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Sleep Problems (Insomnia, Restless Nights & Sleep Hygiene)

Trouble falling asleep, waking in the night or waking too early is very common, and for most people it can be improved. The best-studied help is a short course of talk therapy for sleep (CBT-I), not a pill — and some sleep problems, such as sleep apnea, need a different kind of care.

Get help right away if sleep trouble comes with any of these:

  • Thoughts of suicide or of not wanting to go on. Chronic insomnia can come with anxiety, depression and thoughts of suicide (NHLBI). Call or text 988 to reach the 988 Suicide & Crisis Lifeline, which is free, confidential and open 24/7 (988 Lifeline). If a life is in immediate danger, call 911.
  • Chest pain or pressure, or shortness of breath — including at night. Call 911 even if you are not sure it is a heart attack (MedlinePlus).
  • Drowsy driving. Don’t drive when you feel sleepy (NHS). Sleepy drivers may feel able to drive, yet sleep deficiency can harm driving as much as or more than being drunk, and driver sleepiness is estimated to be a factor in about 100,000 crashes a year in the U.S. (NHLBI). If you keep nodding off at the wheel or at work, see a doctor soon.
  • Loud snoring with gasping, choking or pauses in breathing, or heavy sleepiness in the daytime. These can be signs of sleep apnea, which can be serious if not treated (NHS, MedlinePlus).
  • Sleepwalking or other activity while asleep that has caused, or could cause, an injury. See a doctor if you are worried about accidents or injuries (NHS). If you take a prescription sleep medicine and walk, eat or drive while not fully awake, call your prescriber right away: the labels of zolpidem and eszopiclone carry a boxed warning that such complex sleep behaviors can cause serious injuries, including death, and say the medicine should be discontinued immediately (FDA label, FDA label).
  • Sleep medicines mixed with alcohol or opioid pain medicines. The label of a benzodiazepine sleep medicine warns that combining it with opioids may cause profound sedation, slowed breathing, coma and death (FDA label); zolpidem and eszopiclone add to the effects of alcohol (FDA label, FDA label).

How much sleep do people need?

Experts recommend that adults sleep between 7 and 9 hours a night. Adults who sleep less than 7 hours may have more health problems; sleeping more than 9 hours is not necessarily harmful and may be helpful for young adults, people recovering from lost sleep, and people who are sick (NHLBI). For children, the NHLBI’s totals (naps included) are:

  • Babies 4 months to 1 year: 12 to 16 hours a day (newborn sleep patterns vary widely).
  • Ages 1 to 2: 11 to 14 hours.
  • Ages 3 to 5: 10 to 13 hours.
  • Ages 6 to 12: 9 to 12 hours.
  • Teens 13 to 18: 8 to 10 hours (NHLBI).

The NHLBI page gives one range for all adults and no separate figure for older adults. Some tiredness comes from not allowing enough time for sleep rather than from a sleep disorder (NCCIH), so the first question is simply whether you are giving yourself a chance to sleep. Everyone needs a different amount, and you probably aren’t getting enough if you are constantly tired during the day (NHS).

What is insomnia?

Insomnia is a common sleep disorder. You may have trouble falling asleep, staying asleep, or getting good-quality sleep, even when you have the time and a good place to sleep. It can affect your memory, concentration and mood and make you sleepy during the day (NHLBI). It affects women more often than men, and older adults are more likely to have it (MedlinePlus). Common signs include lying awake a long time before sleep (more common in younger adults), waking often or being awake much of the night (the most common problem, mostly in older adults), and waking too early and not getting back to sleep (NHLBI).

  • Short-term (acute) insomnia is usually brought on by stress or changes in your schedule or surroundings, and can last days or weeks (NHLBI). It is very common; typical triggers are stress at work, family pressures or a traumatic event (MedlinePlus).
  • Long-term (chronic) insomnia happens 3 or more nights a week, lasts 3 months or more, and cannot be fully explained by another health problem (NHLBI, NHS). MedlinePlus uses a looser cut-off of a month or longer, and notes that most chronic insomnia is “secondary” — a symptom or side effect of another problem such as a medical condition, a medicine or another sleep disorder (MedlinePlus).

What can cause it?

Insomnia is more than a nuisance. In the short term it can make it hard to think clearly and raises the risk of falling, having a road accident or missing work; chronic insomnia is linked with a higher risk of heart problems including high blood pressure and coronary heart disease (NHLBI). See our Heart and Blood Pressure guides.

Other sleep problems

There are many sleep disorders besides insomnia: breathing disorders, movement disorders, extreme daytime sleepiness, body-clock (circadian) disorders, and unusual behaviors during sleep (MedlinePlus). Brief notes on the common ones:

  • Sleep apnea and snoring. Sleep apnea makes breathing stop or become very shallow during sleep; it often brings loud snoring and daytime drowsiness, and raises the risk of car crashes and other medical problems (MedlinePlus). Snoring on its own is common and not usually serious (NHS). MBHA is planning Sleep Apnea and Snoring guides.
  • Restless legs syndrome is a strong urge to move the legs, usually when resting at night, and it can keep you from sleeping (NHS). An MBHA guide is planned.
  • Narcolepsy causes overwhelming daytime sleepiness; see our Narcolepsy guide.
  • Nightmares are covered in Bad Dreams & Nightmares.
  • Sleepwalking happens when you partly wake from deep sleep; it usually needs no treatment but safety matters (NHS).
  • Jet lag and shift work disrupt the body clock; see the section below.

When to see a doctor: if changing your sleep habits hasn’t helped, you have had trouble sleeping for months, or it is making daily life hard to cope with (NHS). It helps to keep a sleep diary for a week or two first and bring it with you (NHLBI). Also go if a bed partner notices loud snoring, gasping or pauses in your breathing (MedlinePlus).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) A check of medicines, health conditions and sleep habits; a sleep diary; a sleep study only when another sleep disorder is suspected; cognitive behavioral therapy for insomnia (CBT-I) first; short-term sleep medicines only if needed; treatment of any underlying problem. Medicare Part B covers sleep studies for people with signs and symptoms of sleep apnea (you pay 20% after the deductible). A cost guide puts online home sleep apnea tests at about $99–$464 and a hospital overnight study at a median of about $2,949. CBT-I and medicines: cost estimate being researched. CBT-I is the recommended first treatment for long-term insomnia and its benefits seem to last. Sleep medicines can help in the short term but carry real warnings and are not meant for long use.
Chiropractic No established role for insomnia itself. Some people see a chiropractor for back or neck pain that interrupts sleep. About $55–$100 for a self-pay follow-up visit and $90–$200 for a first visit. Medicare Part B covers only certain chiropractic services. Reviews found minimal to no evidence that chiropractic care helps insomnia. Serious side effects of spinal manipulation are very rare.
Acupuncture Needle sessions (and sometimes ear acupuncture or acupressure) used for insomnia, alongside — not instead of — CBT-I. About $125–$230 for a first private visit and $90–$185 for follow-ups; community clinics about $50–$90. Medicare covers acupuncture only for chronic low back pain. Studies are small and low quality, so the evidence is not strong enough to recommend it for or against. Few complications are reported with a trained, licensed practitioner.
Herbal medicine Melatonin, valerian, chamomile, lavender, magnesium and similar products marketed for sleep. Cost estimate being researched. Melatonin may help jet lag and a few timing problems, but guidelines advise against it for chronic insomnia. Evidence for the herbs is inconsistent or too limited. Supplements may not contain what the label says.
Massage therapy Relaxing hands-on bodywork as part of a wind-down routine. About $70–$90 a month for a membership at one national chain (Massage Envy), which includes one 60-minute session a month; each franchise sets its own rates. Pleasant and low risk, but good evidence that it improves insomnia is lacking. One meta-analysis of mostly Chinese trials reports benefit for tuina massage; we read only the abstract.
MBHA Wellness Coach A steady sleep schedule, a wind-down routine, a sleep diary, smart use of light, caffeine, alcohol, screens and naps, a comfortable bedroom, relaxation and gentle movement, and help finding and sticking with CBT-I. Cost estimate being researched. Good habits are the foundation of better sleep, but sleep hygiene alone is not enough for chronic insomnia — a guideline suggests against relying on it by itself.

Approach 1 of 6

Conventional medicine (AMA)

Conventional care starts by working out why you are not sleeping and whether the problem is insomnia or another sleep disorder. For long-term insomnia, the leading guidelines put a talk therapy for sleep ahead of pills.

1. Getting checked: the sleep diary and sleep study

Your provider will ask about your symptoms, health history, medicines, and use of caffeine, nicotine, alcohol or drugs; when you go to bed and get up on work days and days off; how long you take to fall asleep and how often you wake; and whether you snore loudly or wake gasping. A physical exam looks for other problems, including risk factors for sleep apnea (NHLBI). The NHLBI suggests keeping a sleep diary for 1 to 2 weeks beforehand: when you go to sleep, wake and nap, how sleepy you feel, when you have caffeine or alcohol, and when you exercise (NHLBI).

A sleep study is not needed for every case of insomnia. It looks for other problems such as sleep apnea, circadian rhythm disorders and narcolepsy; actigraphy (a small wrist motion sensor worn for 3 to 14 days) estimates rest and activity; and blood tests can check for thyroid problems (NHLBI). A sleep study monitors brain waves, eye movements, breathing, heart rate and muscle activity through the night (MedlinePlus).

2. Cognitive behavioral therapy for insomnia (CBT-I) — first choice

CBT-I is a 6- to 8-week plan, usually recommended as the first treatment for long-term insomnia. It can be delivered by a doctor, nurse or therapist in person, by phone or online (NHLBI). The parts include:

  • Cognitive therapy to ease worry about not sleeping.
  • Relaxation or meditation to help you fall asleep faster.
  • Sleep education about healthy habits.
  • Sleep restriction, which gives you a set amount of time in bed, even if you can’t sleep during it; as sleep improves, the time is increased.
  • Stimulus control, which links bed with sleep: go to bed only when sleepy, get out of bed if you can’t sleep, and use the bed only for sleep and sex (NHLBI).

What the research says:

  • The American College of Physicians (2016) recommends that all adults receive CBT-I as the initial treatment for chronic insomnia (strong recommendation, moderate-quality evidence), and suggests adding medicine only after a shared decision when CBT-I alone has not worked (ACP guideline, 2016).
  • The 2019 VA/Department of Defense guideline made a strong recommendation for CBT-I (VA/DoD guideline overview). The American Academy of Sleep Medicine (2021) recommends multicomponent CBT-I (strong), and suggests stimulus control, sleep restriction or relaxation therapy as single treatments (conditional), but suggests against using sleep hygiene education as a stand-alone treatment (AASM guideline, 2021).
  • A meta-analysis of 20 trials (1,162 adults) found that, after CBT-I, people fell asleep about 19 minutes sooner, spent about 26 fewer minutes awake in the night, and spent about 10 percentage points more of their time in bed asleep; the changes seemed to last, and no adverse outcomes were reported (meta-analysis, 2015).
  • A 2024 analysis of 241 trials suggested that cognitive restructuring, sleep restriction, stimulus control and in-person delivery were the most helpful parts, and that relaxation exercises did not add benefit and might even be counterproductive; the authors cautioned that hidden interactions could affect the conclusions (network meta-analysis, 2024).
  • For people with cancer, a 2025 Cochrane review found CBT-I may give small improvements in insomnia, but the evidence was mostly low to very low certainty (Cochrane review, 2025).

3. Light exposure

Light is the strongest cue for resetting your sleep-wake cycle. For body-clock problems, doctors may suggest a light box: morning light to move sleep earlier, late-afternoon or early-evening light to move it later. Side effects can include eye strain, headache and nausea, so ask first if you have an eye condition or take medicines that make you light-sensitive (NHLBI). A 2023 review of 22 small studies found that light therapy in insomnia improved time awake after sleep onset, but not how fast people fell asleep, total sleep time or sleep efficiency; the authors called for more research (review, 2023).

4. Sleep medicines, by class

Prescription sleep medicines are meant to be used with care. We name them here only to explain the label warnings; your prescriber decides whether any is right for you. We don’t list doses. Several labels say to re-evaluate if insomnia continues after 7 to 10 days of use (FDA label, FDA label).

  • “Z-drugs” (zolpidem, eszopiclone, zaleplon). The Ambien and Lunesta labels carry a boxed warning about complex sleep behaviors — sleepwalking, sleep-driving and other activities while not fully awake — which can cause serious injury or death, and the medicine is to be stopped immediately if it happens (FDA label, FDA label). They add to the effects of alcohol and other sedating medicines, can impair driving the morning after, and older adults may be especially sensitive (FDA label). The zolpidem label is for short-term treatment of trouble falling asleep; in a Cochrane review of eszopiclone, people slept about 28 minutes longer than on placebo, with more caution needed in older adults (Cochrane review, 2018). The NHLBI lists anxiety, and rarely severe allergic reaction, among side effects (NHLBI).
  • Benzodiazepines (for example temazepam). The Restoril label is for short-term treatment (generally 7 to 10 days) and carries a boxed warning about use with opioids, abuse, misuse and addiction, and dependence and withdrawal; stopping abruptly after continued use can cause withdrawal reactions that can be life-threatening (FDA label). The NHLBI notes they are habit-forming, may cause dizziness, confusion and muscle weakness, and are for only a few weeks (NHLBI). Never stop one suddenly on your own.
  • Orexin receptor antagonists (suvorexant, lemborexant, daridorexant). They are approved for trouble falling and/or staying asleep. Their labels list next-day impairment (caution about driving), sleep paralysis, hallucinations at sleep onset or waking, cataplexy-like symptoms, complex sleep behaviors, and worsening depression or suicidal thinking; they must not be used by people with narcolepsy (FDA label, FDA label, FDA label).
  • Low-dose doxepin (Silenor). Approved for trouble staying asleep, with trials up to 3 months. The label forbids use with MAOI antidepressants and in untreated narrow-angle glaucoma or severe urinary retention, warns of worsening depression, says not to use it with alcohol, and warns of added effects with sedating antihistamines; older adults start low (FDA label). A Cochrane review found low-dose doxepin and trazodone may slightly improve sleep quality in the short term, with no evidence for amitriptyline or for long-term use of antidepressants for insomnia (Cochrane review, 2018). Antidepressants and other medicines are sometimes prescribed “off label” (NHLBI).
  • Melatonin receptor agonist (ramelteon). Approved for trouble falling asleep, with trials up to six months; it must not be combined with fluvoxamine, and rare allergic swelling has been reported (FDA label). Dizziness and fatigue are possible (NHLBI).
  • Over-the-counter antihistamine sleep aids (for example diphenhydramine). The label of one such product says: do not use under age 12 or with other diphenhydramine products; ask a doctor first if you have a breathing problem such as emphysema, glaucoma or trouble urinating from an enlarged prostate; ask before combining with sedatives; avoid alcohol; and stop and ask a doctor if sleeplessness lasts more than 2 weeks, since it may signal serious illness (FDA label). The NHLBI says antihistamines can be unsafe for some people (NHLBI), and the NHS says such products may help for 1 to 2 weeks at most and can leave you drowsy (NHS). See the older adults section below.

5. Treating what lies underneath

If insomnia is a symptom of something else, treating that matters most (MedlinePlus): a mental health condition, pain, restless legs, sleep apnea (referral to a sleep clinic), menopause symptoms, or a medicine that is disrupting sleep (NHS).

What it costs

  • Sleep studies: Medicare Part B covers sleep tests when you have signs and symptoms of sleep apnea; after the deductible you pay 20% of the Medicare-approved amount (Medicare.gov). Without insurance, a 2026 survey of 15 online providers found physician-reviewed home sleep apnea tests from $99 to $464.50 (median $189); one analysis found a median discounted cash price of about $2,949 for an overnight polysomnogram in a hospital, and prices vary widely (The Pricer).
  • CBT-I and prescription medicines: cost estimate being researched.

How well it works — what to expect

CBT-I usually takes weeks, not nights, and some people find it hard at first because it asks you to change habits. Its gains seem to last after the course ends (meta-analysis, 2015). Sleep medicines can help in the short term, but they are not a long-term fix, and their side effects are real.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic care has not been shown to treat insomnia. A 2010 review that searched several databases (through 2006) found no randomized trials specific to chiropractic and insomnia, and concluded there was minimal evidence supporting chiropractic for insomnia (review, 2010). A 2014 review of chiropractic care for menopausal symptoms and insomnia found three eligible articles and no evidence that it works (review, 2014). We read only the abstracts of these reviews.

That said, back or neck pain can itself keep you awake. If pain is what wakes you, a chiropractor may be one option for the pain; see our Back Pain guide. Spinal manipulation commonly causes temporary soreness or stiffness, and very rare serious problems, including strokes from neck artery tears after neck manipulation, have been reported (NCCIH).

What it costs

About $55–$100 for a self-pay follow-up visit and $90–$200 for a first appointment (The Pricer). Medicare Part B covers only certain chiropractic services, and you pay 20% of the approved amount after the deductible (Medicare.gov).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture is widely used for sleep, and the NHLBI notes it “may also help improve insomnia, especially in older adults” (NHLBI). The research, though, is not strong.

What the research says

  • A 2021 review of 11 studies (775 people) suggested acupuncture may help insomnia, but the studies were small, varied a lot and were judged low quality (NCCIH).
  • The 2019 VA/DoD guideline found too little evidence to recommend for or against acupuncture, except for a weak recommendation for acupuncture on points of the outer ear (NCCIH).
  • A 2012 Cochrane review of 33 trials (2,293 people) concluded that, because of poor study quality and publication bias, the evidence was not rigorous enough to support or refute acupuncture for insomnia; side effects were rarely reported and minor (Cochrane review, 2012).
  • For people with cancer, a 2025 Cochrane review found very low-certainty evidence of little to no effect compared with sham acupuncture, and that acupuncture is likely less effective than CBT-I (Cochrane review, 2025).

If you try it, use it alongside — not instead of — CBT-I and care for any underlying cause.

Safety

Relatively few complications have been reported, but they have come from non-sterile needles and improper technique and can include infections, punctured organs and nervous-system injury (NCCIH). Choose a licensed practitioner.

What it costs

Private sessions run about $125–$230 for a first visit and $90–$185 for follow-ups; community clinics charge about $50–$90 (The Pricer). Medicare Part B covers acupuncture only for chronic low back pain (Medicare.gov).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

Many sleep products are sold as supplements, and the evidence for most is limited. The FDA does not review dietary supplements for safety and effectiveness before they are sold (NHLBI). “Natural” does not always mean safe, and “standardized” or “certified” does not guarantee quality (NCCIH). We don’t list doses.

Melatonin

  • What it may help: jet lag, sleep problems linked to shift work, delayed sleep-wake phase disorder (a body clock that runs very late), and some sleep problems in children (NCCIH, NCCIH).
  • Chronic insomnia: a 2022 review suggested melatonin helped people fall asleep sooner and feel less sleepy by day, but did not improve sleep quality or time awake at night. Two guidelines (2017 and 2019) recommend against melatonin for chronic insomnia (NCCIH), and the American College of Physicians found too little evidence to recommend it (NCCIH).
  • Safety: short-term use appears safe for most people, but long-term safety is unknown. People with epilepsy or on blood thinners need medical supervision, and little is known about use in pregnancy or breastfeeding. Melatonin may stay active longer in older people and cause daytime drowsiness, and a guideline advises against it in dementia (NCCIH).
  • Quality: a 2023 study found 22 of 25 melatonin gummies were inaccurately labeled, with amounts from 74 to 347 percent of the label; a 2017 study found most of 31 supplements did not match their labels and 26 percent contained serotonin (NCCIH).
  • Children: a CDC report estimated 11,000 emergency visits from 2019 to 2022 for unsupervised melatonin ingestion by children 5 and under, many involving gummies. Store it out of reach and talk to a provider first (NCCIH).

Valerian, chamomile, lavender, kava and others

  • Valerian: studies give inconsistent results and its value for insomnia has not been shown; a 2017 AASM guideline recommended against it for chronic insomnia. Side effects include headache, stomach upset, mental dullness and vivid dreams; don’t take it with alcohol or sedatives (NCCIH).
  • Chamomile: traditionally drunk as tea, but there is very little information; a 2019 review found one insomnia study, which showed no benefit. Chamomile tea is likely safe in usual amounts, though people allergic to ragweed and related plants can react (NCCIH).
  • Lavender: it is unclear whether lavender aromatherapy helps sleep quality or insomnia, though some people report feeling their quality of life improved (NCCIH). A 2021 review of 16 aromatherapy studies suggested benefit for insomnia, but called for larger, better studies (NCCIH).
  • Kava has been linked to serious, sometimes fatal liver injury, and the VA/DoD guideline strongly recommends against it (NCCIH, VA/DoD guideline overview). L-tryptophan may cause dangerous reactions with medicines that affect serotonin (NCCIH).

Magnesium and vitamin D

There is very little research on magnesium for insomnia. A 2021 review of 3 small studies suggested it may help older adults fall asleep sooner, but the studies were low quality, and a 2022 review found conflicting results. Too much magnesium from supplements can cause diarrhea, nausea and cramping, and extremely high intakes can disturb the heartbeat (NCCIH).

CBD and cannabis

A 2020 review found insufficient evidence for cannabinoids, including CBD, for any sleep disorder (NCCIH). A 2026 Cochrane review of 9 trials (537 adults) found medical cannabis may have little to no clinically meaningful effect on sleep quality or total sleep time, and may slightly increase side effects (Cochrane review, 2026). NCCIH adds that it is uncertain whether cannabis helps sleep directly or by easing other symptoms, and that over-the-counter CBD products may contain more or less than the label says and can cause sleepiness, liver injury and drug interactions (NCCIH).

Before you try any supplement, talk with your doctor or pharmacist, especially if you take other medicines, are pregnant or nursing, or are choosing for a child (NCCIH). Some herbs and medicines interact in harmful ways (NCCIH).

Approach 5 of 6

Massage therapy

Many people find massage a lovely way to wind down, and the NHLBI says a doctor may recommend massage therapy, along with meditation or yoga, to help you relax (NHLBI). Whether it treats insomnia is less clear.

What the research says

  • In a review of people with fibromyalgia, massage helped pain, anxiety and depression but did not affect sleep disturbance (NCCIH).
  • A 2022 meta-analysis of 18 mostly Chinese trials (1,471 people) reported that tuina, a traditional Chinese massage, improved insomnia and sleep quality, alone or combined with other treatments. We read only the abstract and cannot judge the quality of the individual trials, so treat this as promising but unproven (meta-analysis, 2022).

Safety

The risk of harm appears low, though rare serious problems, such as a blood clot, nerve injury or bone fracture, have been reported, sometimes with vigorous deep-tissue massage or in frail older adults. Most states license or certify massage therapists (NCCIH).

What it costs

One national chain, Massage Envy, charges about $70–$90 a month for a 12-month membership that includes one 60-minute session a month; each franchise sets its own rates, so prices elsewhere vary (The Pricer). Independent therapists: cost estimate being researched.

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach can help you build the everyday habits that support sleep, track what helps, and get connected to CBT-I or a doctor when you need one. Habits support — but don’t replace — treatment: an AASM guideline suggests against using sleep hygiene alone for chronic insomnia (AASM guideline, 2021).

A steady schedule

  • Go to bed only when sleepy, get up at the same time every day, and don’t sleep in after a bad night (NHS). Keep your timing close to the same on weekends (NHLBI).
  • Try not to force sleep. If you are still awake after about 20 minutes, get up, do something calm in a comfortable spot, and go back to bed when sleepy (NHS). This is the idea behind stimulus control.
  • Eat at regular times and avoid late-night dinners; limit drinks close to bedtime so you wake less to use the bathroom (NHLBI).

Light, caffeine, alcohol and movement

Screens

Try not to use phones, tablets or computers for an hour before bed; the NHS says blue light can make it harder to fall asleep (NHS). Light from TVs and devices can disrupt your sleep-wake cycle, so keep them out of the bedroom if you can (NHLBI).

Naps

For insomnia, the NHLBI advises avoiding naps, especially in the afternoon, which may help you sleep longer at night (NHLBI). Exceptions: naps are normal for young children (NHLBI), shift workers may benefit from a short nap before a shift (NHLBI), and planned naps are part of care for narcolepsy (see Narcolepsy).

Winding down and easing worry

  • Take a calm hour before bed: a bath, a book, soothing music (NHS). Talk with someone you trust or write down worries and a to-do list for tomorrow (NHS).
  • Relaxation: there is a small amount of low-quality evidence that relaxation alone helps chronic insomnia; it is generally safe, but can occasionally bring on anxiety or intrusive thoughts. A 2022 review found listening to music may improve sleep quality in people with insomnia (NCCIH).
  • Yoga and tai chi: they may improve sleep quality, though not necessarily insomnia itself; reviews found a small-to-moderate benefit of yoga for sleep quality in older adults, and tai chi appears safe. Guidelines say the evidence is insufficient to recommend for or against either for insomnia (NCCIH).
  • Mindfulness: there is not enough evidence to know whether it helps insomnia by itself (NCCIH).

Keeping a sleep diary

A coach can help you keep the 1–2 week diary your doctor may ask for, and help you stick with CBT-I homework between sessions (NHLBI). After treatment, regular sleep times, activity and avoiding caffeine, nicotine, alcohol and recreational drugs help prevent insomnia from coming back (NHLBI).

Another approach

Your bedroom, magnets, far-infrared products and wearables

The basics are free: sleep in a cool, quiet, dark room (NHLBI), with a mattress, pillows and covers you find comfortable (NHS). Earplugs, an eye mask, curtains, white noise and keeping clocks out of view are simple things to try (NHS).

Many products are sold with promises of better sleep. We want to be fair to people who have tried them, because poor sleep is miserable and it is natural to look for help. Here is what we found:

  • Magnetic mattress pads. NCCIH says the research on static magnets (sold in jewelry, mats, pillows and bed pads) is extremely limited and has found no conclusive evidence that they relieve any form of pain. It describes one study in which 6 months of sleeping on magnet mattress pads did not significantly improve pain in people with fibromyalgia. NCCIH’s fact sheet is about pain, not sleep, and we did not find a controlled trial of magnetic pads for insomnia. NCCIH also cautions that magnets can interfere with pacemakers and insulin pumps, and are dangerous if small magnets are swallowed by children (NCCIH).
  • Far-infrared pajamas, blankets and pads. We found little research. A 2023 pilot trial of 40 people with poor sleep compared far-infrared pajamas with look-alike sham pajamas; both groups improved, and the difference between them was not significant (pilot trial, 2023). A 2024 study of a branded far-infrared blanket in 24 men over 45 reported better sleep measures after two weeks, but it was very small and short (study, 2024). Larger, longer trials are needed before anyone can say these products help.
  • Wearable sleep trackers. The American Academy of Sleep Medicine says consumer sleep technologies lack validation and cannot be used to diagnose or treat sleep disorders, though the numbers can be a useful starting point for a talk with your clinician (AASM position statement, 2018). A 2026 systematic review found only poor-to-moderate agreement between wrist-worn devices and how people rated their own sleep, and poorer agreement in people with insomnia and in older adults (systematic review, 2026). If checking a tracker makes you more anxious about sleep, it may be worth taking a break from it. Medical-grade actigraphy is different — your provider may use it for 3 to 14 days (NHLBI).

Low-risk comforts are fine to enjoy, but if a product replaces proven care, or costs a lot, weigh that. Whatever you try, give CBT-I and good sleep habits their chance too.

Another approach

Sleep in older adults

Sleep changes with age. The body clock weakens, so older adults usually sleep less and wake earlier (NHLBI); they may also spend less time in deep sleep and wake more easily (MedlinePlus). Waking often through the night is the most common insomnia pattern in older adults (NHLBI). Insomnia raises the risk of falling (NHLBI), so it is worth treating.

Another approach

Children and teens (brief)

Children need more sleep than adults (see the totals above), and naps are appropriate under age 7 (NHLBI). Many teens naturally prefer later bedtimes (NHLBI).

  • Start with routines. For children with sleep problems, guidelines for specific conditions recommend behavioral treatment — good bedtime habits and parent education — as the first step, sometimes supplemented with medicine (NCCIH). Sleep trouble often goes along with behavior and attention concerns; see Behavioral Problems.
  • Melatonin and sleep aids need care. Reviews of short-term studies found melatonin helped some children fall asleep sooner, but the long-term effects are unknown and it is best to work with a provider (NCCIH). Over-the-counter antihistamine sleep aids are labeled not for children under 12 (FDA label).
  • Nightmares, night terrors and sleepwalking are common in childhood. See Bad Dreams & Nightmares; for sleepwalking, make the home safe and gently guide the child back to bed (NHS).

Another approach

Shift work and jet lag

When your sleep-wake cycle is out of step with your environment, you can have trouble sleeping, poor sleep quality, and daytime sleepiness that raises the risk of workplace and road accidents (NHLBI). Treatment aims to reset the cycle, using healthy routines, bright light and sometimes melatonin (NHLBI).

  • For shift workers: keep regular meal times; follow a regular wind-down routine; consider a short nap before your shift; light-blocking glasses outdoors in the morning after a night shift may help; and avoid caffeine within about eight hours of your desired bedtime. Wake-promoting medicines such as modafinil may help alertness but may only last a short time (NHLBI). Melatonin studies in shift workers were small or inconclusive (NCCIH).
  • For jet lag: it usually improves within a few days. The NHS advises getting rest before travel, shifting your schedule toward the new time zone, getting outside in daylight after you arrive, and not sleeping during the day; too much caffeine or alcohol can make it worse (NHS). Melatonin may help jet lag according to reviews (NCCIH), although the NHS says melatonin tablets are not recommended on the NHS for jet lag because there is not enough evidence they work (NHS).

Another approach

Putting the six approaches together

For most people with long-term insomnia, the best-supported path is CBT-I, delivered in person, by phone or online, with a doctor checking for other causes (ACP guideline, 2016, NHLBI). Wellness coaching can keep you on track with daily habits. Acupuncture, massage and relaxation practices may add comfort and calm, with honest limits on the evidence. Herbs and supplements deserve extra caution because of quality and interaction concerns. Chiropractic has no established role for insomnia itself. Please don’t stop or change a prescribed medicine without talking with your prescriber.

Member stories

Living with Sleep Problems (Insomnia, Restless Nights & Sleep Hygiene)? Share your experience

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This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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