Understanding Insomnia: What Are the Latest Approaches to Better Sleep?

Insomnia has become an increasingly common concern in modern life.

Many people have difficulty falling asleep, wake up repeatedly during the night, wake too early in the morning, or feel that they never get truly restorative sleep. For some people, poor sleep lasts for weeks or months and begins to affect energy, mood, concentration, work, and overall quality of life.

During my years of clinical experience, I have noticed that sleep problems are rarely caused by just one factor. Stress, changes in daily routines, aging, hormonal changes, pain, medications, lifestyle, and emotional well-being may all influence sleep.

Today, modern sleep medicine and Traditional Chinese Medicine offer different perspectives on this increasingly common problem.

What Is Insomnia?

Insomnia is more than simply having an occasional bad night.

Persistent difficulty falling asleep, staying asleep, or waking too early—especially when it affects daytime functioning—may indicate an insomnia disorder that deserves attention.

Before focusing only on sleep itself, it is important to consider what may be contributing to the problem.

For example:

• Stress and emotional tension
• Chronic pain
• Menopausal or other hormonal changes
• Irregular sleep schedules
• Excessive caffeine or alcohol
• Screen exposure late at night
• Certain medications
• Anxiety or depression
• Sleep apnea or other sleep disorders

This is why simply taking a sleep medication may not address the whole picture.

What Has Changed in Modern Sleep Medicine?

One of the most important developments in modern insomnia care is the increasing emphasis on Cognitive Behavioral Therapy for Insomnia (CBT-I).

CBT-I is a structured behavioral approach designed specifically for insomnia. It may include strategies such as:

• Establishing consistent sleep and wake times
• Stimulus control
• Sleep scheduling
• Cognitive strategies for reducing unhelpful thoughts about sleep
• Relaxation techniques
• Healthy sleep habits

The American Academy of Sleep Medicine recommends CBT-I as a first-line treatment for chronic insomnia in adults. Digital and telehealth versions are also expanding access for people who cannot easily see a sleep specialist in person. (Reference 1)

For some individuals, medication may also be considered by a qualified medical professional. Modern insomnia pharmacology includes several medication classes, including newer orexin receptor antagonists, as well as other prescription sleep medications. Medication selection depends on the individual’s symptoms, age, other health conditions, medications, and risk factors. (Reference 2)

The important message is that there is no single sleep medication that is appropriate for everyone.

What Does Traditional Chinese Medicine Look At?

Traditional Chinese Medicine approaches sleep from a different perspective.

Rather than looking only at the number of hours a person sleeps, TCM considers the individual’s overall pattern of health and balance.

Factors such as:

• Emotional stress
• Mental overactivity
• Digestive function
• Menopausal changes
• Fatigue
• Daily rhythm
• Overall constitution

may all be considered when developing an individualized acupuncture plan.

The goal is not simply to “make someone sleepy,” but to support overall balance and relaxation while addressing factors that may be associated with poor sleep.

What Does the Research Say About Acupuncture?

Acupuncture has been increasingly studied as an approach for insomnia.

A 2025 systematic review and meta-analysis of randomized controlled trials found that acupuncture was associated with improvements in subjective sleep quality in people with chronic insomnia compared with sham acupuncture. Improvements were also reported in measures such as sleep efficiency and nighttime wakefulness, although the researchers noted that limitations in the available evidence mean that more high-quality research is still needed. (Reference 3)

Another recent systematic review examining acupuncture and endocrine measures reported improvements in subjective sleep quality and changes in melatonin and cortisol measures, although there was substantial variation among the studies. (Reference 4)

Research on electroacupuncture has also continued to expand. A 2024 systematic review and meta-analysis evaluated randomized trials of electroacupuncture for insomnia and found evidence suggesting potential benefits, while also emphasizing the need for further rigorous research. (Reference 5)

These findings are encouraging, but they should be interpreted carefully. Acupuncture research for insomnia still has differences in treatment protocols, study quality, patient populations, and outcome measures.

An Integrative Way of Looking at Insomnia

In my view, the most useful approach is not to think of Western medicine and Traditional Chinese Medicine as competing systems.

For someone with persistent insomnia, an integrative approach may include:

Sleep evaluation → Identify contributing factors → CBT-I and healthy sleep habits → Medical treatment when appropriate → Acupuncture and other supportive approaches

Each person may need a different combination.

For example, someone with loud snoring and daytime sleepiness may need evaluation for sleep apnea rather than simply focusing on insomnia.

Someone experiencing significant menopausal symptoms may need a different approach.

Someone whose sleep is disrupted by chronic pain may benefit from addressing the pain as part of the overall sleep strategy.

And someone whose sleep is strongly affected by stress and mental tension may benefit from relaxation practices, behavioral strategies, and acupuncture as part of an individualized wellness plan.

What I Tell My Patients

Good sleep is not simply about spending more hours in bed.

It is about creating the conditions in which the body and mind can enter a healthy rhythm of rest and recovery.

If occasional poor sleep becomes persistent, do not simply accept it as “normal aging” or rely indefinitely on over-the-counter sleep aids.

Pay attention to your sleep pattern, look for contributing factors, and seek appropriate professional evaluation.

As a California Licensed Acupuncturist, I provide acupuncture and integrative wellness care to support sleep and overall well-being. Acupuncture may be one component of a comprehensive approach for appropriate individuals, while persistent or severe sleep problems may require evaluation by a primary care provider, sleep specialist, or other qualified healthcare professional.

Better sleep often begins with understanding why sleep has become difficult in the first place.