Insomnia: A Beginner-Friendly Start
Insomnia: the few things that matter most, and the mistakes that catch people out early.
Persistent difficulty falling asleep, staying asleep or waking too early, with daytime consequences.
Key takeaways
- Chronic insomnia: 3 or more nights a week for 3 months or more
- First-line treatment: cognitive behavioral therapy for insomnia (CBT-I)
- Most useful single change: Keep the same wake time every day, including weekends.
- Commonest mistake: Going to bed earlier to make up for a bad night.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Why bother
Guidelines recommend a talking treatment, CBT for insomnia, as the first-line approach rather than medication, and most people have never been offered it.
Start here
These two first. Everything else is easier once they are habit.
- Keep the same wake time every day, including weekends
- Get up and leave the bedroom if you have been awake around twenty minutes
Then add these
Once the first two are automatic, these are worth adding.
- Get daylight soon after waking
- Ask your doctor about CBT-I, available from sleep medicine providers and through digital programs
The numbers, in one place
| Measure | Figure |
|---|---|
| Chronic insomnia | 3 or more nights a week for 3 months or more |
| First-line treatment | cognitive behavioral therapy for insomnia (CBT-I) |
| Get out of bed after | about 20 minutes awake |
| Most important timing anchor | a fixed wake time, 7 days a week |
| Adult sleep recommendation | 7 or more hours a night |
Common early mistakes
- Going to bed earlier to make up for a bad night
- Alcohol as a sleep aid, which fragments the second half of the night
- Sleep restriction without supervision if you have epilepsy, bipolar disorder or severe daytime sleepiness
Related topics
- What the Guidance Really Says About Sleep and Chronic Pain (Chronic Pain)
- What the Guidance Really Says About Sleep and the Brain (Brain Health)
- The Evidence on Talk Therapy, Without the Hype (Mental Health)
- What the Guidance Really Says About Shift Work and Health (Workplace Health)
Where to go next
- What the Guidance Really Says About Insomnia
- Understanding Insomnia: A Plain-English Explainer
- Insomnia — the reference entry
- Sleep: The Complete Guide
- Sleep Apnea: What the Evidence Actually Says
- Caffeine and Sleep: Sorting the Evidence From the Noise
When to speak to a doctor
See your doctor if insomnia has lasted three months or more, if you snore loudly and wake unrefreshed, or if you fall asleep without meaning to during the day, which can point to obstructive sleep apnea. Do not drive when sleepy. If someone may have taken too many sleep medicines, call Poison Control at 1-800-222-1222, or 911 if they are hard to wake or breathing slowly.
Where this comes from
- American Academy of Sleep Medicine — Insomnia
- National Heart, Lung, and Blood Institute — Insomnia
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.
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