National Sleep Foundation

Chapter 2: Insomnia

CBT – Stimulus Control

Stimulus Control Therapy

The premise of stimulus control therapy is that insomnia is a conditioned arousal response to bedtime and to cues associated with the sleep environment. The primary objective is to recreate the natural association of bedtime and the bedroom with rapid sleep onset.

Stimulus control therapy is one of the most effective techniques for insomnia management when used consistently (such as by holding regular, weekly sessions).1, 2
Typical stimulus control therapy instructions include:

  1. Go to bed only when you are sleepy.
  2. Use the bed and the bedroom only for sleeping and having sex.
  3. If you are unable to fall asleep within 15-20 minutes, get out of bed and go to another room until you feel sleepy again. (Repeat as necessary.)
  4. Maintain a regular waking time, regardless of the quality of the previous night’s sleep;
  5. Avoid daytime napping.

References

  1. Bootzin RR, Epstein D, Wood JM. Stimulus control instructions. In: Hauri P, ed. Case Studies in Insomnia. New York, NY: Plenum Press; 1991:19-28.
  2. Espie CA, Inglis SJ, Tessier S, Harvey L. The clinical effectiveness of cognitive behavior therapy for chronic insomnia: Implementation and evaluation of a sleep clinic in general medical practice. Behav Res Ther. 2001;39:45-60.