Sleep has become a public culture priority. The sleep industry now exceeds $68 billion. Nearly half of adults report insomnia symptoms at some point. Chronic insomnia means difficulty falling or staying asleep at least three nights per week for at least three months, with daytime consequences and/or significant distress. About 1 in 3 Americans uses a wearable device to track sleep, suggesting the public truly values sleep.¹ While this attention is encouraging given the importance of sleep, many popular ideas about sleep drift away from what clinical science actually supports.

In my work as a behavioral sleep medicine specialist, I see how these misconceptions lead patients toward strategies that feel helpful in the moment but prolong the struggle over time. Three themes come up again and again. Understanding them can help you build more reliable, more restorative sleep.

Medication can feel like the fastest way to regain control when nights become unpredictable. Yet the gold standard treatment recommended for chronic insomnia is cognitive behavioral therapy for insomnia (CBT-I), given overwhelming randomized controlled studies.

The American College of Physicians, National Institutes of Health, and American Academy of Sleep Medicine all recommend CBT-I as the first-line treatment for chronic insomnia.² Furthermore, the guidelines state that CBT-I should be delivered first, and only after someone fails to see significant improvement from CBT-I, should a sleep medication be prescribed.

Despite these guidelines, almost one in five adults used a sleep medication within the past month.³ These medications can be appropriate short-term tools, but are not approved for long-term use. Sleep medications carry risks—falls in older adults, cognitive effects, and dependence.

CBT-I helps 70% to 80% of patients, matches medication in early improvements, and outperforms medication in long-term........

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