Question 1

What is insomnia and how common is it?

Accepted Answer

Insomnia disorder is defined as persistent difficulty falling asleep, staying asleep, or waking too early — at least three nights per week for at least three months — that causes significant daytime impairment such as fatigue, poor concentration, or mood disturbance. It affects approximately 10–15% of adults chronically and up to 30–35% transiently, making it the most prevalent sleep disorder; it is frequently linked to anxiety, depression, chronic pain, and poor sleep hygiene.

Question 2

What is the most effective treatment for insomnia?

Accepted Answer

Cognitive behavioral therapy for insomnia (CBT-I) is recommended as the first-line treatment by the American Academy of Sleep Medicine (AASM) and the American College of Physicians (ACP) because it addresses the underlying behavioral and cognitive factors driving insomnia and produces durable improvements without the risks of medication. CBT-I includes sleep restriction, stimulus control, relaxation training, and cognitive restructuring; consult your healthcare provider or a behavioral sleep medicine specialist about accessing this therapy.

Question 3

What sleep medications are available by prescription?

Accepted Answer

FDA-approved prescription sleep aids include non-benzodiazepine GABA-A agonists ("Z-drugs" such as zolpidem, eszopiclone, zaleplon), orexin receptor antagonists (suvorexant, lemborexant — the preferred class for most adults per recent guidelines), the melatonin receptor agonist ramelteon (useful for sleep-onset issues), and low-dose doxepin for sleep-maintenance insomnia. Benzodiazepines (e.g., temazepam) are effective but carry higher risks of dependence, falls, and cognitive impairment, particularly in older adults; consult your healthcare provider before starting any sleep medication.

Question 4

Is melatonin effective for insomnia?

Accepted Answer

Over-the-counter melatonin is well-supported for circadian rhythm disorders such as jet lag and delayed sleep phase syndrome, but evidence for its effectiveness in classic insomnia disorder is modest. The AASM does not recommend melatonin as a first-line treatment for chronic insomnia; if you have ongoing insomnia, consult your healthcare provider to evaluate whether CBT-I, a prescription medication, or addressing an underlying condition is the most appropriate approach.

Insomnia & Sleep Disorders

Overview

Drug classes used to treat insomnia & sleep disorders

Medications for insomnia & sleep disorders

Drug comparisons for insomnia & sleep disorders

Frequently asked questions