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.
Understanding Insomnia Part 6 – Stimulus Control Therapy
