Stimulus Control

• Don’t use your bed or bedroom for anything (at any time of the day or night) but sleep (or sex).

• Doing other things in bedroom is “misusing” this room. Doing other things reinforces the notion that a variety of actions are appropriate in this setting (e.g., if you often watch TV in bed, then when you go to bed, you might be tempted to watch TV rather than go straight to sleep). If the bed is reserved for sleep alone, then climbing into bed will again become a strong cue for you to fall asleep.

• If you do not fall asleep within about 15-20 minutes, leave the bed and do something in another room, such as watch TV, play a game, or read a book. Do not eat, drink excessively (particularly alcohol), work at a computer, or exercise. Try to keep the lights dim; do not turn on any bright lights. Go back to bed only when you feel sleepy again. If you do not fall asleep within 20 minutes upon returning to bed, leave the bed again and do something in another room. Repeat this instruction as many times as needed. Clock watching with regard to the 15-20 minute rule is not recommended, so hide the clock.

• Although the idea of getting out of bed to promote better sleep might seem counterintuitive or strange, the reason for doing this is to strengthen the association of the bed and the bedroom with sleep. When you stay in bed when you are not sleepy you might toss and turn, begin to think or become frustrated, and get mentally and physically aroused. That would only reinforce the old habit patterns we are trying to eliminate.

• If you wake up during the night and do not fall back to sleep within 20 minutes, leave the bed and do something in another room, such as watch TV, play a game, or read a book. Do not eat, drink excessively (particularly alcohol), work on a computer, or exercise. Try to keep the lights dim; do not turn on any bright lights. Only go back to bed when you feel sleepy. If you do not fall asleep within 20 minutes, leave the bed again and do something in another room. Repeat as often as needed.

• New habits come only with repeated practice. When first beginning this treatment, it is common to have to get up many times each night before falling asleep.

• Get out of bed when your alarm goes off every morning, regardless of the amount of sleep obtained.

• Getting out of bed at the same time every day (including weekends) will help your body acquire a constant sleep rhythm. If you vary the time you get up, you are shifting your rhythm each day so that it is not in stable harmony with clock time.

• Avoid napping. Naps meet some of your sleep need and make it less likely that you will fall asleep quickly. By not napping, you also help to ensure that any sleep deprivation you feel from last night will increase your likelihood of falling asleep quickly tonight. If you must nap, sleep for less than one hour before 3 pm.