Sound Sleep Guru

Understanding Insomnia Part 6 – Stimulus Control Therapy 

If you’ve been following along you’ll know that in part 4 I wrote about “conditioned arousal” as a key perpetuating factor in chronic insomnia.  

One of the strategies for addressing conditioned arousal is called stimulus control therapy (SCT).  

Rationale for SCT: 
✅ Trying harder to sleep is not productive 
✅ Sleep debt can promote sleep  
✅ Sleep needs are variable 
✅ Focus on improving quality of sleep first  

👩🏻‍⚕️ Rules for SCT 
✅ Time your sleep in sync with estimate from your biological clock* 
✅ Get out of bed no longer than 15 minutes after your anchored wake time* 
✅ Do not go to bed before sleepy and not before the prescribed bedtime* 
✅ Get out of bed when wide awake or unable to sleep, return to bed only when you feel sleepy enough to fall asleep. 
✅ If you cannot seem to shut off your mind go to another room until you can return without this thinking interrupting your sleep 
✅ Avoid activities in bed such as watching TV and using the cell phone 
✅ Avoid napping outside of your prescribed sleep window* 

The goal of these strategies is to re-train the bed and bedroom to be a strong stimulus for sleep.

I hope this was a helpful glimpse into the first steps of a CBT-I program. I’d like to revisit other aspects again in the future. I’ll wrap up this series tomorrow by touching upon cases when CBT-I alone is not effective or only partially beneficial.

Any questions? 

*These parameters would be determined by your board-certified sleep medicine physician based on 1-2 weeks of sleep diaries or sometimes actigraphy.

Sleep Tips Newsletter!