Most people experience a sleepless night now and then—stressful deadlines, travel, or an overactive mind can keep anyone awake. But when sleep difficulties become persistent, they can take a toll on both physical and emotional well-being. Insomnia isn’t just about feeling tired—it can affect how we think, feel, and function throughout the day. Understanding the broader impact of insomnia can help us take sleep more seriously and seek support when needed.
What Is Insomnia?
Insomnia involves difficulty falling asleep, staying asleep, or waking up too early with trouble returning to sleep. Nighttime struggles are only part of the picture—insomnia also affects how we feel during the day. Many people describe exhaustion, irritability, brain fog, or the sense of running on empty.
When insomnia lasts for months or becomes a nightly pattern, it can have measurable effects on health.
How Insomnia Affects the Body and Mind
1. Daytime Fatigue and Cognitive Challenges
Even one poor night of sleep can affect concentration, memory, and decision-making. When insomnia is chronic, these difficulties accumulate. Tasks take longer, mistakes increase, and it’s harder to stay focused or recall information. Many people also notice increased emotional sensitivity or difficulty coping with everyday stress.
2. Mood and Emotional Health
Sleep and mood are deeply connected. Insomnia can increase irritability, stress reactivity, and feelings of overwhelm. Research shows that chronic insomnia is associated with a higher risk of anxiety and depression. The relationship is bidirectional—insomnia can worsen mood, and low mood can make sleep more difficult—creating a cycle that can feel exhausting.
3. Physical Health and Immune Function
Sleep is when the body restores, repairs, and recharges. Without regular deep sleep, the immune system may not function optimally, making us more susceptible to illness and slower to recover. Over time, chronic insomnia is associated with increased inflammation and may contribute to elevated risk for conditions such as high blood pressure and metabolic concerns.
4. Hormones and Metabolism
Sleep influences hunger hormones, including ghrelin and leptin, which regulate appetite. When sleep is disrupted, hunger signals can increase and satiety signals decrease, which may contribute to cravings and changes in eating patterns. Some research suggests that long-term sleep disruption may affect glucose regulation and weight management.
5. Cardiovascular and Long-Term Health
While occasional poor sleep isn’t dangerous, chronic insomnia may place strain on the cardiovascular system. Over time, difficulty sleeping has been associated with increased risk for hypertension and cardiovascular concerns. Quality sleep is essential for heart health, blood pressure regulation, and nightly recovery of the nervous system.
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Why Addressing Insomnia Matters
Sleep isn’t a luxury—it’s a foundational part of health. When insomnia persists, many people begin to adjust their lives around fatigue: skipping social plans, relying on caffeine, napping during the day, or worrying hours before bedtime. These coping patterns are understandable, but they often reinforce the sleep struggle.
The good news: insomnia is highly treatable, and people often see significant improvement with the right support.
Approaches like Cognitive Behavioral Therapy for Insomnia (CBT-I) are considered the gold standard treatment. CBT-I helps retrain the brain to sleep naturally by addressing habits, sleep schedules, and thought patterns that maintain insomnia. Many individuals notice improvement within a few weeks.
Moving Toward Restful Nights
If you’ve been struggling with sleep, you’re not alone—and you don’t have to push through it indefinitely. Sleep is a skill that can be relearned. Addressing insomnia can improve energy, mood, focus, emotional resilience, and overall health.
Quality sleep supports the body and mind in countless ways. When we sleep better, everything feels a little more manageable.
What Is CBT-I? A Proven Approach to Treating Insomnia
Struggling to fall asleep, stay asleep, or wake feeling unrefreshed can affect every part of life—mood, focus, energy, work, and relationships. Many people try to cope by scrolling late at night, forcing themselves to lie in bed awake, relying on naps, or turning to sleep aids for relief. Yet the frustration often continues.
Cognitive Behavioral Therapy for Insomnia (CBT-I) is one of the most effective treatments for chronic insomnia, backed by decades of research. Unlike medication, which may offer short-term relief, CBT-I addresses the thoughts, behaviors, and habits that maintain sleep difficulties. It helps retrain the body and mind to sleep naturally again.
What Is Cognitive Behavioral Therapy for Insomnia (CBT-I)?
CBT-I is a structured, evidence-based therapy designed specifically to improve sleep. It focuses on identifying patterns—such as worry about sleep, inconsistent routines, or time spent awake in bed—that interfere with restful sleep. Through targeted strategies, CBT-I helps reset the sleep system, reduce nighttime wakefulness, and build confidence in one’s ability to sleep.
Most people complete CBT-I in six-eight sessions and experience lasting improvements.
Why CBT-I Works
Insomnia is rarely just one problem. It is often a cycle: Difficulty sleeping leads to anxiety about sleep, which leads to habits like going to bed early, sleeping in, or checking the clock—patterns that inadvertently make sleep worse. CBT-I breaks this cycle.
Research shows that CBT-I:
- Improves sleep onset and sleep maintenance
- Reduces nighttime awakenings
- Enhances sleep quality and next-day functioning
- Works as well as or better than sleep medication for chronic insomnia
- Provides long-term benefits after treatment ends
What Happens in CBT-I?
CBT-I includes several components that work together to reset the sleep-wake rhythm:
1. Sleep Education
You learn how sleep works—what drives sleepiness, how circadian rhythms operate, and which daytime choices influence nighttime rest. Understanding the science helps make each strategy feel logical and purposeful.
2. Sleep Scheduling (Sleep Restriction Therapy)
This is one of the most powerful tools in CBT-I. It temporarily limits time spent in bed to match actual sleep time. This builds healthy sleep pressure so that when bedtime arrives, the brain is ready for sleep. Over time, sleep becomes deeper and more consolidated.
3. Stimulus Control
The bed becomes a cue for sleep—not worry, wakefulness, or scrolling. This means:
- Going to bed only when sleepy
- Getting out of bed if unable to sleep
- Using the bed only for sleep and intimacy
- Waking up at a consistent time
This retrains the brain to associate bed with sleep rather than frustration.
4. Cognitive Strategies
Insomnia often comes with thoughts like “I’ll never fall asleep,” “I won’t function tomorrow,” or “Something’s wrong with me.” These thoughts increase arousal and make sleep more elusive. CBT-I helps challenge worry-based thinking and replace it with more balanced, realistic expectations about sleep.
5. Relaxation Techniques
Breathing exercises, mindfulness, and muscle relaxation help calm the nervous system and reduce nighttime tension—especially helpful for those who feel “tired but wired.”
6. Sleep Hygiene
Lighting, screen use, caffeine, naps, and evening routines all matter. While sleep hygiene alone rarely fixes insomnia, refining habits can support the other CBT-I strategies.
Who Can Benefit?
CBT-I is effective for:
- Difficulty falling asleep or staying asleep
- Early morning awakening
- Middle-of-the-night rumination
- Light, nonrestorative sleep
- Insomnia connected to stress, anxiety, or life transitions
- Individuals reducing or hoping to stop long-term sleep medication
Even long-term insomnia can improve—sleep is a skill the brain can relearn.
A Path Toward Restful Sleep
Living with insomnia can feel isolating and exhausting, but it is highly treatable. CBT-I empowers individuals to rebuild trust in their ability to sleep naturally, without relying heavily on medication. Most people notice improvement within just a few weeks, and gains often continue well beyond treatment.
If you are struggling with sleep, you don’t have to navigate it alone. CBT-I offers a structured, research-backed path forward—and restful nights are possible.
Dr. Sara Michelson is a Licensed Psychologist in Chapel Hill N.C.
I am a doctoral-level licensed psychologist in Chapel Hill North Carolina; I have expertise in various evidence-based treatments for adults and am committed to providing scientifically validated interventions. I work with a diverse population, including trauma, insomnia, mood disorders, anxiety, and relationship problems. I take my work and clinical specializations seriously and continue to devote a considerable amount of time and effort to advance my training and professional development. For your convenience, my services are provided via telehealth.