With the change of people’s living habits and work rhythm and the increasing pressure from various aspects, nearly 1/4 of the world’s people are troubled by insomnia, and insomnia patients account for more than 95% of sleep disorder patients, which has become the focus and difficulty of Chinese and Western medicine diagnosis and treatment. The combination of Chinese and Western medicine can complement each other’s strengths and be used flexibly. Insomnia is usually a subjective experience of patients who are not satisfied with the time or quality of sleep, and it affects their daytime social functions. Insomnia is classified according to its duration: acute insomnia (duration less than 4 weeks); subacute insomnia (duration greater than 4 weeks, less than 6 months); chronic insomnia (duration greater than 6 months). Acute insomnia, physiological insomnia, psychophysiological and other mild insomnia, by finding the cause and eliminating the trigger, insomnia symptoms will soon be relieved or disappear, and some even do not need drug treatment. For psychophysiological insomnia, paradoxical insomnia, poor sleep hygiene, etc., we use Chinese medicine’s emotion therapy such as overcoming emotion with emotion, language enlightenment, following emotion from desire, transferring emotion to sex, implying and solving confusion, and combining cognitive and behavioral therapy to achieve “sleep first, then sleep”. Cultivate good sleep habits, most patients will get better sleep. For those who need medication, choose a small dose of medication, the time should not exceed 3 weeks, most can be cured, should not be over-treated. Insomnia due to medical diseases, insomnia due to drug or substance abuse, insomnia due to mental disorders, etc., are usually subacute insomnia or chronic insomnia. For these patients with moderate or above, etiological treatment is the primary principle, and sedative-hypnotic drugs are the main clinical means of treatment. The dosage of western medicine can be gradually reduced or discontinued after the improvement of sleep by medium-dose drugs or antidepressants with sedative effect, together with Chinese medicine treatment for 2-3 months. If the above-mentioned treatment effect is not good, non-organic insomnia (insomnia), chronic insomnia severe, its cause is complex, long duration, a wide range of symptoms, taking more kinds of drugs, etc. resulting in highly unsatisfactory results, and has no confidence in sleep or fear, and seek medical help around to no avail, can be considered as persistent insomnia should be hospitalized systemic treatment.