Stimulus Control as a Treatment for Insomnia
Hira Hussain
Dr. Sara Elkins
Cognitive Behavioral Therapy
University of Houston Clear Lake
Stimulus Control as a Treatment for Insomnia
Insomnia is the difficulty to initiate and maintain sleep (Spiegler, 2016). Insomnia is a common condition that affects about 10 percent of the adult population. Insomnia is common amongst females and the elderly. Insomnia is typically associated with psychological and medical disorders. Despite the high prevalence of negative effects of insomnia (psychological distress, impaired daytime functioning, poorer quality of life, etc.) less than 15% of individuals with insomnia receive treatment for their problems (Mimeault & Morin, 1999).
While insomnia can be treated pharmacologically, treating it this way can lead to many long-term effects. Hence, cognitive behavior therapy (CBT) has been suggested to be an alternative treatment option for insomnia (Wang, Wang, & Tsai, 2005). CBT s a typical treatment for insomnia and can come in the form of a treatment package where multiple components are combined to treat insomnia. An intense treatment package for insomnia can include all or some of the following: sleep restriction, stimulus control, relaxation training, cognitive therapy, cognitive restructuring, and sleep education. Insomnia can also be treated using an individual component or combined components of CBT (Spiegler, 2016; Wang, Wang, & Tsai, 2005). Many of the individual components of CBT are usually recommended as treatment for insomnia. One of the individual components of CBT that is recommended to treat insomnia is stimulus control (Wang, Wang, & Tsai, 2005). Stimulus control are cues or conditions that set the stage for behaviors to happen. There are two types of stimulus control and they are prompts and setting events. Prompts are cues that help to perform a behavior. Setting events are environmental conditions that provoke a behavior. Setting events are broader and more complex than prompts. Setting events can be anything from who is present, what people are doing, the time of day, and the physical organization of the environment. Every setting event stimulates different behaviors (Spiegler, 2016). Stimulus control treatment consists of changing setting events and explaining to the insomniac individual(s) a set of instructions to inhibit sleep-in-compatible behaviors and regulate the circadian rhythm. Instructions given to the individual(s) would consists of having the individual(s) go to bed only when they are sleepy at night, only use the bed and bedroom for sleep and sex, to get out of bed and go to another room when they are unable to fall asleep or to fall asleep within 15-20 minutes and …show more content…
Stimulus control can produce up to a 58% mean change in sleep-onset latency (Jacobs, Rosenberg, Friedman, Matheson, Peavy, Domar, & Benson, 1993). Puder, Lacks, Bertelson, and Storandt (1983) studied the effects of short-term stimulus control therapy on sleep-onset insomnia in older adults. They found that short-term stimulus control therapy was effective and decreased sleep-onset insomnia. They were able to find statistical as well as clinical significance. Sleep latency was reduced more than half of the participants by more than 50%. Results from post-treatment indicated that participants had a 30 minutes or longer sleep onset latency zero or once during the week. This indicates that short-term stimulus control therapy of about four weeks, is effective in young insomniac, as well as adults over the age of 60 (Puder, Lacks, Bertelson, & Storandt,
Hira Hussain
Dr. Sara Elkins
Cognitive Behavioral Therapy
University of Houston Clear Lake
Stimulus Control as a Treatment for Insomnia
Insomnia is the difficulty to initiate and maintain sleep (Spiegler, 2016). Insomnia is a common condition that affects about 10 percent of the adult population. Insomnia is common amongst females and the elderly. Insomnia is typically associated with psychological and medical disorders. Despite the high prevalence of negative effects of insomnia (psychological distress, impaired daytime functioning, poorer quality of life, etc.) less than 15% of individuals with insomnia receive treatment for their problems (Mimeault & Morin, 1999).
While insomnia can be treated pharmacologically, treating it this way can lead to many long-term effects. Hence, cognitive behavior therapy (CBT) has been suggested to be an alternative treatment option for insomnia (Wang, Wang, & Tsai, 2005). CBT s a typical treatment for insomnia and can come in the form of a treatment package where multiple components are combined to treat insomnia. An intense treatment package for insomnia can include all or some of the following: sleep restriction, stimulus control, relaxation training, cognitive therapy, cognitive restructuring, and sleep education. Insomnia can also be treated using an individual component or combined components of CBT (Spiegler, 2016; Wang, Wang, & Tsai, 2005). Many of the individual components of CBT are usually recommended as treatment for insomnia. One of the individual components of CBT that is recommended to treat insomnia is stimulus control (Wang, Wang, & Tsai, 2005). Stimulus control are cues or conditions that set the stage for behaviors to happen. There are two types of stimulus control and they are prompts and setting events. Prompts are cues that help to perform a behavior. Setting events are environmental conditions that provoke a behavior. Setting events are broader and more complex than prompts. Setting events can be anything from who is present, what people are doing, the time of day, and the physical organization of the environment. Every setting event stimulates different behaviors (Spiegler, 2016). Stimulus control treatment consists of changing setting events and explaining to the insomniac individual(s) a set of instructions to inhibit sleep-in-compatible behaviors and regulate the circadian rhythm. Instructions given to the individual(s) would consists of having the individual(s) go to bed only when they are sleepy at night, only use the bed and bedroom for sleep and sex, to get out of bed and go to another room when they are unable to fall asleep or to fall asleep within 15-20 minutes and …show more content…
Stimulus control can produce up to a 58% mean change in sleep-onset latency (Jacobs, Rosenberg, Friedman, Matheson, Peavy, Domar, & Benson, 1993). Puder, Lacks, Bertelson, and Storandt (1983) studied the effects of short-term stimulus control therapy on sleep-onset insomnia in older adults. They found that short-term stimulus control therapy was effective and decreased sleep-onset insomnia. They were able to find statistical as well as clinical significance. Sleep latency was reduced more than half of the participants by more than 50%. Results from post-treatment indicated that participants had a 30 minutes or longer sleep onset latency zero or once during the week. This indicates that short-term stimulus control therapy of about four weeks, is effective in young insomniac, as well as adults over the age of 60 (Puder, Lacks, Bertelson, & Storandt,