Do you remember Pavlov’s dogs?? If you have ever taken a psychology course you have likely heard of Pavlov’s dogs. Let me give you a basic refresher… Pavlov was a behaviorist who did studies on many different types of animals. He was interested in shaping behavior. One of his experiments involved dogs, a bell, and dog food. He would present food to the dog and at the very same time he would ring a bell. The dog would salivate in response to the food that was being presented to him. After several trials of this pairing of the food with the bell, when Pavlov then just rang the bell and did not present the food, the dog still salivated! So what he discovered was that by pairing the bell with the food eventually the bell became associated with food and the dog salivated to the bell even in the absence of food. Ok, so what in the world does this have to do with sleep? Well when we spend a lot of time in our beds awake, say watching tv, reading, knitting, doing work, we start to associate our beds with being awake. Just like the dog’s associated the bell with food. Over time as we spend a lot of wake time in bed, it starts to become difficult to sleep there because we respond to it as a place for wakefulness. This is referred to as conditioned insomnia. One sure fire sign that you have developed conditioned insomnia is if you find yourself falling asleep or feeling very sleepy on the couch in the living room but as soon as you get into bed you feel wide awake. That is a sign that your bed is a wakefulness cue for you. Another sign is if you tend to sleep better in a hotel versus your bedroom. Something to be mindful of is that people who are tense or anxious may be more susceptible to conditioned insomnia than others. Spending time in bed awake refers to not only spending time in our beds during the day awake, but also during sleepless nights. If someone with insomnia is up in the middle of the night and spending 2-3 hours awake laying in bed, that is an anxious experience. The person may then start to dread going to bed because they anticipate the sleepless night. The bed becomes a cue for the sleeplessness. When I ask my clients with insomnia what they do when they are up in the middle of the night, resoundingly all of them say with pride, “I stay in bed and try to go back to sleep.” There are two things perpetuating the insomnia in that statement. One thing that Dr. Meg Danforth, Ph.D. CBSM, of Duke University Medical Center, stressed in her training was that you cannot “try” to fall asleep. She said sleep is the one thing that does not reward hard work. The more you try to sleep, the more there is no payoff. Sleeping is the one thing that you cannot try to do. The more you try to fall asleep, the more you fail because sleep requires complete relaxation and trying is essentially the opposite of relaxing! She did say that relaxation exercises are beneficial, however, as long as their goal is just to relax, not to fall asleep. Again, as soon as you start to focus on sleep as the goal, the more difficulty you will have reaching that goal. The other thing perpetuating the insomnia in that statement is that the person is staying in bed awake! Again, the more time you spend in bed awake the stronger the association between being awake and your bed. So, what do you do? You create a quiet comfortable place to go to in the middle of the night if you cannot sleep. I often suggest finding a place near a lamp where you can read, watch unexciting television, or do something else, quiet and non-stimulating. You go to this place when you cannot sleep and you stay there doing something non-stimulating until you feel SLEEPY. This is important - it is not until you feel tired, it is until you feel SLEEPY. SLEEPY meaning your eyes are starting to close or your head is nodding. When you feel sleepy you go back to bed and lay down. If you get into bed and you find yourself suddenly feeling awake again, get back out of bed and go to your place until you feel, you guessed it, sleepy again. By getting out of bed when we are awake, the research shows that we can re-associate our bed with sleep in about two weeks. If you find yourself awake in the middle of the night and unable to fall back asleep in about 20 minutes, get out of bed to break the association of wakefulness and your bed! Until next time :) Dr. B. References Perl, J. (1993). Sleep Right in Five Nights: A clear and effective guide for conquering insomnia. New York, NY: William Morrow and Company, Inc. Danforth, M. (2018). Treating Insomnia: Evidence-based strategies to help your clients sleep. Presentation, New Jersey.
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