Stimulus Control in Insomnia

Little Albert was a little boy who was shocked anytime he saw a white rat. Soon he became fearful of the white rat even when the shock didn’t happen. Classical conditioning caused Little Albert to be fearful of all white furry objects.  They became a “stimulus” for shock causing Little Albert to become fearful and cry each time he saw them.  Classical conditioning, explains why you are having difficulty sleeping even though the initial cause of your insomnia may have resolved. 

Let’s say that Emma gets sick during finals.  The stress of finals, difficulty breathing, and a cough causes her to toss and turn with little sleep.  Once finals are over and she is well, she continues to have difficulty sleeping.  Because she spent so much time in bed tossing and turning, frustrated about not being able to sleep, she became classically conditioned.  Her bed became a place, or a stimulus,  for being awake and frustrated instead of being a place for sleep. 

This problem gets worse when you try to go to bed earlier or stay in bed later attempting to make up for lost sleep.  The more time you spend in bed awake, the more you reinforce this problem.  Like little Albert who associated white furry objects with shock, you are likely associating your bed with being awake, anxious, and frustrated, instead of associating it with sleep.  

Stimulus Control involves waiting to go to bed until sleepy and getting out of bed after what feels like about 15 minutes of being unable to fall asleep or in an even shorter period of time if frustrated or anxious. The goal is to make your bed a place for relaxation and sleep rather than associating the bed with wakefulness, anxiety, and frustration. Some people sleep better when going to an extra bedroom or the couch.  When out of bed, do something relaxing with low lights and wait until feeling calm and sleepy before returning to bed.

In stimulus control it is important to reserve the bed for the three S’s: Sleep, Sick, and Sex.  I even think it’s best to be on the couch when sick.  Experts are divided about reading in bed.  I believe that reading something low-key with amber lights or low light focused on the book, can help make the bed a place for relaxation and ultimately lead to slumber.  

by Jennifer L. Abel, Ph.D. author of “Melt Worry and Relax Card Deck"