Many patients develop "bad habits" when faced with a chronic insomnia, such as frequently watching the clock and "counting down" the time remaining before needing to start their day, or spending extended periods of time in bed without sleeping, or worrying about the consequences of having a bad night of sleep. Stimulus control therapy is employed to break negative associations of the bed as a place of frustration. As an important technique of stimulus control therapy, patients are instructed to not watch the clock and to even remove the clock from the bedroom. The insomnia patient should not stay longer than 20-30 minutes in bed without sleeping. Getting out of bed when not able to sleep, helps break the association of the bed as a place of frustration or dread. Finally, patients should not "catastrophize" when faced with a "bad night," but instead should try to view a bad night in a positive light in the sense that the sleep deprivation experienced from a bad night will help consolidate sleep the following night. Stimulus control therapy is particularly useful for patients with chronic "psychophysiologic," or conditioned, insomnia.
