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Removing the Shroud of Mystery from CBTI, Part I: Stimulus Control

Sleeprate is unique in that it not only monitors and offers a very detailed assessment of your sleep, but also provides treatment for Insomnia through an exclusive Stanford-developed program called Cognitive Behavioral Treatment for Insomnia — CBTI. Unless you’re a psychologist, this is probably Greek to you, so here’s a crash course in CBTI.

CBTI made easy

Put simply, CBTI is a therapy technique that helps you modify your behavior so that you sleep better. It does NOT involve medication, meditation, sensory deprivation or anything weird. The changes you make tend to be small, commonsensical steps that yield very impressive results by aligning the three systems that govern our ability to sleep:

  1. Sleep Drive: i.e. how tired we are

  2. Circadian Clock: tuning our internal biological clock for better sleep

  3. Flight-or-Fight System: avoiding being hyper-aroused when we need to sleep

CBTI aligns these system through a set of behavioral modifications that changes bedtime, wake up time and activities around bedtime and wake up time. Most respond fairly quickly — some  experience significant changes after only two weeks of treatment, and most others after four to six weeks.

Assessing your sleep

CBTI starts by measuring sleep parameters for about a week. Based on this, you’ll receive a tailored set of behavioral modifications which, if followed, will significantly improve your sleep. One of the first behavioral changes involves stimulus control.

Stimulus Control

Designed to strengthen the bed as a cue for sleep and weaken it as a cue for wakefulness, the key instructions are:

  • Establish a regular morning rise time. This will help strengthen the circadian clock regulating sleep and wakefulness. This also lays the foundation for establishing a regular bedtime by strengthening your circadian Rhythm.

  • Go to bed only when sleepy. The idea is to train yourself to fall asleep quickly — and you start by going to bed when your body is actually ready to sleep. It’s important to note that fatigue — a state of low energy — and sleepiness, which is a state of having to struggle to stay awake, are different. That’s why people with Insomnia often feel tired, yet “wired.”

  • If unable to fall asleep, get up. Whether at the start or middle of the night, if you can’t sleep, get out of bed and return when you’re sleepy.

  • Avoid excessive napping. A brief nap (15 to 30 minutes), taken approximately 7 to 9 hours after rise time, can be refreshing and is not likely to disturb nocturnal sleep. Any more than that might make it tougher to fall asleep.

Removing the Shroud of Mystery from CBTI, Part I: Stimulus Control

…To be continued