Sleeping pills are not the first answer. The best-proven treatment for insomnia is a short skills program, and many sleep problems have a body cause worth checking. Here is every option, ranked.
Chronic insomnia means trouble falling or staying asleep at least three nights a week for three months. It is very common, and very treatable. Guidelines put a specific form of CBT first, ahead of medication.
The list below is ordered by strength of evidence. Each card shows the approach, what it involves, what the research found, and who provides it.
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Enter your ZIP code. We will list providers under every approach below.
Recommended first by clinical guidelines. Start here.
A 4 to 8 session program that resets your sleep schedule, retrains your brain to link bed with sleep, and quiets nighttime worry. Recommended as the first treatment for chronic insomnia.
Evidence: American College of Physicians guideline, Annals of Internal Medicine, 2016; American Academy of Sleep Medicine guideline, 2021
Loud snoring, gasping, or daytime sleepiness can mean sleep apnea, which needs its own treatment. A home or lab sleep test gives the answer.
Evidence: American Academy of Sleep Medicine diagnostic guideline, 2017
Backed by good trials. Works well alongside first-line care.
Some prescription sleep medications help in the short term when CBT-I is not enough or not available. Used with a prescriber, at the lowest effective dose.
Evidence: American Academy of Sleep Medicine pharmacologic guideline, 2017
Regular physical activity improves sleep quality and helps people fall asleep faster.
Evidence: Kredlow et al., Journal of Behavioral Medicine, 2015 (meta-analysis)
Smaller or mixed studies. Many people find these helpful as add-ons.
Meditation programs improve sleep quality compared with education or waitlist controls.
Evidence: Rusch et al., Annals of the New York Academy of Sciences, 2019 (meta-analysis)
Gentle movement practices that improve sleep in several trials, especially in older adults.
Evidence: Supported in trials. Evidence strongest in older adults.
May improve sleep, but a Cochrane review found trials too small and varied to be sure.
Evidence: Cheuk et al., Cochrane Review, 2012
Still being studied, or reserved for when first treatments have not worked.
Melatonin helps with jet lag and body-clock problems, but sleep guidelines advise against relying on it for chronic insomnia. Evidence for magnesium and CBD is limited.
Evidence: American Academy of Sleep Medicine pharmacologic guideline, 2017
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