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August 4, 2025 34 mins

We all think we know what insomnia is: trouble sleeping, tossing and turning, maybe staring at the ceiling until sunrise. But does the public really have a clear picture of insomnia and does that impact the massive health impact it has? In this episode, we will:

  • Explain how insomnia is not a single problem but a progressive condition, starting with a few rough nights and, in some, developing into a chronic disorder
  • Explore why insomnia is often a disorder of perception, where patients significantly underestimate how much they sleep
  • Review what studies show about actual sleep time in insomnia—based on polysomnography, actigraphy, and other objective measures
  • Identify how public misunderstanding of insomnia has contributed to ineffective treatments and persistent myths
  • Walk through a new six-level clinical framework for managing insomnia, from public health education to relapse prevention
  • Highlight why “doing nothing new” after a bad night may be the best form of early treatment—and why CBT-I remains the gold standard when things don’t resolve
  • Discuss the role of hyperarousal, sleep identity, and over-attention to sleep in making insomnia worse over time

Produced by: Maeve Winter

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Thanks for listening and sleep well!

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