Live discussion with Dr Vicki Creanor - 7th December 2016

Dr Creanor will be hosting a live online discussion here on Wednesday 7th December 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 1 Dec 2016 at 9:12 PM
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  • Sleepio Member

    • 1970 comments
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    in reply to Sleepio Member
    Expert

    HI there,
    Everyone (even as babies) has a point at which they fall asleep due to the sleep pressure building within them that causes increasing tiredness. However, some people are prone to not feeling tired until later in the night (we sometimes call them night owls) so it feels as if they can't drop off until much later but it's because they are going to bed earlier than their bodies are ready for them to. Sometimes shifting the sleep window to a later time can mean they spend less time lying awake and find it easier to drop off this way. Hope this helps?

  • Sleepio Member

    • 1970 comments
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    in reply to Sleepio Member
    Expert

    Hi there,
    Thanks for your post. There are many things that need to be in place in order to feel ready to sleep. These include:
    – having a good pro sleep schedule (wind down time each night, regular bed and wake times)
    – if there are thoughts that whizz round one's head at night, having time in the day to challenge these properly can help using the thought challenging technique in the programme
    – making sure that caffeine, alcohol etc are kept to a minimum
    – making sure that the bedroom is a relaxing non-stimulating environment – engaging in relaxation as part of the wind down routine

    The other thing to bear in mind for many is that, if there is an underlying mental health problem (stress/anxiety/depression/low mood) at play, it's important to get this supported as well as these interfere with our ability to fall asleep initially, too.

    Hope this helps.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    I would also add that sometimes it's important to think about the right time one should sleep – if one is a night owl it may be that they are not ready to sleep until later in the evening, for instance.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    Yes there is some evidence that screens such as laptops and tablets can suppress melatonin production (and thus inhibit the sleep response). TVs can be the same depending on their set-up but it does depend on the types. If in doubt, I would avoid anything that seems to emit this light but more than this, it is good practice to reduce the amount of technology we use before bed as it's also the stimulation factor we need to think about. Technology use encourages us to stay up later, engage in social media etc which also interferes independently with our sleep.

  • Sleepio Member

    • 21 comments
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    Graduate

    If I sit down in mid afternoon – say 3.30 or 4 o'clock and watch some daytime tv, I can fall asleep in the chair and wake with a jump. Why does this happen, and is it advisable to avoid it or should we look on it as a useful bit of extra sleep time? I usually feel it may prevent me getting to sleep at bedtime.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Sleep restriction is very tricky and people will feel more tired than usual in many cases. Caffeine can be used early in the day to kick start the system (although not beyond about 11am/12 noon) and taking light exercise and getting fresh air can really help in this period. Avoid naps as tempting as they are, unless they are recommended for health reasons or they are needed for safety (if one needs to drive or operate machinery).

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    You are correct – it will take away the sleep pressure for bedtime, which we want to avoid. SO, avoid naps at all costs (except for health/safety reasons as noted above in my last post). Try to do other activities that make napping less likely – getting fresh air can really help when sleepy in the daytime.

  • Sleepio Member

    • 3 comments
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    Graduate

    I am on day 5 of restricted sleep and feeling exhausted. i got up at 5.15 this morning, sat in the chair relaxing watching TV and fell asleep soundly from 6 until almost 9. i felt so much better for catching up on my sleep but I know I am not supposed to do this. any suggestions on keeping awake??

  • Sleepio Member

    • 1970 comments
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    in reply to Sleepio Member
    Expert

    The techniques that will be covered on the next couple weeks (and those already covered) all tie together to help with this problem. Sleep restriction, the quarter hour rule, regular bed and wake times all play their part, so my advice would be to stick with everything you have been taught and keep putting them into practice until you see the changes. There is little I would add to what the programme already offers as it is tailored to help this problem. Good luck!

  • Sleepio Member

    • 1970 comments
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    in reply to Sleepio Member
    Expert

    If one wakes before the scheduled wake time, get up after 15 mins awake and then return to bed after feeling sleepy (even if there are only 30 mins to go before wake time). If one wakes at their scheduled wake time and feels exhausted, getting fresh air will help as will a shower, caffeine or doing something stimulating like exercise. Loud music can also help wake some people up in the morning. Hope these suggestions help – sometimes it's trial and error! But avoid sleeping in the chair as this weakens the bed-sleep connection and will make sleep worse.

  • Sleepio Member

    • 1970 comments
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    in reply to Sleepio Member
    Expert

    the reason we suggest this is because a full stomach can keep people awake or can lead to through-the-night indigestion which will wake people up. It's not completely fixed, as long as the food has a chance to digest before bedtime

  • Sleepio Member

    • 1970 comments
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    in reply to Sleepio Member
    Expert

    Hi there,
    Those at the start of the programme will soon cover a technique to challenge their thinking – this is the best way (a CBT technique) to help with intrusive thoughts. Good luck when you come to it – it's very effective.

  • Sleepio Member

    • 1970 comments
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    in reply to Sleepio Member
    Expert

    It's really hard at certain points to keep on going with any type of psychological treatment, especially when one is so tired. Although alcohol can seem like a helpful tool, as mentioned, it can help one fall asleep initially but really disrupts the stages of sleep we have after that and basically disrupts the night (and sometimes subsequent nights). The techniques within Sleepio are all designed to help people get their sleep back on track but it does take time. I would always say it's important to have supportive people around when doing any type of treatment programme as these are the people who can support you to keep going when things get tough. Use of this community forum can also help speak to people in the same situation and can be very supportive.

  • Sleepio Member

    • 1970 comments
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    in reply to Sleepio Member
    Expert

    Hi there,
    I'm wondering if the quarter hour rule has come into play yet? It's really important not to do anything but sleep (not including sexual activity) in bed if falling asleep is an issue. After 15 mins of not falling asleep, one needs to get up and move to another room. The programme will help talk people through this but this is an important technique to follow to help get the sleep-bed connection back on track which ultimately increases the success rates of getting to sleep initially.

  • Sleepio Member

    • 1970 comments
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    in reply to Sleepio Member
    Expert

    thanks for your post. This topic came up earlier too so it's a hot topic! We would usually recommend not reading in bed initially to make the bed-sleep connection more pure and help people rely on themselves alone to sleep, however good sleepers read to get to sleep and think nothing of it, so I would say it's OK as long as one falls asleep within 15 mins reading…otherwise, I would read at other times and follow the guidance in the programme on what to do when lying awake at the start of the night.

  • Sleepio Member

    • 1970 comments
    • 319 helped
    in reply to Sleepio Member
    Expert

    Hi there,
    If a nap is required for health reasons or for safety reasons (ie if one needs to drive when tired or operate machinery) then this is OK, however, naps in general should be completely cut out in order to improve night time sleep. By doing so, sleep pressure at night is increased which helps sleep greatly. Naps will undermine many of the techniques used in the programme, unfortunately, which is why we encourage them to be stopped.

  • Sleepio Member

    • 1970 comments
    • 319 helped
    in reply to Sleepio Member
    Expert

    Hi there,
    It sounds as if life is very tricky just now. For those with similar life situations that restrict the time they can spend on certain techniques, it can be tricky to find time to focus on some things. If techniques can be carried out then this is great, however if it is too hard to stick to rigidly, perhaps it is not the right time for treatment. Often life is so busy that it's impossible for techniques to be put in place. Having said this, if there are ways to incorporate the techniques, this can still be done. It's more about whether the person is feeling psychologically steady for engaging in treatment. It sounds as if using the relaxation will be very helpful in this circumstance. On the waking once a night for administering meds note, once a night waking is normal for good sleepers, so I'd encourage people not to focus on this too much. What is important is using the thought challenging technique to combat any thoughts that increase anxiety around this waking.

    Hope this helps.

  • Sleepio Member

    • 1970 comments
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    Expert

    That's all for today folks – thanks for the many questions. Good luck with the programme until we speak again…

  • Sleepio Member

    • 6 comments
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    in reply to Sleepio Member
    Graduate

    I think I misunderstood the concept of eating 3 hours before bedtime…I assumed it meant you were supposed to wait 3 hours before bed to eat dinner. LOL

  • Sleepio Member

    • 7 comments
    • 0 helped
    Graduate

    On average the past 2 months, I sleep one night about 7 hours the next I never fall asleep. I require and always have 8.5-9 hours a night. I have been on Lunesta 3mg for about 8 years and it worked fine till this summer (from August till now it has progressively gotten worse.) My doctor added 1mg Xanax and it did nothing. Then I went to a sleep specialist that added Trazadone 50 mg. Tonight, per her direction, I am taking 100 mg of Trazone Since for months I didn't sleep on Lunesta ( i quit the xanax) Should I assume the Lunesta no longer works for me? I have tried 12.5 Ambien, 20mg Belsomra and 3 mg Melatonin with no change. I am Bipolar so it is particularly vital for me to get regular sleep. I am on the sleep restriction phase of the program lesson 3. Please advise and give any guidance.

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