Stimulus Control Therapy for Sleep
What is Stimulus Control Therapy?
Stimulus control therapy is a behavioral technique designed to help individuals with insomnia and other sleep disorders establish healthy sleep patterns. This method focuses on identifying and altering the stimuli that trigger negative associations with sleep, such as lying awake in bed or engaging in stimulating activities before bedtime. By modifying these stimuli, individuals can learn to associate their bed and bedroom with sleep rather than wakefulness. This approach helps to create a positive sleep environment and encourages the development of consistent sleep patterns.
How Stimulus Control Therapy Works for Sleep Problems
The goal of stimuli control is to train your mind and body that going to bed means going to sleep. This training process is done through learned association.
People with insomnia and difficulty falling asleep can begin to associate bedtime with frustration, dread, and even fear. Because they have likely spent many hours lying awake and tossing and turning in bed, going to sleep develops a negative association for them over time. This can become a negative cycle as well when worry about sleep deprivation leads to more difficulty falling asleep. This therapy is particularly effective for individuals experiencing persistent insomnia, helping them to retrain their brains and deactivate the nervous system.
Stimulus Control Breaks the Negative Cycle
Clinicians and cognitive-behavioral therapists recommend that you do not spend too much time in bed struggling to get to sleep. Instead, they advise practicing stimulus control to prevent or break this negative cycle associated with bedtime. This technique involves learned association with sleep-related stimuli and is part of a larger behavior modification method designed to restore healthy sleep patterns, known as CBTi.
How to Use Stimulus Control for Better Sleep
The concept of this cognitive behavior therapy technique may seem backward. But the idea is that it is better to stay awake in your living room all night than to toss and turn in bed. Stimulus control is a key component of cognitive therapy, particularly Cognitive Behavioral Therapy for Insomnia (CBT-I), which addresses dysfunctional thoughts about sleep. Here is the basic process:
- You should loosely keep track of how long you have been trying to fall asleep.
- If you are not sleeping within about 20 minutes, get up from bed and do something that usually helps you relax. For many, this includes reading a book, listening to music or a podcast.
- When you start to feel sleepy, it is time to go back to bed. Give yourself another 20 minutes to try to fall asleep.
- Then, if you do not fall asleep in that window of time, the stimulus control process can be repeated as necessary.
Establish a Consistent Sleep Schedule
A key component of stimulus control therapy is establishing a consistent sleep schedule. This involves setting a regular bedtime and wake-up time and sticking to it, even on weekends. By doing so, individuals can regulate their body’s internal clock, which can significantly improve the quality of their sleep. A consistent sleep schedule helps to reinforce the association between the bed and sleep, making it easier to fall asleep and wake up feeling refreshed.
Create a Sleep-Conducive Environment
Creating a sleep-conducive environment is another crucial aspect of stimulus control therapy. This involves transforming the bedroom into a sleep haven by ensuring it is dark, quiet, and cool. Removing any stimulating activities or objects from the bedroom, such as TVs, computers, and smartphones, is also essential. By making these changes, individuals can create an environment that promotes relaxation and sleep, further reinforcing the positive association between the bed and sleep.
Things to Avoid…
Going to Bed Before You Are Tired
To limit frustration by the amount of time wasted rolling around awake, only go to bed when you feel sleepy. Spend time in the evening winding down in another part of the house. For some people, this includes watching TV on the couch or reading a book in an armchair. Then, you can head to the bedroom when you are actually tired.
Stimulation
During the extra wind-down time, it is important to avoid things that are stimulating. Do not turn on bright lights and activities that tend to make you more alert, such as watching scary movies, eating, and exercising. Practicing good sleep hygiene also means cutting out stimulants like caffeine, TV and other screen time before going to bed.
Unnecessary Stress
Don’t bring work to bed, literally. Checking email and doing work activities in bed is stimulating for your brain and, therefore, counterproductive when you are trying to fall asleep. Plus, it can create a negative association between your bed and stress.
Using the Bed for Non-Sleep Activities
Part of the cognitive training process with stimulus control requires that your bed be used only for sleeping and sex, which are positive sleep-related stimuli. Both of these two activities are connected to the part of the brain and nervous system that is responsible for relaxation and happiness. In fact, research has shown that sex and good-quality sleep are beneficial because they help alleviate anxiety.
Watching the Clock
It may be counter-productive to use a clock to keep track of time in bed. If you find yourself worried about how much time has passed, watching the clock and counting minutes, this creates undue stress. Instead, just go by your feelings. If it seems like it has been nearly 20 minutes since you put your head on the pillow, that is all you need to know.
For people struggling with long-term insomnia, cognitive behavioral therapy combines multiple techniques aimed at modifying simple habits and thoughts in order to promote healthy sleep patterns. Stimulus control is just one method that is used together with sleep hygiene education, sleep restriction therapy, and relaxation therapy.
Stimulus control therapy helps people reset their associations with bedtime and look forward to lying down for a good night’s sleep. When used consistently, many are able to successfully break the negative cycle created by insomnia and get more restful sleep night after night.
As you work through the CBTi process, keep a sleep log to help you and your doctor better understand your sleep patterns and monitor progress.
Learn more about the symptoms of insomnia and the Advantages of Drug-Free Sleep Disorder Treatment for Insomnia.
Get Up If You Can’t Sleep
A technique used in stimulus control therapy to break the negative cycle of lying awake in bed is to get up if you can’t sleep. If you find yourself unable to fall asleep within 15-20 minutes, it is recommended to get out of bed and engage in a relaxing activity, such as reading or listening to calming music, until you feel sleepy again. This practice helps to associate the bed with sleep rather than wakefulness and can reduce the frustration and anxiety often associated with insomnia.
By incorporating these techniques into their daily routine, individuals can improve the quality of their sleep and reduce symptoms of insomnia and other sleep disorders. Stimulus control therapy is a non-pharmacological treatment that can be used in conjunction with other therapies, such as cognitive behavioral therapy, to provide a comprehensive approach to sleep medicine.
Find Relief from Chronic Insomnia and Sleep Disorders
Contact Sleep Health Solutions of Ohio to begin the process of evaluating your sleep problems and identifying an effective solution. Schedule an initial consultation today.
