For insomnia patients, finding effective sleeping pills is a matter of course. However, for a doctor, the insomnia patient cannot be limited to a prescription for sleeping pills. Otherwise, they may miss some important causes that cannot be ignored and miss the opportunity to treat the cause. Strictly speaking, insomnia is not a disease, but a symptom common to many diseases, just as abdominal pain and fever is a common symptom of appendicitis, the simple treatment of abdominal pain and fever is only a stopgap measure, the most fundamental is to remove the appendix or apply antibiotic treatment, in order to achieve the purpose of curing abdominal pain and fever. There are usually five important causes of insomnia. One is physical disease, if the patient has heart disease, liver disease, kidney disease, asthma, ulcer disease, arthritis, bone and joint disease, various cancers, endocrine system diseases and other physical diseases, then panic, shortness of breath, cough, frequent urination, abdominal pain, chest pain, stomach pain, joint pain, surgery, etc. can cause insomnia. Second, changes in physiological conditions, such as business trips and train rides, especially long-distance flights, “three shifts” at work, “night driving” when studying, because it disrupts the normal rhythm of sleep and wakefulness, will cause insomnia. Third, psychological factors, such as anxiety, irritability, restlessness or low mood, unhappiness, the so-called anxiety and depression, are also important causes of insomnia. Fourth, a variety of serious mental illness, whether it is schizophrenia, or manic-depressive psychosis, post-traumatic stress disorder, insomnia is always accompanied by the entire course of the disease. Fifth is the drug factor many central nervous excitatory drugs can cause insomnia, the most common ones such as caffeine, ephedrine, Ritalin and other psychoactive substances as well as alcohol lamp non-psychoactive substances have the effect of causing insomnia. So if insomnia, doctors should first look for the cause of insomnia, and then treat the cause, the process of treatment can be appropriate short-term application of sedative-hypnotic drugs, which is the “cure first”, rather than headache, foot pain.