It is 2:30 AM on a Tuesday. You begrudgingly glance at the clock on your phone for the fifth time. The responsibilities of tomorrow loom, and the harder you try to push yourself to drift asleep, the more awake you seem to become. How often have you found yourself in this paradoxical predicament of rest? Multiple days each month? Each week?
You are not alone. Research on the prevalence of insomnia suggests that approximately 10% of the adult population struggles with an insomnia disorder, and another 20% experiences occasional insomnia symptoms (Morin and Jarrin, 2022).
Most of us have an idea of what insomnia entails, but how do we define it more precisely? According to the DSM-5-TR, the primary authoritative guide for the classification of mental illness, insomnia disorder is defined as dissatisfaction with sleep quantity or quality, characterized by difficulty falling asleep, staying asleep, or waking too early. To meet the criteria, this must occur at least three nights a week for three months or longer, despite ample opportunities to sleep (American Psychiatric Association [APA], 2022).
Insomnia is primarily triggered by stress, poor sleep habits, or other routines that offset our circadian rhythm. When we worry about things like health, work, school, and finances, it keeps our minds active, making it hard to unwind. Poor sleep hygiene—such as inconsistent sleep-wake times, daytime napping, exercising right before bed, working or eating in bed, consuming caffeine or alcohol, or using phones and computers before sleeping—can also severely disrupt our rest. Additionally, certain medications and underlying medical conditions can contribute to insomnia.
It is crucial to note that insomnia becomes more common with age. As we get older, our circadian rhythm naturally shifts forward, causing us to tire earlier in the evening and wake earlier in the morning. Aging also brings shifts in physical health, such as arthritis or bladder problems, alongside an increased use of medications, all of which can exacerbate insomnia symptoms.
Many common solutions to insomnia do not actually work. According to the American Academy of Sleep Medicine, alcohol and antihistamines have been shown to be largely ineffective for chronic insomnia. A slew of studies demonstrate that having the age-old “nightcap” before bed momentarily increases sleepiness, but later causes frequent nighttime and early-morning awakenings (Park et al., 2015). Similarly, while some over-the-counter antihistamines induce drowsiness, newer studies indicate that these medications offer only modest sleep benefits, build tolerance quickly, and cause next-day grogginess (Jaradat et al., 2026).
Oh, and we cannot count on counting sheep as a remedy for insomnia either! According to a 2002 study from Harvey and Payne, counting sheep is much too boring for our brains to successfully distract us from intrusive nighttime worries. So, what actually works?
Cognitive behavioral therapy for insomnia, abbreviated as CBT-I, is universally recognized as the gold-standard, first-line treatment for chronic sleep issues. CBT-I helps individuals identify and modify the specific habits and beliefs that perpetuate their insomnia symptoms. Treatment with a clinician typically consists of two core components: sleep restriction and stimulus control therapy, supported by two supplemental components: sleep hygiene and cognitive therapy.
Together, these interventions break cycles of sleeplessness, allow us to develop a healthier relationship with rest, and restore confidence in our body's natural ability to sleep.
While CBT-I is a structured treatment delivered by a trained mental health professional, there are strategies we can begin implementing on our own. Perhaps one of the simplest is establishing a consistent bedtime routine as part of overall sleep hygiene. We can start by trying our best to go to bed and wake up at the same time every day, even on weekends.
From there, in the hour before bed, we can attempt to reduce the noise of our nearby external world by dimming lights, silencing notifications, and limiting exposure to phones, tablets, and other electronic devices. Engaging in calming activities—such as reading, journaling, listening to soothing music, taking a warm shower, or practicing mindfulness exercises—can facilitate a smoother transition to sleep.
Attention should also be given to our sleep environments. Keeping our rooms cool, dark, and quiet promotes physical comfort and reduces the chances of our sleep onset being disturbed. Lastly, avoiding caffeine, nicotine, and alcohol late in the day and limiting meals close to bedtime can support a healthier sleep routine. While none of these adjustments can guarantee immediate results on their own, adapting them into a consistent routine strengthens the body’s natural sleep-wake rhythm, creating the ideal conditions for restful sleep.
Perhaps one of the most important takeaways regarding insomnia is that sleep is not something we can command into existence through sheer willpower. More often than not, the harder we try to force sleep, the harder it is to fall into it. CBT-I offers us an alternative approach, one that helps us modify the thoughts, behaviors, and habits that may be unintentionally maintaining our sleep difficulties.
While bedtime routines provide a helpful foundation, many of us will benefit from understanding and addressing the broader patterns that contribute to insomnia with the help of a professional. Should you be interested, our therapists at Pacific CBT are here to help. Regardless of where you are on your journey, remember that sleep, after all, is not a skill we must master so much as a process we must learn to support. Schedule a free 15 minute consultation today.
References
Harvey, A. G., & Payne, S. (2002). The management of unwanted pre-sleep thoughts in insomnia: Distraction with imagery versus general distraction. Behaviour Research and Therapy, 40(3), 267–277. https://doi.org/10.1016/s0005-7967(01)00012-2
Jaradat, O., Awad, A., Abu Samaan, H., Al-Toom, S., Alsadder, T., Jaber, M., & Shawahna, R. (2026). Impact of antihistamines on sleep, cognition, and daily functioning: Evidence from primary and Community Care. Journal of Primary Care & Community Health, 17. https://doi.org/10.1177/21501319261442260
Morin, C. M., & Jarrin, D. C. (2022). Epidemiology of insomnia. Sleep Medicine Clinics, 17(2), 173–191. https://doi.org/10.1016/j.jsmc.2022.03.003
Park, S.-Y., Oh, M.-K., Lee, B.-S., Kim, H.-G., Lee, W.-J., Lee, J.-H., Lim, J.-T., & Kim, J.-Y. (2015). The effects of alcohol on quality of sleep. Korean Journal of Family Medicine, 36(6), 294. https://doi.org/10.4082/kjfm.2015.36.6.294
Walker, J., Muench, A., Perlis, M. L., & Vargas, I. (2022). Cognitive behavioral therapy for insomnia (CBT-I): A Primer. Clinical Psychology and Special Education, 11(2), 123–137. https://doi.org/10.17759/cpse.2022110208
Christian R. Wertman has a Master of Science in Counseling with a concentration in Marriage and Family Therapy, and is beginning the path toward licensure as a Marriage and Family Therapist in California.
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