Stimulus control

Stimulus control limits the amount of time spent awake in bed, conditioning the patient to associate their bed and bedroom with sleep and intimacy only. Stimulus control is useful for patients who associate their bed or bedroom with frustration, worry and poor sleep. These patients are often ‘wired and tired’ rather than sleepy.

Stimulus control involves:

• reserving the bedroom for sleep and intimacy—avoid activities that do not promote sleep (eg reading, eating, using computers, watching TV, working, worrying)
• only going to bed when sleepy and, if sleepless after 20 minutes, getting out of bed and going to another room to engage in a relaxing activity (eg listening to music or an audiobook, meditating, drinking a cup of warm milk or noncaffeinated tea) until sleepy, then returning to bed; this process repeats as long as the patient remains awake
• waking and arising at a consistent time to help adjust the patient’s circadian rhythm.