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Psychological research over three decades demonstrates the power of Stimulus Control Therapy.
Cant get a good nights sleep? Youre not alone. In surveys of what would improve peoples lives, a good nights sleep frequently
comes near the top of the list.
Poor sleep results in worse cognitive performance, including degraded memory, attention, performance and alertness. And in the
long term insomnia is also associated with anxiety and depression. And peoples sleep gets worse as they get older. After 65 years
old, between 12% and 40% of people have insomnia.
All sorts of methods have been tried to combat poor sleep, from drugs through psychological remedies to more outlandish treatments.
The problem with drugs is that they have side-effects and are often addictive. The problem with the more outlandish treatments is
that although they tend not to have side-effects, we dont know if they have any effect at all. Psychological remedies, though,
combine the best of both worlds: studies show they work without side-effects.
Of these the most successful single intervention is called Stimulus Control Therapy (Morin et al., 2006). Youll be happy to hear it
consists of six very straightforward steps. If you follow these it should improve your sleep. After the list Ill explain the thinking
behind them. First, here are their six steps:
Why it works
This method is based on the idea that we are like Pavlovs drooling dog. We attach certain stimuli in the environment to certain
thoughts and behaviours. Famously Pavlovs dogs would start drooling when a bell rang, because they associated hearing the bell
with getting food. Eventually the dogs would drool at the sound of the bell even when they didnt get any food. Replace the bell with
a bed and food with sleep and conceptually youre there.
If we learn to do all kinds of things in bed that arent sleep, then when we do want to use it for sleep, its harder because of those
other associations.
This is just as true of thoughts as it is of actions. Its important to avoid watching TV in bed, but its also important to avoid lying in
bed worrying about not being able to get to sleep. Because then you learn to associate bed with worry. Worse, you suffer anticipatory
anxiety: anxiety about the anxiety youll feel when you are trying to get to sleep.
So, this therapy works by strengthening the association between bed and sleep and weakening the association between bed and
everything else (apart from sex!).
Other treatments supported by the research are progressive muscle relaxation, which is exactly what it sounds like, and paradoxical
intention. This latter technique involves stopping people trying so hard to get to sleep. The paradox being that when people stop
trying so hard, they find it easier to fall asleep.
All this assumes you dont live next door to a late night drummer and youre not downing a double espresso before hitting the sack,
but those sorts of things are pretty obvious. Everything else being equal, though, Stimulus Control Therapy seems the easiest for
most people to implement.
The latest posts from HealthiestBlog.com, the new blog from PsyBlog's author:
When You Eat Just As Important As What You Eat Mon, Mar 16, 2015
Sitting Disease: More Deadly Than Smoking or Cancer? Fri, Mar 13, 2015
Unwind
This post is part of a series on the science of rest, relaxation and sleep:
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Dr Jeremy Dean is a psychologist and the author of PsyBlog and HealthiestBlog.com. His latest book is "Making Habits, Breaking
Habits: How to Make Changes That Stick". You can follow PsyBlog by email, by RSS feed, on Twitter and Google+.