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The core stimulus control rules for CBT-I — rebuilding the association between bed and sleep.
Stimulus control re-establishes the bed as a cue for sleep rather than wakefulness. Follow these rules consistently. Track your adherence and note what's hardest.
Introduce alongside sleep restriction as a core behavioural intervention in CBT-I. Stimulus control re-associates the bed and bedroom with sleep rather than wakefulness, frustration, and arousal.
Explain that the bed has become associated with being awake and trying to sleep, which maintains insomnia. The instructions aim to rebuild the bed-sleep association. Frame the rules as temporary training tools, not permanent lifestyle changes.
For clients who share a bed with a partner, discuss practical adjustments — having a designated 'getting up' spot in another room. For those with mobility issues who cannot easily get out of bed, adapt to sitting up and engaging in a quiet activity in bed with the light on.
Use with caution in clients with severe depression who may use the instruction to 'get up if not asleep' as an opportunity for rumination or self-harm. Ensure safety planning is in place. Not appropriate if the only available sleeping environment is unsafe to leave at night.
The most important rules are: only go to bed when sleepy (not tired), and get up if not asleep within approximately 15-20 minutes. Emphasise not watching the clock — go by feeling. Common compliance barriers include cold weather, fear of disturbing others, and not having a comfortable alternative space.
Suitable for clients working with insomnia, stimulus control, cbt-i, sleep hygiene, bed-sleep association. This tool can be used as a standalone worksheet or as part of a structured homework plan.
Create a free account to access 10 worksheets per month.
The standard CBT-I sleep diary — record bed times, sleep times, wake times, and daytime functioning to track patterns and calculate sleep efficiency.
Identify and challenge dysfunctional beliefs about sleep that fuel insomnia-related anxiety and arousal.
A formulation based on Spielman's 3P model — mapping predisposing, precipitating, and perpetuating factors that maintain insomnia.
Set and track your prescribed sleep window as part of sleep restriction therapy — with weekly adjustments based on sleep efficiency.