Sleeping better: what actually works
For lasting insomnia, the recommended first treatment is cognitive behavioural therapy, not a pill or supplement.
Covers: Adults with trouble falling or staying asleep. Supplements, screens and specific treatments have their own Sylos as subtopics. Sleep apnoea and other medical sleep disorders need clinical assessment and are only mentioned.
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The short answer
Evidence-backedThe best-supported fix for persistent poor sleep isn't a pill or a gadget: it's cognitive behavioural therapy for insomnia (CBT-I), which physicians' and sleep medicine guidelines recommend first. Popular supplements such as melatonin and magnesium show small effects at best, and most adults should aim for seven or more hours a night.12345
- Evidence 13
- Interpretation 1
In brief
At a glance
The picture in numbers
Live · updated just now
7 hours
7 minutes
17 minutes
The evidence behind it
11 sources- Reviews of many studies6
- Other studies and data5
When it was published
Newest from 2026
| Source | Kind | Year |
|---|---|---|
| Recommended amount of sleep for a healthy adult: a joint consensus statement of the AASM and Sleep Research Society | Other studies and data | 2015 |
| Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians | Other studies and data | 2016 |
| Behavioral and psychological treatments for chronic insomnia disorder in adults: an AASM clinical practice guideline | Other studies and data | 2021 |
| Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults | Other studies and data | 2017 |
| Meta-analysis: melatonin for the treatment of primary sleep disorders | Reviews of many studies | 2013 |
| Oral magnesium supplementation for insomnia in older adults: a systematic review & meta-analysis | Reviews of many studies | 2021 |
| Melatonin natural health products and supplements: significant variability of melatonin content | Other studies and data | 2017 |
| Cognitive behavioral therapy for insomnia-assisted discontinuation or reduction of benzodiazepine receptor agonists and Z-drugs in chronic insomnia: A systematic review and meta-analysis. | Reviews of many studies | 2026 |
| Digital Cognitive Behavioral Therapy for Insomnia in Older Adults: A Systematic Review and Meta-analysis. | Reviews of many studies | 2026 |
| Pharmacological and non-pharmacological interventions of insomnia in geriatrics: A systematic review. | Reviews of many studies | 2026 |
| Transdiagnostic effects of combined sleep-circadian interventions on depressive symptoms and sleep outcomes in adults with mental disorders: a systematic review and meta-analysis of randomized controlled trials. | Reviews of many studies | 2026 |
The community around it
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What it means for you
Which fits you?
Pick the situation closest to yours. Each answer says what it rests on.
If you've slept badly at least three nights a week for three months
That meets the usual definition of chronic insomnia. Ask a clinician about CBT-I, in person or through a reputable digital programme.12
Evidence-backedIf you're just not leaving enough time for sleep
No supplement fixes too little time in bed. Adults need seven or more hours regularly.3
Evidence-backedIf you snore loudly, stop breathing at night or are very sleepy by day
Get assessed for sleep apnoea. It is a medical condition that sleep aids don't treat.
InterpretationWhat's your biggest sleep problem right now?
Your individual response is private. Only totals are shown.
The full story · 3 chapters
01
How much sleep adults need
AI summary:Adults should regularly get seven or more hours of sleep a night, since less is linked to health and performance problems.
Evidence-backed: A joint consensus of the American Academy of Sleep Medicine and the Sleep Research Society recommends that adults sleep seven or more hours per night on a regular basis. Regularly sleeping less is associated with weight gain, diabetes, high blood pressure, heart disease, depression and impaired performance.3
02
CBT-I: the first-line treatment
AI summary:Guidelines recommend CBT-I first for chronic insomnia, and sleep hygiene advice alone is not a standalone treatment.
Evidence-backed: The American College of Physicians recommends CBT-I as the initial treatment for all adults with chronic insomnia. The American Academy of Sleep Medicine makes a strong recommendation for it.12
Evidence-backed: CBT-I combines sleep restriction (limiting time in bed to consolidate sleep), stimulus control (using the bed only for sleep), and changing unhelpful beliefs about sleep. Sleep hygiene advice alone is not recommended as a standalone treatment.2
03
Over-the-counter aids and supplements
AI summary:Guidelines suggest against diphenhydramine, melatonin, valerian and L-tryptophan for chronic insomnia because trial benefits were small.
Evidence-backed: The AASM suggests clinicians not use diphenhydramine, melatonin, valerian or L-tryptophan for chronic insomnia, because the benefits found in trials were small.6
Common insomnia approaches compared
Ahead on the ratings available: CBT-I, though it has no reviewed data on Product reliability. Best option rated on all your priorities: Melatonin.
- 1CBT-IExcellent fit on what's knownNo reviewed data on Product reliability, so it's left out rather than counted as zero.
- 2MelatoninPoor fit
Not ranked: too little reviewed data on your priorities for Magnesium, Diphenhydramine (OTC sleep aid).
See every rating and what it rests on
| Criterion | CBT-I | Melatonin | Magnesium | Diphenhydramine (OTC sleep aid) |
|---|---|---|---|---|
| Size of benefit | Excellent2Strong recommendation based on clinically meaningful improvements across trials | Weak4About 7 minutes faster sleep onset in pooled trials | Weak5About 17 minutes faster sleep onset; low-quality evidence | No reviewed data |
| Guideline support | Excellent12ACP and AASM both recommend it as first-line treatment | Poor6AASM suggests not using it for chronic insomnia | No reviewed data | Poor6AASM suggests not using it for chronic insomnia |
| Product reliability | No reviewed data | Poor11Content ranged from −83% to +478% of label | No reviewed data | No reviewed data |
- CBT-II've used it0I'd recommend it0I had problems with it0
- MelatoninI've used it0I'd recommend it0I had problems with it0
- MagnesiumI've used it0I'd recommend it0I had problems with it0
- Diphenhydramine (OTC sleep aid)I've used it0I'd recommend it0I had problems with it0
Counts are SyloSpace participants who chose to say so. They aren't a representative sample and don't change the ratings above. Who reacted is private. Sign in to add yours.
How this works
Ratings summarise the cited guidelines and meta-analyses for chronic insomnia in adults. They are not about any one person's results. Cells without reviewed data are left empty on purpose.
Editors rate each option from 1 (poor) to 5 (excellent) on each criterion, only where cited sources or firsthand contributions support a rating. Your fit is the average of those ratings weighted by your priorities. A missing rating is left out, never counted as zero, and an option with ratings on less than 50% of what you weighted isn't ranked. Options within a quarter point are treated as a close call.
Ratings last changed Sep 30, 2026.
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Discussion
Sources
Numbers match the citations in the article. A working link isn't proof that a page supports a claim; check the quoted passage and date.
- 1Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of PhysiciansAnnals of Internal Medicine (Qaseem et al.)Published Jul 19, 2016Checked Sep 30, 2026
“ACP recommends that all adult patients receive cognitive behavioral therapy for insomnia (CBT-I) as the initial treatment for chronic insomnia disorder.”
- 2Behavioral and psychological treatments for chronic insomnia disorder in adults: an AASM clinical practice guidelineJournal of Clinical Sleep Medicine (Edinger et al.)Published Feb 1, 2021Checked Sep 30, 2026
“Strong recommendation for multicomponent CBT-I; conditional recommendations for brief therapies, stimulus control, sleep restriction and relaxation; sleep hygiene alone is not recommended as a single therapy.”
- 3Recommended amount of sleep for a healthy adult: a joint consensus statement of the AASM and Sleep Research SocietyJournal of Clinical Sleep Medicine (Watson et al.)Published Jun 15, 2015Checked Sep 30, 2026
“Adults should sleep 7 or more hours per night on a regular basis to promote optimal health.”
- 4Meta-analysis: melatonin for the treatment of primary sleep disordersPLOS ONE (Ferracioli-Oda et al.)Published May 17, 2013Checked Sep 30, 2026
“Melatonin reduced sleep onset latency by about 7 minutes and increased total sleep time by about 8 minutes.”
- 5Oral magnesium supplementation for insomnia in older adults: a systematic review & meta-analysisBMC Complementary Medicine and Therapies (Mah & Pitre)Published Apr 17, 2021Checked Sep 30, 2026
“Three trials, 151 older adults; sleep onset about 17 minutes faster; low to very low quality evidence.”
- 6Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adultsJournal of Clinical Sleep Medicine (American Academy of Sleep Medicine)Published Feb 15, 2017Checked Sep 30, 2026
“Suggests clinicians not use diphenhydramine, melatonin, valerian or L-tryptophan to treat chronic insomnia in adults.”
- 7Transdiagnostic effects of combined sleep-circadian interventions on depressive symptoms and sleep outcomes in adults with mental disorders: a systematic review and meta-analysis of randomized controlled trials.Frontiers in psychiatry (Xu et al.)Published Aug 6, 2026Checked Oct 4, 2026
“Sleep-circadian interventions were associated with reduced depressive symptom severity (SMD = -0.51, 95% CI: -0.72 to -0.30) and higher treatment response (RR = 1.68, 95% CI: 1.25 to 2.27). Remission also favored the intervention groups, but this estimate was based on only two trials (RR = 2.06, 95% CI: 1.09 to 3.90). Improvements were observed in insomnia severity (MD = -5.23, 95% CI: -6.41 to -4.04), sleep disturbance or sleep quality (SMD = -0.92, 95% CI: -1.19 to -0.65), sleep-related impairment (MD = -7.91, 95% CI: -9.89 to -5.93), and functional impairment (MD = -4.78, 95% CI: -6.42 to -3.15). Evidence certainty ranged from very low to moderate, and several outcomes were supported by few trials.ConclusionSleep-circadian interventions may improve depressive symptoms, selected sleep outcomes, and functioning in adults with mental disorders. Given the heterogeneity of diagnoses and interventions, these findings should be viewed as promising transdiagnostic evidence. Larger trials with longer follow-up are needed.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier CRD420261412965.”
- 8Pharmacological and non-pharmacological interventions of insomnia in geriatrics: A systematic review.The Medical journal of Malaysia (Shalihin et al.)Published Sep 1, 2026Checked Oct 4, 2026
“Benzodiazepines and Zdrugs were associated with significant fall risks (Risk Ratio ~1.47), cognitive decline, and are classified as potentially inappropriate medications. For non-pharmacological management, face-to-face cognitive behavioral therapy for insomnia (CBT-I) demonstrated clinically significant improvements across 14 RCTs, including sleep efficiency (MD +8.36%; 95% CI: 5.96-10.76) and wake after sleep onset (wake after sleep onset (WASO) Mean Difference (MD) -23.44 min; 95% CI: -32.41 to -14.47), though statistical heterogeneity was high (I2=85%), reflecting variations in Sleep Restriction Therapy adaptation. Digital CBT-I, music therapy (SMD-0.79), and structured exercise also demonstrated substantial benefits.ConclusionCBT-I remains the evidence-based first-line treatment for geriatric insomnia. DORAs represent the safest pharmacological option when medication is mandatory, while benzodiazepines and Z-drugs must be actively deprescribed. A multimodal, individualized approach integrating behavioral and safe, targeted pharmacological strategies is strongly recommended.”
- 9Digital Cognitive Behavioral Therapy for Insomnia in Older Adults: A Systematic Review and Meta-analysis.International journal of behavioral medicine (Liu et al.)Published Sep 1, 2026Checked Oct 4, 2026
“Mean differences (MDs) in insomnia severity were pooled using random-effects models. Subgroup analyses examined therapist guidance and control type.ResultsNine RCTs involving 760 participants were included. Compared with control conditions, dCBT-I significantly reduced insomnia severity at post-intervention (MD = - 3.96, 95% CI - 5.35 to - 2.56; I2 = 56.3%). A significant reduction was also observed at follow-up (MD = - 3.66, 95% CI - 5.37 to - 1.94; I2 = 10.3%), although follow-up evidence was limited. Unguided interventions were also associated with significant improvements (MD = - 4.36, 95% CI - 6.06 to - 2.66; I2 = 37.7%).ConclusiondCBT-I may reduce ISI-measured insomnia severity in relatively younger older adults, with limited evidence regarding the durability of effects at follow-up. Unguided interventions may offer practical advantages in scalability and accessibility, although the incremental value of therapist guidance remains uncertain. Further well-powered randomized controlled trials with longer follow-up are needed to confirm long-term efficacy and determine the optimal delivery format.”
- 10Cognitive behavioral therapy for insomnia-assisted discontinuation or reduction of benzodiazepine receptor agonists and Z-drugs in chronic insomnia: A systematic review and meta-analysis.The Journal of international medical research (Zhang et al.)Published Sep 17, 2026Checked Oct 4, 2026
“Dose-reduction outcomes were not pooled as confirmatory endpoints because thresholds and time points differed, and repeated time points from the same trial could not be treated as independent observations. No clear difference was found in dropout or intervention noncompletion (10 trials; 885 participants; risk ratio = 0.93, 95% confidence interval: 0.40 to 2.16; I2 = 58.6%). Post-treatment Insomnia Severity Index scores were lower with CBT-I-assisted interventions (3 trials; 126 analyzed participants; mean difference = -4.73, 95% confidence interval: -8.46 to -0.99; I2 = 0%); however, the evidence remained uncertain because the synthesis was based on three small trials.ConclusionsThis review does not provide high-certainty evidence that CBT-I-assisted interventions reliably improve complete discontinuation of benzodiazepine receptor agonists or Z-drugs. CBT-I may nevertheless have clinical value as a behavioral component of individualized deprescribing programs by supporting dose reduction and insomnia-related coping during gradual tapering. Larger trials with standardized outcomes, long-term follow-up, and complete safety reporting are needed.”
- 11Melatonin natural health products and supplements: significant variability of melatonin contentJournal of Clinical Sleep Medicine (Erland & Saxena)Published Feb 15, 2017Checked Sep 30, 2026
“Melatonin content ranged from −83% to +478% of the labelled amount.”
How it changed
Published 5 times since Sep 30, 2026.
- Version 5Sep 30, 2026Live now
Removed a survey poll that wasn't a close enough match to this topic.
- Updated “How much sleep adults need”.
- Version 4Sep 30, 2026
Added a reader poll shown alongside published survey figures.
- Updated “How much sleep adults need”.
- Version 3Sep 30, 2026
Connected the supplement and screens subtopics and added a comparison of common approaches.
- Added section “Over-the-counter aids and supplements”.
- 1 new source cited.
- Key takeaways were added.
- Version 2Sep 30, 2026
First brief from the sleep duration consensus and the insomnia treatment guidelines.
- The main finding was rewritten.
- The finding is now labelled “evidence” (was “interpretation”).
- Added section “How much sleep adults need”.
Help improve it
The brief is open about what's uncertain. These are the specific gaps that new material would fill.
“How much sleep adults need” rests on one independent source
A second, independent source that confirms or challenges it would make this part more reliable.
Size of benefit: no data for Diphenhydramine (OTC sleep aid)
From the comparison “Common insomnia approaches compared”. Firsthand experience or a source would let readers weigh this.
Guideline support: no data for Magnesium
From the comparison “Common insomnia approaches compared”. Firsthand experience or a source would let readers weigh this.
Product reliability: no data for CBT-I, Magnesium, Diphenhydramine (OTC sleep aid)
From the comparison “Common insomnia approaches compared”. Firsthand experience or a source would let readers weigh this.
Open questions
Which digital CBT-I programmes have been tested in randomised trials?
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How long are waits for CBT-I where you live, and what did you do meanwhile?
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Which sleep question should get its own Sylo next: naps, caffeine, alcohol or exercise?
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