How to Cure Insomnia? Treatments Ranked

You’ve tried everything. The melatonin, the magnesium, the darkened bedroom, the sleep hygiene lists. But you’re still awake at 2 a.m., wondering how to cure insomnia when nothing seems to work. Whether you’re in Vancouver, Surrey, Abbotsford, or anywhere across British Columbia, the advice feels the same, and equally ineffective.

Here’s the problem: most advice treats all insomnia treatments as equal. They’re not. The research shows a clear hierarchy. So instead of another exhaustive list, let’s rank them by what actually works for chronic insomnia.

Why Rankings Matter for How to Cure Insomnia

Not all treatments are created equal. Some show sustained improvement in research trials. Others do essentially nothing despite their popularity. The tier system matters because time matters; every month spent on ineffective approaches is another month of poor sleep and mounting frustration.

Context still matters, but on average, the hierarchy holds. Let’s start at the top.

Quick Reference: Insomnia Treatments Ranked

A-Tier: CBT-I (The Gold Standard for How to Cure Insomnia)

There’s only one treatment in A-tier. CBT-I with ACT Solutions stands alone at the top.

Every major medical organization recommends Cognitive Behavioral Therapy for Insomnia as first-line treatment. Not as one option, as the first option. Why? CBT-I produces clinically significant improvements in 50-75% of patients, and the results last. Follow-ups show benefits persisting months and years after treatment ends.

How it works: CBT-I retrains your sleep system through specific interventions. Sleep restriction creates mild sleep deprivation, consolidating fragmented sleep. Stimulus control re-associates your bed with sleep instead of wakefulness. Cognitive restructuring addresses anxious thoughts that fuel nighttime arousal.

Treatment runs 6-8 sessions. When combined with acceptance-based approaches like ACT, it becomes even more robust. You can learn more in our comprehensive guide to CBT-I treatment.

The catch: There’s a shortage of trained CBT-I therapists in BC and across Canada. However, many therapists now offer online sessions throughout British Columbia, making evidence-based treatment accessible whether you’re in the Fraser Valley, Metro Vancouver, or elsewhere in the province. CBT-I requires commitment over several weeks, but it works without side effects, addressing mechanisms rather than just symptoms.

B-Tier: Medication (Helpful But Limited)

Medication for insomnia occupies complicated territory. In the right context, it can be helpful. But it’s firmly B-tier for a reason.

When it makes sense: Short-term insomnia from acute stress. Severe insomnia that prevents engaging with behavioral treatment. As a bridge while setting up CBT-I. Several medication classes are FDA-approved: benzodiazepine receptor agonists, melatonin receptor agonists, orexin receptor antagonists, and low-dose doxepin.

Why it’s not A-tier: Medication suppresses symptoms without addressing underlying mechanisms. Stop the medication, insomnia typically returns. Studies show behavioral treatments outperform medication long-term. Side effects include morning grogginess, cognitive impairment, potential dependency, and rare complex sleep behaviors.

The reality check: Not all sleep meds perform equally. Over-the-counter antihistamines have weak evidence and notable side effects. Some are effectively C or D-tier despite being widely used. Medication decisions need individualization with a provider who understands both medications and behavioral alternatives.

C-Tier: Sleep Hygiene (Helpful But Insufficient Alone)

Sleep hygiene might be the most oversold treatment in sleep medicine. It’s not useless—but it’s far less effective than most people assume.

What it is: Behavioral and environmental recommendations like consistent schedules, dark cool bedrooms, avoiding caffeine, not watching TV in bed, exercising regularly. The principles are sensible and some have solid research backing.

The problem: Treating it as a cure for insomnia. Research shows sleep hygiene education alone produces small to medium effects—considerably less effective than CBT-I. The American Academy of Sleep Medicine specifically recommends against using sleep hygiene as standalone treatment for chronic insomnia.

Why it fails alone: Chronic insomnia persists because of specific mechanisms—conditioned arousal in bed, irregular schedules, anxious thoughts about sleep. Sleep hygiene doesn’t address these. Most people with chronic insomnia already know the principles. They’ve optimized their environment. The insomnia persists anyway.

Sleep hygiene is essential as a component of multicomponent treatment. But as a standalone cure? C-tier at best.

D-Tier: Supplements (Minimal Evidence, Minimal Effect)

Supplements are heavily marketed, widely used, and minimally effective for most people with chronic insomnia.

Melatonin: Helps with circadian rhythm disorders: jet lag, shift work. For chronic insomnia in adults? Mixed evidence showing modest effects; usually 7-12 minutes improvement in sleep onset. That might help mild difficulties but won’t cure chronic insomnia.

Magnesium: Theoretical mechanisms exist, and some studies show benefits particularly in older adults or people with deficiencies. But evidence overall is inconsistent. Effects are modest at best.

Other supplements: Valerian, L-theanine, glycine, chamomile—even thinner evidence. Small studies, inconsistent results, minimal effects.

Why they fail: Supplements don’t address the behavioral and cognitive patterns maintaining chronic insomnia. They might produce mild sedation but won’t retrain your sleep system or address conditioned arousal. Supplement quality also varies wildly since the FDA doesn’t regulate them like medications.

Unranked: Sleep Hacks and “Gutting Through It”

Some approaches don’t make the tier list. They’re untested, viral-trend-driven, or actively counterproductive.

Viral sleep hacks: Social media has given us lettuce water, mouth taping, weighted blankets, grounding sheets, bed rotting, and countless other hacks. A recent survey found over 40% of Americans have tried viral sleep trends. Most are unproven at best, potentially dangerous at worst. The sleepmaxxing trend represents people prioritizing sleep, which is positive, but quick fixes often delay people from seeking what actually works. Additionally, trying very hard to optimize sleep can actually have the counterintuitive effect of worsening insomnia.

Gutting through it: Just toughing it out makes chronic insomnia worse. Your bed becomes associated with wakefulness. Anxiety increases. Compensatory behaviors develop that fragment sleep further. It’s not treatment—it’s allowing a treatable condition to worsen.

How to Choose the Right Treatment to Cure Your Insomnia

Start with A-tier unless you have a specific reason not to. CBT-I works for most people with chronic insomnia, whether it’s primary insomnia or related to other conditions.

If CBT-I isn’t accessible locally, consider online programs or app-based CBT-I. Digital is far more effective than cycling through C and D-tier options. Medication makes sense as a bridge—starting while you arrange CBT-I, or during difficult periods while maintaining behavioral treatment. Combining medication with CBT-I can be more effective than either alone.

Sleep hygiene and supplements can support other treatments but shouldn’t be your primary strategy. If you’re wondering what to expect in your first session, the initial appointment involves detailed sleep history and collaborative goal-setting.

The pattern many people follow—trying supplements, then sleep hygiene, then giving up—is backwards. Start with what works.

The Bottom Line on How to Cure Insomnia

The hierarchy reflects decades of research. CBT-I works better than anything else for chronic insomnia. Medication works short-term but doesn’t address underlying mechanisms. Sleep hygiene is helpful but insufficient alone. Supplements show minimal effects. Viral hacks are mostly noise.

You don’t have to try everything. Chronic insomnia is genuinely treatable, not just manageable. If lower-tier treatments haven’t helped, that’s not failure—it’s the predictable outcome of starting with less effective approaches. Understanding why therapy is the missing piece in treating insomnia can shift your perspective from “I’ve tried everything” to “I haven’t tried the most effective thing yet.”

Start at the top. If you need support finding effective insomnia treatment in British Columbia—whether you’re in Surrey, Abbotsford, Langley, Chilliwack, or anywhere in the Fraser Valley and Metro Vancouver—book a consultation to discuss whether CBT-I is right for you.