Based on the case study below, identify two specific behavioral changes you would recommend to the individual to improve their sleep. For each recommendation, explain the reasoning based on the principle of strengthening the association between the bed and sleeping.

Applying Behavioral Principles to Improve Sleep

This method helps remove factors that condition your mind to resist sleep. For example, you might be coached to set a consistent bedtime and wake time and avoid naps, use the bed only for sleep and leave the bedroom if you cannot go to sleep within 20 minutes, only returning when you are sleepy.




Kennesaw State University

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University of Michigan - Ann Arbor

Cognitive-behavioral therapy for insomnia (CBT-I) is a highly effective form of psychotherapy for treating sleep disorders. This approach focuses on altering the cognitive processes and problematic behaviors that contribute to insomnia. Treatment often incorporates stress management techniques and aims to change detrimental habits, such as spending excessive waking time in bed, to improve sleep.

Cognitive Behavioral Therapy for Insomnia (CBT-I)

van Straten, A., van der Zweerde, T., Kleiboer, A., Cuijpers, P., Morin, C. M., & Lancee, J. (2018). Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis. Sleep Medicine Reviews, 38, 3-16. https://doi.org/10.1016/j.smrv.2017.02.001

Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis

Spielman, R. M., Jenkins, W. J., & Lovett, M. D. (2020, April 22). Psychology (2nd ed.). OpenStax. https://openstax.org/books/psychology-2e/pages/1-introduction

OpenStax Psychology (2nd ed.) Textbook

1. Difficulty falling asleep at night
2. Waking up during the night and being unable to return to sleep
3. Waking up earlier than desired
4. Feeling tired after a night's sleep
5. Daytime fatigue or sleepiness


Symptoms of Insomnia

Insomnia is a major public health problem. In addition, insomnia is strongly associated with other somatic and mental health problems as well as with an increased mortality rate. Treatment of insomnia is highly desirable, mostly to decrease the burden of insomnia itself. But it might also contribute to a decrease of the associated somatic and mental health problems such as depression and cardiovascular risk. The overall effects for insomnia treatments seem to be in line with psychological treatments for other disorders such as depression, social phobia, panic disorder with or without agoraphobia. However, the magnitude of the effects varied between the different outcome parameters. Despite the limitations we conclude that CBTI, either its components or the full package, is effective in the treatment of insomnia. 



Stimulus Control Therapy

Lying in bed when you are awake can become a habit that leads to poor sleep. This treatment reduces the time you spend in bed, causing partial sleep deprivation, which makes you more tired the next night. Once your sleep has improved, your time in bed is gradually increased.

Sleep Restriction

This method of therapy involves changing basic lifestyle habits that influence sleep, such as smoking or drinking too much caffeine late in the day, drinking too much alcohol, or not getting regular exercise. It also includes tips that help you sleep better, such as ways to wind down an hour or two before bedtime. Components of sleep health include:

•Duration

•Timing

•Quality

Sleep Hygiene

Based on a therapeutic approach that targets the connection between thoughts, behaviors, and sleep problems, propose one specific behavioral intervention for the client described in the case study below and explain why it would be effective.

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