Stimulus Control for Insomnia

Think of this as "learning to sleep correctly." The insomniac is taught to eliminate or ignore stimuli that prevent sleep. The method tries to teach the subconscious mind that at a certain time (bed time) and in a certain location (the bedroom) it is time to sleep. These ideas are good for everyone, not just those with chronic insomnia.

Practices include intentionally removing activities from the bedroom that conflict with sleep. No reading, eating, or television watching should be done in bed, or indeed, anywhere in the bedroom. The insomniac is instructed to avoid lying awake in bed for an extended period of time – if sleep does not come the person should get out of bed and leave the room. If these sound like the principles of sleep hygiene, they are.

Sleep hygiene describes beneficial behaviors and negative routines that can affect one’s sleep. Areas covered include the sleep environment, sleep schedules at night, daytime napping, amounts of stimulating foods and beverages consumed, overly rigid bedtime routines, general health behaviors, and timing of exercise. For instance many sufferers try to fall asleep, but despite being unable to do so, continue to lie in bed hour after hour watching the clock. Positive sleep hygiene encourages you to get out of bed after 20 minutes or so, and to engage in a sleep-promoting behavior like reading. Once you feel drowsy again, you get back into bed for another try. Continuing to lie in bed increases anxiety and makes sleep even less likely. As the insomniac learns about the positive and negative effects of specific behaviors on sleep quality and length, good habits can be formed.

Some would include relaxation techniques as a type of stimulus control.

Stimulus control works better for reducing sleep latency than for preventing nighttime awakenings. It is therefore more effective in cases of sleep onset insomnia than sleep maintenance insomnia. Stimulus control can have long lasting effects if the patient stays with it. And staying with it is the key. Doctors know this type of therapy is more likely to be effective in highly motivated patients who will take charge of their insomnia management. The more lazy patients may be better off with medication.

The University of Maryland website says “stimulus control is considered the standard treatment for primary chronic insomnia.” Doctors might not call it stimulus control – they are more likely going to refer to it as sleep hygiene or habits. This fits in with our philosophy at Sleepdex.

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