What to do if you can’t sleep?

You’re lying awake, alternately counting sheep and staring at the ceiling. It’s two, then three in the morning. Birds, squirrels, even bugs are sleeping — everyone but you. Most people have some experience with this, and if you have insomnia, you’ve experienced it a lot. Well, we’ve got the silver bullet: Get up!

This sounds like a non sequitur, but bear with us: In Ivan Pavlov’s famous behavioral experiments, he found that dogs started salivating when they saw scientists in white lab coats. (There were no actual bells in his experiments.) To the canines, the coats signaled that they were about to be fed. The coats, in other words, gave the dogs a strong and vibrant “food cue.”

Environmental cues like this play a bigger role in human psychology than we give them credit for. They don’t just make dogs drool; they help us fall asleep. Insomnia, in fact, often arises when people’s beds and bedrooms no longer offer a clear “sleep cue.”

Hence stimulus control therapy, a popular insomnia treatment developed by clinical psychologist Richard Bootzin in the 1970s. Its central idea is that you should only use your bed for sleep (and sex). To ensure this, Bootzin recommends going to bed only when you’re really sleepy.

In other words, you shouldn’t lie awake in bed. If you’re awake, get up. “Do not read, watch television, eat, or worry in bed,” either, Bootzin advises. Doing so amounts to “stimulus dyscontrol” and creates the opposite of a sleep cue — a muddled cue that tells your brain that it could be bedtime, dinnertime, or anxious ceiling-staring time.

So what should you do instead? Well, stimulus control therapy involves making your bed a sleep-only zone, but it’s more complex than that. All told, his therapy has five steps:

1. Only go to bed when you’re really sleepy.
Not just tuckered out from a long day — sleepy, as in you’re yawning and you can’t keep your eyes open.

2. Get up if you can’t sleep.
If after 15 minutes or so spent lying in bed, you’re still counting sheep, leave your bedroom and do something low-intensity for a half hour to an hour. Try to avoid looking at a screen, since the blue light can disturb your sleep even more. Instead, try reading a book, listening to a podcast, or drawing a picture.

When you’re in bed, don’t watch the clock to see if 15 minutes has passed, though. Clock-watching is the opposite of going to sleep. If you feel frustrated and wide awake, get up.

3. Stay up for a predetermined length of time.
When you get up in the middle of the night, don’t wait to feel tired before you go back to bed. That puts too much pressure on you to monitor yourself and keeps you from relaxing. Instead, decide how long you’ll stay up in advance — say, 20 minutes — and stick to it. If you go back to bed and still can’t sleep, get up again.

4. Wake up at the same time every morning.
Yes, even on weekends. This is just good sleep hygiene and has health benefits for everybody. However, for insomniacs specifically, a regular wake-up time — no matter how well or badly you slept the night before — helps the body shift into healthier sleep patterns.

5. Don’t nap.
Napping throws off your sleep cycle. Yes, sometimes it feels good, but long term, it has the same effect as an erratic wake-up time: It teaches your body that sleeping at night is optional. Plus, if you sleep on the office couch as well as your bed, it weakens the bed’s sleep cue.

Check out my related post: Should your dog sleep in bed beside you?

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