Is difficulty falling asleep treated differently from difficulty staying asleep?

Reviewed by Yoshinori Abe, MD

Internal Medicine

Difficulty falling asleep (sleep-onset insomnia) and difficulty staying asleep (sleep-maintenance insomnia) are two distinct types of insomnia, and they are often treated differently. Sleep-onset insomnia is typically addressed with relaxation techniques, stimulus control therapy, or short-acting sleep aids, while sleep-maintenance insomnia may require longer-acting medications, cognitive behavioral therapy for insomnia (CBT-I), or treatment of underlying conditions like sleep apnea or anxiety.

Because the right treatment depends on identifying which type of insomnia you're experiencing—and what may be causing it—understanding your specific symptoms is the critical first step. Taking a free, instant, online symptom check can help you pinpoint what's going on, rule out related conditions, and guide you toward the most effective next steps with your healthcare provider.

Reviewed for medical accuracy: 07/20/2026

Important Next Steps

Discover why you're waking up at night Learn if insomnia needs care today Find out what’s causing your sleep problems See OTC options for better sleep Find a doctor for sleep disorders Discover evidence-based home remedies for insomnia Understand whether sleep issues need evaluation

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Explanation

Difficulty falling asleep and difficulty staying asleep are two different types of insomnia. According to the research by Pillai et al., these are stable insomnia phenotypes, meaning they have different characteristics and may require different treatment approaches.

Types of Insomnia:

Difficulty Falling Asleep: This is often called sleep-onset insomnia. It involves trouble getting to sleep at the start of the night.
Difficulty Staying Asleep: Known as sleep-maintenance insomnia, this involves waking up during the night and having trouble getting back to sleep.

Treatment Approaches:

For Difficulty Falling Asleep: Treatments may focus on helping the person relax and prepare for sleep. This can include relaxation techniques or cognitive behavioral therapy.
For Difficulty Staying Asleep: Treatments might focus on maintaining sleep throughout the night. This could involve strategies to improve sleep quality or address any underlying issues, such as anxiety.

Each type of insomnia may require a different approach based on the specific sleep challenge. If you are experiencing sleep problems, you can check your symptoms with a free AI-powered tool to better understand what might be affecting your rest, and it is important to speak with a healthcare provider for guidance.

(References)

Pillai V, Roth T, & Drake CL. (2015). The nature of stable insomnia phenotypes. Sleep, 25325468.
Yue JL, Chang XW, Zheng JW, Shi L, Xiang YJ, Que JY, et al. (2023). A systematic review and network meta-analysis. Sleep medicine reviews, 36701954.
Lack LC, Gradisar M, Van Someren EJ, Wright HR, & Lushington K. (2008). The relationship between insomnia and body temperatures. Sleep medicine reviews, 18603220.

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