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 passed 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.
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 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 then to toss and turn in bed. 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.
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 for the bedroom when you are actually tired.
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.
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. 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 feeling. 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.
Stimulus Control Therapy for Insomnia
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 to 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 to better understand your sleep patterns and monitor progress.
Learn more about the symptoms of insomnia and Advantages of Drug-Free Sleep Disorder Treatment for Insomnia.
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