Sleepless in the 21st Century: Rethinking Chronic Insomnia Care (Colin Espie, PhD)

Prof. Colin Espie argues that chronic insomnia should be viewed and treated as a disorder in its own right, not merely a symptom of other conditions. The strongest evidence supports **CBT-I/CBTx as first-line treatment**, with stimulus control and sleep restriction as its most effective components. While medications remain important, the major challenge is the underprovision—not overprescription—of evidence-based behavioral care. Digital CBT-I platforms now offer scalable, FDA-cleared solutions that can deliver guideline-based treatment at population level. Effective insomnia treatment can also improve comorbid mental and physical health outcomes.