Insomnia is a condition in which a patient complains of difficulty falling asleep, difficulty maintaining sleep, and poor sleep quality, which in turn leads to some form of daytime dysfunction, despite having adequate sleep conditions. Insomnia can occur in all age groups of people of all races, and according to the survey, about 27% of people worldwide have sleep problems. The main manifestations of insomnia are: difficulty falling asleep, difficulty maintaining sleep (≥2 awakenings throughout the night), early awakenings —- (total time <6 hours and difficulty falling asleep after waking), loss of sleepiness (feeling that you have not slept all night), decreased sleep quality, no sense of recovery after sleep, and no relief from fatigue. It may be accompanied by daytime loss of energy and may cause physical dysfunction or significant discomfort. Daytime hypofunction: fatigue or general malaise; reduced attention, attention maintenance, or memory; reduced ability to learn, work, or socialize; mood swings or irritability; daytime sleepiness; reduced interest or energy; increased tendency to make mistakes at work or while driving; tension, headache, dizziness, or other somatic symptoms associated with sleep deprivation. After a detailed outpatient consultation, secondary insomnia due to organic disease should be ruled out first for the first visit. This usually includes most notably sleep breathing disorders, sleep movement disorders or circadian rhythm sleep disorders; or insomnia due to medical or psychiatric disorders; or insomnia due to medications. Physical examination: focus on the eyes, ears, nose, throat, neck, and blood pressure. If there is an organic problem, the original disease found should be dealt with promptly. If there is no problem with any of the above, their primary insomnia is more likely and they should further understand the variety and efficacy of previous medications and give systematic treatment recommendations: (1) Over-the-counter medications: The most commonly used are antihistamines. The efficacy of these drugs has not been systematically observed, and the adverse effects caused by these drugs are noteworthy. (2) Prescription drugs: phenobarbital. Phenobarbital, introduced in the 1920s, has been withdrawn from the category of sedative-hypnotic drugs. Due to their high addictive potential and poor safety, doctors should no longer use them as hypnotic drugs under any circumstances. Benzodiazepines: are non-selective agonists of the GABA receptor complex, and also have anxiolytic, muscle relaxant and anticonvulsant effects. Can shorten sleep latency and prolong total sleep time, but also affect normal sleep physiology. It can lead to daytime sleepiness, impaired cognitive and psychomotor function, rebound and withdrawal symptoms. Long-term heavy use can produce dependence. Long half-life drugs have a more significant effect on psychomotor and cognitive function the day after the drug is taken. Short half-life drugs have more severe rebound and withdrawal symptoms upon discontinuation. Benzodiazepines are not advocated as the first choice for treating patients with first-time sleep disorders. Treatment of short-term sleep disorders generally favors the use of short half-life drugs as much as possible, which should not be used for >12 weeks and should be tapered at the time of discontinuation. For patients with intractable sleep disorders, long half-life drugs should be used, but special attention should be paid to whether the patient has significant symptoms of sleepiness, fatigue, forgetfulness, and psychomotor dysfunction the day after taking the drug. In fact, many patients are using “Valium” to cure insomnia, but patients who use Valium year-round, especially the elderly, the incidence of dementia and other cognitive decline is 50% higher than the average person. The main drugs include: diazepam, clonazepam, alprazolam, midazolam, lorazepam and so on. The emergence of non-benzodiazepine zolpidem, zopiclone, and zaleplon has gradually replaced the traditional tranquilizers and has become the drug of choice for the treatment of sleep disorders. They are all selective GABA receptor agonists, and therefore have no anxiolytic, muscle relaxant or anticonvulsant effects. They do not affect the normal sleep physiology of healthy people, and can even improve the sleep physiology of patients with sleep disorders. Safety and effectiveness are better than traditional tranquilizers, so it is recommended! Antidepressants: Their use is gradually increasing, especially as many people have sleep problems stemming from the stresses and bad moods of daily life. For patients with accompanying poor mood, the use of antidepressants with sedative-hypnotic effects is a double whammy. Trazodone is currently the most used and can significantly improve various sleep parameters with stable short-term application, but there is a lack of long-term research data. Mirtazapine is useful for sleep improvement and has been shown to improve appetite and gastrointestinal malfunction. Patients with refractory intractable insomnia can also be augmented with small doses of atypical antipsychotics that have sedative-hypnotic effects.