SleepSet
Sleep issues guide/Chronic insomnia
FIG. 02

Chronic insomnia

SleeplessnessAround 10% of adults, long-term

Insomnia stops being a temporary patch and becomes a condition at about the three-month mark. By then the original trigger — stress, a new baby, a deadline — has often passed, and what keeps it going is the effort of trying to sleep. Treatment targets that conditioned arousal loop rather than the original cause.

What it looks like
Lying awake more than 30 minutes at lights-out
Waking at 3am and unable to fall back asleep
Dreading bedtime, or repeatedly watching the clock
Irritability and difficulty concentrating the next day
How it's confirmed

Diagnosed on clinical history and a two-week sleep diary, not a machine. A sleep study is only ordered when apnea or limb movements are suspected underneath.

Two-week sleep diaryActigraphy tracking

Solutions

ranked by evidence level
Evidence scale — what the meter means
Strong — Multiple clinical trials or established guidelines.
Moderate — Some clinical research, fewer or smaller studies.
Emerging — Early research signals.
Limited — Expert opinion or common clinical practice.
S-01CBT-Istrong evidencebehavioral

Cognitive behavioural therapy for insomnia — structured sessions covering stimulus control, sleep restriction and worry management. Outperforms sleeping pills at twelve months.

No product needed — this is clinical behavioral therapy.
S-02Fixed wake timestrong evidencebehavioral

The same alarm seven days a week, weekends included. The most reliable single physiological lever to build homeostatic sleep pressure.

Behavioral routine adjustment.
S-03Stimulus controlstrong evidencebehavioral

Out of bed after roughly 20 minutes awake. Staying put frustrated teaches the brain that the mattress is where you worry.

No product needed — this is a behavior change.
S-04Sleep-restriction therapymoderate evidencebehavioral

Temporarily compressing time in bed to match actual sleep time, consolidating fragmented sleep. Effective but best guided by a clinician.

Requires structured clinician oversight.
S-05Low-dose melatoninemerging evidencesupplement

A chronobiotic timing signal rather than a sedative. Useful for delayed sleep phase; weak evidence for classic chronic insomnia.

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