What actually causes insomnia

Acute insomnia (lasting under 3 months) is usually triggered by a stressful event. Chronic insomnia (3+ months, 3+ nights/week) is a learned pattern — your brain has come to associate the bed with anxiety.

Comorbid insomnia rides alongside another condition: depression, sleep apnea, chronic pain, restless legs, or heart disease. Treating the comorbid condition often resolves the insomnia.

Cognitive Behavioral Therapy for Insomnia (CBT-I) outperforms sleep medications at 12-week and 12-month follow-up. Core techniques: stimulus control (only use bed for sleep), sleep restriction (compress sleep window to increase efficiency), cognitive restructuring (challenge sleep-anxiety thoughts), and relaxation training.

CBT-I works for 70–80% of chronic insomnia patients without the dependency or rebound problems of pharmacological treatments.