Sleep has become a public culture priority. The sleep industry now exceeds $68 billion. Nearly half of adults report insomnia symptoms at some point. Chronic insomnia means difficulty falling or staying asleep at least three nights per week for at least three months, with daytime consequences and/or significant distress. About 1 in 3 Americans uses a wearable device to track sleep, suggesting the public truly values sleep.¹ While this attention is encouraging given the importance of sleep, many popular ideas about sleep drift away from what clinical science actually supports.
In my work as a behavioral sleep medicine specialist, I see how these misconceptions lead patients toward strategies that feel helpful in the moment but prolong the struggle over time. Three themes come up again and again. Understanding them can help you build more reliable, more restorative sleep.
1. Misconception: Sleeping pills are the quickest path to better sleep.
Medication can feel like the fastest way to regain control when nights become unpredictable. Yet the gold standard treatment recommended for chronic insomnia is cognitive behavioral therapy for insomnia (CBT-I), given overwhelming randomized controlled studies.
The American College of Physicians, National Institutes of Health, and American Academy of Sleep Medicine all recommend CBT-I as the first-line treatment for chronic insomnia.² Furthermore, the guidelines state that CBT-I should be delivered first, and only after someone fails to see significant improvement from CBT-I, should a sleep medication be prescribed.
Despite these guidelines, almost one in five adults used a sleep medication within the past month.³ These medications can be appropriate short-term tools, but are not approved for long-term use. Sleep medications carry risks—falls in older adults, cognitive effects, and dependence.
CBT-I helps 70% to 80% of patients, matches medication in early improvements, and outperforms medication in long-term outcomes.⁴ Yet many people don’t learn about it until years into their sleep struggle.
I once worked with a 72-year-old man who had taken Ambien for decades. One night he woke up and could not remember if he took his Ambien, so took another dose. He woke again later (as he had increased urinary frequency being a senior), and he fell while walking to the bathroom—he hit his head on the bedpost, fracturing his skull. He came to see me and we were able to taper him off his Ambien in conjunction with CBT-I. While going through the program, he began crying, asking why no one had guided him toward safer, evidence-based options earlier. His story is not unusual, and it’s one reason increasing access to behavioral sleep care remains essential.
2. Misconception: The right product will fix insomnia.
When sleep feels fragile, it’s natural to search for the perfect pillow, mattress, supplement, or gadget. But insomnia is not a product problem. It is a clinical condition influenced by physiology, cognitive-behavioral factors, and often coexisting medical or mental health factors. Buying products can feel proactive, but chronic insomnia requires evaluation and treatment—not breaking the bank on consumer purchases.
Research shows that chronic insomnia is linked with increased cardiometabolic risk, cognitive challenges, irritability, and reduced quality of life.⁵ Well-intended shopping cannot address these underlying mechanisms. Evidence-based behavioral treatment can.
Products can offer comfort; some even provide helpful data. But none of them replace the structured behavioral plan that chronic insomnia requires.
3. Misconception: Deep sleep is the most important measure of sleep quality.
Wearables have led to more people paying attention to sleep, but many users become alarmed when they wake up to seeing low “deep sleep” on their devices. Deep sleep sounds like the holy grail of restoration, so low numbers can feel discouraging.
But deep sleep naturally decreases with age, varies night to night, and is difficult to measure accurately outside a sleep lab. Consumer algorithms have improved, but they still differ from EEG used in polysomnography, the gold-standard sleep stage measurement.⁶
The metrics that most reliably predict next-day functioning are:
Sleep Essential Reads
- Consistent sleep and wake times.
- Adequate total sleep time.
Chasing perfect deep sleep often creates more anxiety, which worsens sleep. Focusing on consistency creates more predictable change.
How to Strengthen Your Sleep Starting Tonight
1. Identify your real sleep need.
Most adults need between seven and eight hours, but individual needs vary—some need as much as nine, others as little as six hours. Try one week at seven hours and one week at eight, etc. Let ratings of your energy, mood, and focus guide your conclusions.
2. Create a real wind-down hour.
Your nervous system needs time to transition. Light reading, a warm bath or shower, or soft music are ideal. If you need to involve electronics, we’d rather you use familiar TV, and stay away from handheld devices. Turn off your cellphone and laptop as scrolling and digital interactions should be avoided within the hour before bedtime. Stay away from emotionally charged conversations with family members during that hour as well.⁷
3. If you feel sleepy despite enough sleep, check for snoring.
Snoring and daytime sleepiness, despite adequate sleep duration, can be signs or symptoms of possible obstructive sleep apnea. Oftentimes patients don’t want to admit that they snore due to social stigma, so if your bed partner tells you that you snore, believe them. Sleep apnea is common and often goes undiagnosed.⁸ If you sleep alone, recording apps can help you determine whether you snore. If you snore, and you are sleepy, ask your doctor for a sleep study.
The Bottom Line
Improving sleep is not best accomplished through products and purchases. It is an essential field of health care—one that requires clinical attention in support of cognition, emotional resilience, metabolic health, and relationships. While you can’t control every variable that affects sleep, you can control the structure of your evenings, the consistency of your schedule, and the decisions that support your body’s natural rhythms.