out all the periods at night when you're awake/tossing and turning. Hope that makes sense?

  • Sleepio Member

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    Graduate

    Hi Vicki
    Judging by the comments I have seen with Sleepio's, 90% seems very hard to achieve. I have taken a view on my sleep even as a good sleeper and pretty sure I would not hit 90% even then. I appreciate this figure is researched based, however considering the comments from people that I have been in contact with and even some of the graduates and greeters, it would appear they have not or do not achieve 90%. What % of people that are or were active on Sleepio have hit 90%?

    Sorry, I do not want to sound negative, its just based on own experience and those of others I have been in contact with and it does appear people get hung up on achieving the holy grail of 90% when surely the focus should be on getting restful sleep.
    Thanks
    Stu

  • Sleepio Member

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    Expert

    Hi Sturan,
    All comments are welcome! I think you're right – people can get hung up on figures but I also agree that the main aim is increasing sleep efficiency. I'm sure you will agree that this is easier to do when there is some figure to aim towards and it's been chosen as a goal because it tends to be what good sleepers manage to get. I appreciate your thoughts though it is a valid point.

  • Sleepio Member

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    Graduate

    Hi Vicki
    This query is related to QHR. I could not get my head around the concept and thus never did it.
    QHR appeared odd to me personally as to get out of bed for me would just wake up all my senses and I would be wide awake.
    I actually decided to stay in bed and I used to listen to an audio trance by Paul McKenna which would actually help me get back to sleep I would say 9 times out of 10.
    Now when I wake, I count back slowly from 300 to zero. I sometimes have to do it 2 or 3 times which would mean effectively being awake in bed probably more than 30 minutes but again it is a technique which helps me get back to sleep.
    Again, discussing with other Sleepio's, some of which are graduates, they also struggled with QHR and actually some now admit to not actually doing it.
    I wondered if the Sleepio team would consider expanding the QHR process for people to try techniques for longer, especially if they are sleepy.
    I fear a lot of people take instruction as read when in fact Sleepio cannot be a one size fits all program and thus maybe should offer an expansion of techniques.

    Thanks
    Stu

  • Sleepio Member

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    Expert

    Hi Sturan,
    The QHR is, without doubt, tricky to adhere to (most will admit this) as it seems counterintuitive when you are craving sleep and in a comfortable bed. However, in my role as a clinical psychologist even outwith Sleepio, I believe it to be one of the most effective techniques in dealing with the psychological barriers in sleep problems. The theory behind it is that, when you get into poor sleep patterns, you start (subconsciously) viewing your bed as a negative place where you will feel anxious and frustrated due to lack of sleep. Thus, we encourage any time that is spent in bed but not asleep (beyond 15 mins which is the max time a good sleeper will take on average to fall asleep) to be squeezed out by removing yourself from the bedroom, with an aim of getting back a good, positive sleep-bedroom connection in the brain. There is a lot of anxiety around getting to sleep in many poor sleepers and this comes from the poor sleep-bed connection problem. I will certainly contact the rest of the team with your comments, however, as it's always important to get accurate feedback from people who use Sleepio.

  • Sleepio Member

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    Graduate

    Hi
    Just some other pointers while I am on a roll :)

    1. Would Sleepio consider to impart some of the useful techniques earlier in the course. I found it odd that certain techniques did not come into effect until week 3 or 4 when in fact this surely would have been more useful in the beginning.

    2. Would Sleepio consider giving a better warning to people with regards to week 3 and the SR. This is an absolute killer and I think every one notes it is extremely hard. I think actually how hard it is, is a surprise and I wonder if some kind of pre warning suggesting people to take a weeks holiday from work or reduce their social plans would be a good idea. I say this from experience that I truly struggled with work and if I had been better warned I might have booked time off work. As it was I was lucky as I can work from home and thus could manage my time better than some others probably could.

    Thanks
    Stu

  • Sleepio Member

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    Expert

    Thanks Sturan I will raise these comments with the wider team too.

  • Sleepio Member

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    Expert

    5 more minutes of the discussion if anyone has any more questions?

  • Sleepio Member

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    Graduate

    Thank you for your time. It has been a good discussion. Wish I had joined these weeks ago!

    Regards
    Stu

  • Sleepio Member

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    Expert

    That's good to hear – nice to talk to you, Sturan.

  • Sleepio Member

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    Expert

    That's all for tonight – thanks for the great questions – see you again soon.
    Vicki

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hi Sturan
    It's quite possible that those who hit 90% don't post either because they leave the programme when they graduate or because they don't want to make those who don't hit it feel bad. I've got an average of 91% at the moment but it has been as high as 93%. The Prof keeps nudging me to add to discussions so I can help others with my tips, but I have really only used sleep restriction and the “The the” technique in conjunction with feeling myself relax into my mattress as I breath out. I used to take hours to go to sleep (since childhood and I am now 60!) and then wake and be awake for hours in the night. I've come to the conclusion that I was aiming for too much sleep and and 7.5 hours in bed seems to be the optimum for me! I still get the odd night when sleep seems elusive but that's when thoughts on family issues refuse to to abate even with the the the. I only tried the QHR once and was up for 2 hours (after 2.5 hours asleep) and went back to bed for 30 minutes without sleeping and so got up for the day – at 3.30. However, the next night was a good one! It's probably best not to overthink things. I also got a Fitbit so I didn't try to remember all my wakings and add up how long I thought I had been awake – which just made me wake up properly each time and cause me to stay awake longer. I sort of “let go” the problem and just accepted what sleep I got from fairly early on in the programme and apart from jetlag in the middle causing a frightful 10 days/nights things have progressed fairly well. I'm sorry you're still having problems and hope you begin to see some good nights soon.
    Tatty Helen

  • Sleepio Member

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    Graduate

    Hi Tatty Helen
    Yep good points. I guess its a bit like people complaining in life generally. When people get good service then no praise given but when something goes wrong, then people are only too quick to complain.

    It would still be interesting for Sleepio to publish Sleepio figures though. I assume people would still complete their diaries and then the spread of people hitting 90% would be interesting.

    My wife is a great sleeper but I am fairly certain she does not attain 90%....I am not saying she never does but probably only on a school day when she realises she is late and dashes out of bed.

    Interesting you state you only tried QHR once. Does seem to be common at least to the people I have spoken to where QHR appears to have failed or people cannot stick to it. Maybe Sleepio might consider invoking other techniques such as mindfulness in waking and accepting being awake and just relaxing in bed and being mindful of senses and feelings. I am reading another book at the moment that promotes this and in accepting being awake in your surroundings, you stop worrying about sleep and trying to fight it, eventually over time this relaxes the body and mind and then sleep will come. Food for thought…

    My questioning on Dr Vicki is more about my quest for knowledge and my own experiences. My whole way of thinking is not to just to something because experts say that's how we should do it, I want to understand the concepts behind it, and really drill into the process, way of thinking and the results. I have been an analyst for years….sometimes its a bit of a bug bear to always want to pull things apart to understand how it works rather than just go with the flow :)

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hi Sturan
    I'm a bit of a scientist type myself, but it's best not to get too analytical in the night if you can help it.

    I think the point about QHR, the the, etc, is that different people have different mindsets and the Sleepio programme recognises this and provides all sorts of tools and each person who goes through the Sleepio course picks the tools that fit best with their mindset. (I'm not sure that Sleepio would agree with me on that but there is such a wide range of techniques in the programme that it would be impossible to do all of them – I for one would lie awake wondering if I left one of them out!) QHR just didn't fit with me. Nor did thinking of being on the beach or wherever (someone will always throw a beachball at me or a whale will suddenly beach beside me!) as my brain, once given something to think about, likes to make things more interesting so I have to use the the the so it gets bored and switches off. Before Sleepio I tried counting backwards from 2000 but I kept recognising dates – my father died, my kids were born, I got married, etc., so that wasn't brilliant and counting sheep was worse than useless because my brain would throw in a pink one or a wolf or have one refusing the jump… The one tool that Sleepio insists on is SR and all the rest are to supplement that (in my opinion). I don't think I could remember all the tools we were given, but I can remember having positive thoughts about the the the when the Prof introduced it and it has helped a lot. Some out there will chime with what helps me and others will scoff at it. You just have to find what works for you.

    Tatty Helen

  • Sleepio Member

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    in reply to Sleepio Member
    Graduate

    Hi Tatty Helen, I love what you have to say as I've experienced it too, just 'letting go' and no transfixing myself on thinking about whether I'd sleep or not has really helped. The other thing that almost puts me to sleep is a deep muscle relaxation an hour before bed or just before. I read in the articles by the docs that this and imagery can really help for those of us where anxiety was one of the causes of bad sleep (me) . I agree find what suits you as the individual! zzzzZZZZZ

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