Objective: To make the case that insomnia is better conceptualized, not as a symptom, but as a primary disorder.
Data sources: PubMed was searched from 1975-2009 using the search terms insomnia, insomnia and treatment, insomnia and cost, and insomnia and treatment and safety.
Study selection: English-language articles and other materials were selected to address the following claims: insomnia is unremitting, insomnia is disabling, insomnia is costly, insomnia is pervasive, insomnia is pernicious, and insomnia treatment is safe and effective.
Data extraction/synthesis: Insomnia, at least when chronic, should be conceptualized as a comorbid condition, one for which effective interventions are available.
Conclusions: It is speculated that treatment for insomnia will only become the norm when it has been demonstrated that treatment not only addresses the problem of insomnia but also serves to reduce medical and psychiatric morbidity. At that time, the question will no longer be "Why treat insomnia?" but instead "When isn't insomnia treatment indicated?"