Live discussion with Dr Vicki Creanor - 9th August 2017

Dr Creanor will be hosting a live online discussion here on Wednesday 9th August, 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. 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 3 Aug 2017 at 2:15 PM
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  • Sleepio Member

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    Graduate

    I do not have any question neither comment

  • Sleepio Member

    • 13 comments
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    Graduate

    For those of us that awaken during night, are there tips you'd recommend for getting back to sleep? Or will the tips happen later in the Programme?

  • Sleepio Member

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    Graduate

    Sorry to bother you again but I'm getting quite anxious about this which isn't helping but ….. I've been having trouble falling asleep in the last couple of weeks. Or wakening probably after 0.5 to 1hr or so of sleep.

    Last week Dr Sheaves suggested trying to make the evenings a worry-free time, using 'talk back' to any worrying thoughts rather than letting your mind amplify them. All of which I understand but the anxiety/thoughts aren't about anything specifically, except whether I'll have a good night or not! And if anything it's getting worse.

    I'd normally go to bed at 11.30 but for the last four nights I've had to get back up, sometimes twice and probably haven't gone back until about 1 to 2.30 am although I never check the clock. I don't want to undo the good work that I've done in sticking to my sleep hrs of 11.30 to 7am so I just wondered if you had any other suggestions or strategies to help me overcome this particular challenge? Thank you again.

  • Sleepio Member

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    Graduate

    Hi Dr. Creanor
    I've had to take Zopiclone to get out of the insomnia cycle. I want to try and tough it out but I have to drive an hour for work. The problem is that I have been advised against napping when I get back from work. I am so anxious that most days I cant nap anyway. What can I do to overcome the anxiety about not getting a good nights sleep. Because that's what is fuelling the insomnia. And once I'm in an insomnia cycle I find it hard to break out of it.
    Thanks
    Sag

  • Sleepio Member

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    Graduate

    Just started the Sleepio course as advised by my GP. I am 69, physically active, and lucky enough not to have any worries at all. However I cannot get to sleep before 3.30am.

    After winding down and relaxing during late evening, I become incredibly tense and restless when trying to allow myself sleep to the extent of needing to wildly swing my arms, legs and torso about for half an hour at a time – what a bizarre state to be in.

    I have had daily RLS for 50 years, and that is a separate issue, but I have to emphasize that my general restlessness is quite different from RLS.

    The standard relaxation process of avoiding late exercise, avoiding caffine and focusing on the relaxation of different parts of the body is impossible. I still feel I am floating and writhing 3inches above my bed!

    Only two things work – a bottle of wine, or Temazepam, or both – enjoyable but not a great idea.

  • Sleepio Member

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    Expert

    Hello and welcome to the live Sleepio session. Here, questions about sleep and the Sleepio course can be put forward and I will aim to answer as many as I can. Questions about medical problems/medicines cannot be answered here as these are best answered by a medical doctor who knows that person's medical history.

    Let's begin…

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    Thanks for your question. Unfortunately we're not able to comment on individuals' medical complaints (including those about medicine) – as I'm sure you'll understand, it's really important that such issues are discussed with a person's own medical doctor or the person who prescribed the drugs as they know that person's medical history and also know the medicines involved. Most (if not all) medicines have side effects, so when these are experienced, it's good to discuss them with the appropriate professional.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hello and thanks for your question. This sounds really tough, especially after the progress made previously. Working hours are a big problem for sleep! But there are some things one can do in a situation such as this. I would advise avoiding caffeine completely if possible, as this often makes us very stimulated and has a huge impact on us at night time if taken in excess. This means cutting out caffeinated coffee, tea, fizzy drinks, energy drinks and large amounts of chocolate. Difficult in the work place (!) but worth it to feel calmer later in the evening. Relaxation methods used previously at night time can be used during the day as well – it may be hard to take breaks, but even using the excuse at work to go to the toilet, where one can spend a few minutes doing slow breathing or using an alternative relaxation technique. This can also be done at the desk but it's healthy to keep moving around at work to get away from the work space. Making sure the diet is healthy can help reduce stress as well – this may mean being prepared for work with healthy snacks. Using the commute home to unwind, listen to relaxation or music can also be helpful so that the relaxation process actually starts as you leave work and continues at home. Keeping to a set bedtime routine as well will help the body wind down faster as it becomes automatic. In addition to all this, though, if it's just a very new work schedule it will take a little time to settle into it and allow the body to adjust to it, so usually it gets easier over time.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there, thanks for your post. It's often tricky when we're trying to get our sleep back on track to keep everything else exactly as it is. Sometimes (in fact quite often), those working on their sleep also find it helpful, or sometimes necessary, to shift other aspects of their life around a little to ensure the focus (for the short term) is on improving sleep. But this is hard when other aspects of life are also very important, like a sport. The problem is that eating later, and in large amounts, will likely always have an impact on sleep and/or digestion. Also drinking lots of fluids will have the same impact. I wonder, therefore, to accommodate lifting and sleep work, whether there is any scope to do the lifting in the morning, when the post-training eating and drinking won't have an effect on sleep?

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hello – thank you for your post. In terms of back pain, this is something a medical doctor or physiotherapist should be looking at first and foremost. As for the thoughts going through ones head at night time, this is a very common symptom/cause of insomnia, therefore it is actually addressed within the Sleepio programme under the 'challenging your thoughts' section (I think this is session 3). This technique will help to target the difficult and persistent thoughts that plague us at bedtime. I see you're at session, 2, so this technique should be covered soon.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi – thanks for your question on this. This is a tricky one to answer as we would usually recommend consistency throughout, however life is not always that standardised!! What I might do here is stick to very consistent sleep patterns for the other nights of the week (including weekends) and for that one longer night, make sure the sleep window is achieved (ie still aim for the same number of hours but just shifted forward). If it wasn't so late on that other night, I might suggest trying to make the other nights the same bedtime, however my guess is this wouldn't be suitable, unless there is no limit to when to get up any mornings. If this is just a short period where this one night is longer and required, the other option is to pause the programme until this period is over and you can go back to the same bedtime each night.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    HI there – a very important question! So there are a number of techniques geared at helping people in this situation, given it's very very common. Sleepio will teach you over the course of the sessions exactly what to do when those night time wakenings occur in order for them to reduce in the longer term. I won't go into them here as people tend to find it helpful to progress through the techniques one by one through the course and it can sometimes be unhelpful to jump ahead too much. Rest assured, this will definitely be covered…

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,
    It sounds very frustrating at the moment. There are a few things that could be done here, but the first thing I would say is to make sure you are safe when driving. People who are exhausted need to plan when they are driving and ensure that the avoid doing so when at higher risk of dosing off, for obvious reasons.

    So, someone in this situation might want to try and reduce sleepiness in the evening to help stick the later sleep window…this could be done by keeping busy and avoiding sitting down too much as this increases likelihood of falling asleep. Talking to people, having louder music on, getting fresh air can all help.

    Failing this, the sleep window could be shifted slightly each week…so if it's at 10pm now, it could be moved (very gradually) to 10.30pm the following week. It's not how we usually work but if need be it can be shifted gradually to suit individual needs.

    The last thing I would mention here is the importance of putting all the other techniques into place upon wakening in the night…addressing negative thoughts, using relaxation, using the quarter hour rule- all these compliment the other techniques and without all of them, sleep sometimes doesn't improve as well.

    Hope that helps.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    This is a good point to raise for all women in the same situation. Periods affect different women differently. Some do not notice any change in their sleep across their cycle, while others notice huge differences. The obvious thing to mention here is potential pain/sensitivity/discomfort during periods – this is sometimes what keeps women awake longer or wakes them up during the night. Like any trigger for someone with already-poor sleep, this can lead to many negative thoughts such as “urgh I can't get to sleep this is so annoying – I bet I don't sleep tonight at all”...which can be self-fulfilling. Here, it's helpful to use relaxation and thought-challenging techniques to combat these.

    The other thing to be aware of is the rise in temperature for women during or before their periods. Something that triggers the release of the sleep hormone, melatonin, in humans is a drop in temperature. So, if this isn't happening, sometimes it means not getting as sleepy as usual to trigger the need for sleep. So keeping the bedroom cooler during this time may help, as might having a warm bath before bed…this will then help reduce the temperature of the body upon coming out the bath.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there – yes, there are many techniques for this and they will be covered very soon within the programme and at a pace to allow people to practise them as much as possible between sessions.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hello, thanks for your post. I think one of the main things here is to recognise that when people recover from insomnia, there will be blips along the way. The body is getting used to a new pattern of good sleep and, for a while, remains vulnerable to disruption. But rather than seeing these sleepless periods as a return for sure to square one (this is probably very inaccurate), it can help to repeat to yourself that this is a common blip. Sometimes what happens is the negative fixation on any later periods of poor sleep (which will happen to us all at some point – including to good sleepers) causes the problem to be maintained and get worse. Telling yourself that you've managed to sleep better already in the past and so it can definitely be done again will help. I agree as well with Dr Sheaves' comments in that sometimes we slip in our bedtime routines after the initial rigidity we put in place at the start of the programme…going through each of the techniques again and ensuring they're being done properly can also help this temporary blip.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hello there. Anxiety is often what drives insomnia – the fear of not being able to sleep often keeps the problem going. There are several techniques within the programme that target anxiety with regards to sleep..challenging negative thoughts, relaxation, thought-blocking, a good wind down routine and having a scheduled 'worry time' during the day. Sometimes when people have graduated from Sleepio it's a good idea just to go through the techniques again, one by one, when blips occur so that the problem can be addressed in a methodical fashion again. If people feel that their anxiety is underlying the insomnia but not a result of it, it is usually a good idea to seek help for this anxiety, too.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    Hi there,

    I see you are in Session 1 so welcome to the Sleepio course. The first thing I would say is that the sessions you'll do over the net number of weeks will help with how to properly unwind and get a set sleep window (period of sleep) in place to help maintain consistency and routine, which both help improve sleep patterns. You will also be coached on how to respond when sleep doesn't occur, so there are plenty of techniques ahead for you.

    A couple of things spring to mind, though, to perhaps think about here. First of all, I wondered if any medications are interfering via side effects to make sleepiness occur later in the night. Secondly, I wondered if you may be one of the people we sometimes speak to whose body clock is just simply set later than most, making sleep occur later. It's worth thinking about how sleep has been over the years, and when younger, to see if this fits for someone.

  • Sleepio Member

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    in reply to Sleepio Member
    Expert

    I'm aware that the comment about mixing medicine and alcohol was likely in jest, but just in the interest of public information (!) – this should clearly never be done. We tend to also advise that alcohol is limited or cut during sleep work given the huge impact it has on sleep.

  • Sleepio Member

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    Expert

    That's all for today's session – thanks for the questions and speak to you all again soon…

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