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Insomnia FAQs

Q. “My Mother suffers from Insomnia and its spoiling her life, can I talk to you about it?”

A. “thanks for your question, there wouldn't be much point in talking about your mohter's problem with you, it would be much better for me to see her and talk direct to her. If her Gp refers her to me at Spire Sussex I would be more than happy to chat things through with her.”

Q. “I dont feel anxious and dont think this is the cause of my insomnia”

A. “you may be right however the inability to sleep itself can lead to anxiety as can worry about its implications for the day ahead. This doesn't mean you are an anxious or depressed person.”

Q. “No question this is the place to get this info, tnhaks y'all.”

A. “Thank you for your feedback”

Q. “Did I hear you on the radio a couple of months ago?”

A. “Yes I was asked to contribute to a piece on Insomnia on the morning show on BBC radio Kent. I was attending a conference on Insomnia at the Royal Society of Medicine (RSM) so this was timely! Part of my work with whilst a committee member of the British Sleep Society and the Sleep section of the RSM is to raise the profile of Sleep medicine and sleep problems as a whole.”

Q. “What is a sleep coach? Are you the same?”

A. “Thank you Karen. A sleep coach is someone who gives one to one advice - mainly practical about improving your sleep. This can be from advising on mattresses, pillows, bedroom temperature, ambient light, relaxation and bedroom ritual. This is a big industry with premiership football clubs having their own sleep coaches to ensure their players are well rested and able to perform at the top of their abilities. There is a role in big business and with elite sportsmen and women, or indeed anyone who wants intensive one to one support to improve all aspects of their sleep. I am a consultant in sleep medicine which means that the majority of my work is seeing patients with sleep disorders. I am however happy and more than qualified to provide sleep coaching services. Feel free to contact me via this website and we can discuss this.”

Q. “Do you see children sleep problems? I cant get my 4 year old to stay in her bed, she used to sleep well.”

A. “I am a consultant in adult sleep medicine, but I do have some experience in the sleep of developmentally normal children. However I have no experience in the management of the sleep problems which are particulary prevalent in children with developmental disorders such as autistuc spectrum. I can however recommend a professor of sleep medicine who has lots of experience in this area. Regarding your question I believe that children need a fixed bedtime routine, perhaps including a set tea time, a bath, a story and then to bed at a set time. For a 4 year old this really shouldn't be any later than 8pm, but preferably earlier. A reward chart can be useful in 'encouraging' your daughter to stay in bed, and if that doesnt work, just returnming her to bed every time she gets up with a minimum of interaction, therefore not 'rewarding' her for getting up. I hope this helps!”

Q. “How long does it take to be seen once you have been referred.”

A. “The short answer is 2-4 weeks. Its always at least 2 weeks because we ask you to complete a sleep diary for 2 weeks and complete some online insomnia questionnaires. There is never a significant wait though.”

Q. “Hi, Please can you help.. I currently experiencing insomnia brought on by my marriage separation. Its been happening for about 4 months to the point where i panic each night when its time to sleep and sweat, and without medication i dont sleep at all. I've experienced insomnia in the past before when faced with difficult life situations but never this bad. Please can you let me know if you feel your treatment will help ? with GP referral can i be seen via NHS free? does private health cover this? also have you heard or treated anyone in this similar situation before? ”

A. “I’m really sorry to hear about your marriage separation, a really stressful event such as this is a common trigger for sleep difficulties and insomnia. If it has been going on for 4 months action needs to be taken soon to stop it from becoming a long term problem. Anxiety and panic related to going to bed can be part and parcel of Insomnia. Most of my insomnia patients have at some time had a stressful / traumatic event which seemed to be the trigger for their insomnia. In order to know if CBT I (Cognitive behavioural Therapy for Insomnia) will be of help to you I would need to assess you in clinic. Roughly 80% of patients experience a significant improvement in their Insomnia symptoms with CBT-I. From the limited information you have given me in this email it seems that CBT-I would be beneficial. This treatment is offered on a private basis only. There is an initial sleep assessment for 45 - 60 minutes - there is an online sleep diary to complete and online insomnia questionnaires to do prior to your appointment, these are accessible via the members only section of the website. Thereafter if I feel you are suitable and you wish to proceed you would have 6 x 45 minute cognitive behavioural sessions at weekly intervals and then a final assessment with me at the end to tie up loose ends. This is done as an all or nothing package - it involves considerable commitment on the part of our psychologist, and indeed yourself. Private healthcare is unlikely to cover this, most sleep problems are excluded from health cover although its worth asking your insurance company. A referral from your GP is not absolutely necessary but is often really helpful, especially if we need your GP to stop or start medications. It is important that your GP is aware of any treatment you are receiving. Please let me know if you would like us to arrange an appointment. We would be able to see you within the next 3 weeks. I hope this is useful. ”

Q. “please please please could you get in touch with me . ihave been to the doctors for years with no joy . last time i went i was told it was tough and i would have to get on with it. so please please please can you help me it is like being tortued .thank you ”

A. “I’m sorry you seem to be having a difficult time at the moment. It isn’t right for a healthcare professional to say 'tough’ and just get on with things. We are more than happy to see you in our clinic and discuss things further. In order to speed up your assessment and treatment it would be wise to see your GP and ask for a referral to Dr Simon Merritt, Consultant Insomnia Clinic, Spire Sussex Hospital.”

Q. “why is this service not more widely available?”

A. “We will / can see patients from any areas, the main thing is however that you need to be able to travel to us on a weekly basis during your CBT. Regarding provision within the NHS, sadly Sleep medicine, certainly the parts of it that are not to do with obesity and sleep apnoea, is very small print in the scheme of things. What is not recognised by health authorites / commissioners is that the initial cost of CBT saves an awful lot of money in the future in terms of reduced days off work, increased productivity, fewer (if any) prescriptions for sleeping tablets, fewer visits to the GP, better mental health, i could go on! ”

Q. “Do you see patients at Beneden Hospital”

A. “Not currently, although there will be possibilities in the future. Interestingly members of Beneden healthcare society can already get a significant amount of the costs of this treatment back from the society, even if they are seen in Spire Sussex. The costs of both of the consultations with Dr Merritt, our sleep specialist are covered, and a significant proportion of the CBTI costs, leaving less than £200 to pay in total for the 8 appointments! ”

Q. “what about online CBT?”

A. “Thank you for yuor question. There are a number of websites offering online CBT for Insomnia, and I have no doubt that at least some of them will contain good quality information. The trouble with 'web therapy' is that it takes a certain sort of person to be able to consistently stick to the program, it takes considerably more motivation than seeing a therapist face to face. It is also a rather generic one size fits all sort of therapy, which flies in the face of what CBT is all about. Its about personalised therapy, not a conveyor belt! The therapy we offer is tailored to individual needs, I am a medical doctor, experienced in the tretament of all manner of sleep disorders. I provide a thorough and individualised assessment session and explanation of CBT for Insomnia, prior to 6 face to face sessions with our very experienced psychologist.”

Q. “I have been taking 10mg Temazepam for over 5 years, is this a problem?”

A. “That is a good question. There has been some adverse publicvity regarding long term use of sleeping tablets, with some suggestion that overall life expectancy might be reduced and the chance of strokes increased. It is difficult to know how reliable these studies are and in the sleep world we are eagerly awaiting another study to show the same thing. We know that Insomnia itself has adverse health consequences, so it may be due to the insomnia not the tablets. Watch this space!”

Q. “Can i just come as a one off appointment to see how things go, and then perhaps commit to the CBT sessions?”

A. “Of course. I am happy to arrange this, I will make the arrangements.”

Q. “Do you see children with sleeping problems?”

A. “I’m we only see those aged 16 years and older.”

Q. “what is your current waiting time to be seen”

A. “Thank you for your question. the waiting time varies depending on demand, but we would aim to see everyone within one month of referral. at least two of these weeks will be spent completing a daily sleep diary and insomnia questionnaires, which are essential before we see you in clinic.”

Q. “Hi, could you tell me if there is a possibility of rebound insomnia lasting on and off for several years ? I am a 53 year old woman and have been having bouts of insomnia for four and a half years now. I do not cope well when I can't sleep ! I don't have a stressful life or job, I practice good sleep hygiene, yet these episodes are becoming more frequent. and are utterly debilitating. I took Zopiclone five years ago following minor surgery, then started again four and a half years ago when I was having sleep problems. After taking them for two and a half months I eventually stopped without too much difficulty, but have had bouts of insomnia ever since. I now take them when I am desperate, but only for two or three nights.My GP is sympathetic and will let me have them for occasional use only - but I wonder if I am making things worse ? I would really welcome the chance to speak to someone who really knows about sleep problems as I have lots of questions ! Maybe I would benefit from a one off consultation ? I understand there is a charge and I am sure my GP would be happy to refer me. My latest episode brought me to my knees - so tired, but not sleepy ! I felt unable to leave the house and certainly not safe to drive. I would really welcome some advice. Thank You”

A. “Thank you for your question. i have replied more fully by email. Once you have had insomnia, there is certainly a chance of it coming back as you describe. This would could happen at times of psychological vulvnerability, such as high stress or physical fatigue. Im happy to see you and discuss things. The good thing with CBTI is that as part of it you learn things you can do in the future should symptoms come back.”

Q. “Why can't I sleep?”

A. “That is an impossible question to answer without more information, please feel free to post another question, or click on the contact us icon, alternatively ask your GP to send a referral letter to Dr Simon Merritt, Consultant Respiratory and Sleep Medicine, Spire Sussex Hospital. The insomnia links are very informative, particularly the ones at the bottom of the list, as is the insomnia info section of this website. ”

Q. “I live in tunbridge wells, will you see me?”

A. “Ofcourse. we will see anyone from anywhere as long as they can travel easily for their 8 appointments. People routinely travel from Rye, Cranbrook, Wadhurst, Hawkhurst, Tunbridge wells, Eastbourne, Battle, Bexhill, Brighton, to name and further afield to see consultants at the Spire Sussex Hospital.”

Q. “I wish to enquire about insomnia treatment. I have suffered with insomnia on and off for the past year. I try to manage night times by taking herbal remedies and drinking warm milk before bed, to help me relax. On average I sleep for about 3-4 hours a night. When the insomnia is particulary bad I have been prescribed zopiclone by my GP. I am extremely aware of how addictive zopiclone can be and I'm reluctant to take it. I recently went back to my GP and have now been prescribed a mild anti depressant. I am also reluctant to start taking the pills as I do not feel low in self confidence or motivation. The primary cause of my insomnia is stress linked to work and moving house. My mind finds it very difficult to switch off come bed time,and the stress is at the fore front of my mind.I have researched heavily around the subject and wondered if CBT is the next step for me to achieve a good nights sleep?How do I arrange a consultataion? Is there a cost? Kind regards.”

A. “Thank you for your question, I do understand how awful it feels not being able to sleep properly. I will respond in more detail to your question by personal email, but in short, your history is very typical of an insomniac. Particularly the history of stress and anxiety that you describe, this classically perpetuates the insomnia. It is key that you restore the assocaition, in your mind, between bed and sleep, rather than your bed and sleeplessness. Part of this involves altering how you think about your sleep, your sleep hygiene and temporalily altering the time you spend in bed - sleep restriction, to name but a few. From your question i think you would be very suitable for CBT, but a s a matter of course you would have a one off appointment with Dr Merritt to go through the treatment in more detail and to assess your suitability for it. If we don't think its likely to be helpful then we wouldn't recommend that you undertake it. To arrange a consultation you would ideally ask your GP to send a referral letter to Dr Merritt Consultant Sleep and Respiratory Medicine, Spire Sussex Hospital. I'm afraid this service is not available locally on the NHS, there is therefore a charge. ”

Q. “Do you see people who have sex in their sleep? {please don't publish my name}”

A. “This is something called sexsomnia and is thought to be quite common, although few people actually go to their doctor and complain of it. I have seen a number of people with this problem. It is due either to a form of epilepsy, or most commonly to a variant of sleep walking. From your email it does sound like you should see a doctor about this. I am happy to help.”

Q. “Why isn't this service offered in more places?”

A. “Insomnia is a very specialised problem and a review fisrstly by someone with experience in sleep medicine is necessary and then treatment by a psychologist who has experience in CBTI (cognitive behavioural therapy for Insomnia). There are relatively few doctors with the necessary sleep medicine experience and even fewer psychologists with the experience and knowledge of CBTI. If you need anymore information on this then please click on the contact us part of the website and Dr Merritt can contact you personally.”

Q. “I've tried lots of the things you suggest before, why will your treatment help?”

A. “Many people have tried a few of the sleep hygiene and other ideas contained within the "how to help yourself" section but very few people have done all of them at the same time, and for at least 2 months. The treatment of insomnia is difficult and there are no easy fixes. The published research studies suggest that 70-80% of people are helped with Cognitive Behavioural Therapy for Insomnia, we do however expect lots of effort on your part, indeed without it the treatment is unlikely to be very successful.”

Q. “are sleeping tablets really a bad thing?”

A. “Not always, but often they don't give satisfying and refreshing sleep. Also they tend to become less effective with time. They can be useful for a short period of time but in the end the underlying cause and /or precipitating factors need to be considered and ideally addressed. CBT I doesn't pretend to solve all of your problems and anxieties but gives you ways of coping with and of managing them such that they causeless of a problem. It provides you with a mental tool kit to manage such issues, particularly those that interfere with sleep. Importantly its effects seem to be long lasting.”

Q. “I don't mean to be a smart arse but your sleep hygiene advice refers in one sentance to putting clocks and watches out of sight and then in another talks about staying in bed awake for no longer than 20 minutes, this doesn't seem to make sense. Please enlighten me.”

A. “You are correct in saying that these points are very important parts of sleep hygiene. When timings such as 20 minutes are referred to they are approximate. It is important to not spend any part of the night clock watching, this tends to stimulate the brain and make sleep much harder. ”

Q. “I've hit my wife during my sleep. She doesn't believe I wasn't awake. Can this happen?”

A. “This sounds like a problem called REM Behaviour Disorder. It occurs almost always in men and usually starts off in the early to mid fifties. It can occur in the context of narcolepsy, this usually presents much earlier in life and is associated with extreme daytime sleepiness and (usually) disturbed sleep at night. You need to be seen by a sleep specialist. If you contact me again via the 'contact us' icon found on each page of this website, I can let you know of the sleep clinic nearest to you, alternatively if you live within travelling distance of the Spuire Sussex Dr Merritt can see you.”

Q. “Is a GP referral necessary before I can receive treatment?”

A. “Ideally it is. Your GP is the gate keeper of your health and can give you valuable advice on this treatment option and can also provide important information on your past medical history which may change how we treat you. Whilst we will accept self referrals, it would be beneficial for you if we could contact your GP and find out about any past medical problems. We may rarely need your GP to prescribe short courses of medication for you so we will need to be in contact with them. With your permission we will write to your GP at the start and end of your treatment. ”

Q. “This might be able to help me, how do i find out more?”

A. “If you click on the contact icon or link then we will get in touch with you by phone or email, whichever is preferable. We can then talk through our method of treatment and whats involved. We look forward to hearing from you. ”

Q. “What's the point of sleep?”

A. “Thats a really good question and the long and short of it is that we don't really know. There are many theories, some related to consolidation of memory and learning and some related to the fact that by sleeping at night we avoid nocturnal predators (in the cave man era!) - humans don't see so well at night and are best off asleep and not wandering around in the dark! We do however know from animal experiments performed a long time ago that total deprivation of either total amount of sleep or just dream sleep alone shortens lfe considerably.”

Q. “Is getting exceptionally drunk a good way to deal with insomnia?”

A. “No, definitely not. Although alcohol can act as a sedative in the short term, it tends to lighten the depth of sleep and results in one waking earlier than usual, often not feeling refreshed at all. Patients with alcohol problems often find they have problems with insomnia. It would be important to deal with the alcohol problem prior to addressing the insomnia. ”

Q. “Do you see patients with other sleep problems?”

A. “Yes, we accept GP referrals for adults with any sleep disorder. Dr Merritt is a sleep specialist, he regularly sees patients with Sleep apnoea (OSA), excessive sleepiness, Narcolepsy, patients who act out their dreams (REM behaviour Disorder) as well as Insomnia. For further information please click on the contact us icon, alternatively ask your GP to send a referral letter to Dr Simon Merritt, Consultant Sleep and Respiratory Medicine, Spire Sussex Hospital.”

Q. “I have to sleep during the day sometimes due to work, any tips?”

A. “Humans are designed to sleep at night so it is almost impossible to get normal sleep (duration and quality) when sleeping during the day. It is important to try to sleep in a completely dark room, ideally in fact when leaving work in the morning you would wear sun glasses to reduce your exposure to light. Napping during a night shift will make it harder to sleep during the day. The last suggestion I have would be to ensure plenty of bright light exposure during most of your night shift, and if possible dimming this light during the last 3 hours before you will be going to bed.”

Q. “Can you cure my Insomnia?”

A. “We would initially assess you in a stand alone 45-60 minute appointment to determine if Cognitive Behavioural Therapy (CBT) would be useful for you, and to go through in more detail what this treatment involves and what you might expect by the end of treatment. If we judge you to be suitable, and you wish to proceed, then we would put together a package of 6 CBT sessions, followed by a final session with Dr Merritt. A total of 6 hours treatment / assessment. . We would aim to improve most patient's sleep experience, which often involves falling asleep quicker and staying asleep longer, how much of an improvement is very much an individual thing and can not be predicted at the outset. We are happy to discuss this in the first consultation. It is often impossible, however, to improve things to such an extent that you go from 2.5 hours sleep to 8. The published research shows that 70-80% of patients find that they get a significnt imporovement in their sleep with CBTI Although we are confident we will help you, it is impossible to promise to cure you, and anyone who does shouldn't be trusted! Everybody is individual and therefore not only responds differently to treatment, but also requires treatment tailored to them, which is what we aim to provide.”