Insomnia, or inability to sleep, is the most commonly reported sleep problem in the industrialized world. 1 Estimates suggest that between 40 and 70 million Americans are affected by either intermittent or chronic sleep problems, representing approximately 20 percent of the population. 2 The Sleep in America Poll, conducted by the National Sleep Foundation, revealed that almost 50 percent of people surveyed had complaints of frequent insomnia, but only 6 percent were formally diagnosed. 3 Moreover, approximately, 30 to 35 percent of respondents complained of nightly insomnia. 3 The most prevalent symptoms of insomnia, experienced at least a few nights a week by people with insomnia, include waking up feeling unrefreshed (34 percent) and being awake often during the night (32 percent). 3 The symptoms of difficulty falling asleep and waking up too early are less common, but still experienced at least a few nights a week by about one-fourth of adults with insomnia (23 to 24 percent). 3 Risk Factors for Insomnia Although some risk factors and etiologies of insomnia have been identified, the nature of the relationships has not been fully elucidated. Some risk factors for insomnia that have emerged from data related to insomnia include female gender 3 and old age. 4 Additional risks factors include less education, unemployment, separation or divorce, and medical illness. 1 Insomnia may be primary or secondary to other sleep problems and may be associated with a number of co-morbidities. An association has been found between insomnia and psychiatric (depression and anxiety) and psychological disorders. 4 There is increasing evidence that chronic insomnia may predispose individuals to the development of psychiatric disorders. 5-6 Persistent insomnia increases the risk of depression, substance abuse, and anxiety disorders. Environmental factors such as irregular sleep schedules, use of caffeine or other stimulants, co-morbid medical conditions, and/or shift work may also predispose vulnerable individuals to insomnia. Consequences of Insomnia Insomnia has significant direct and indirect effects on the health and wellness of affected individuals. Insomnia has been correlated with frequent use of medical services, 7-8 chronic health problems, 9-10 increased drug use, 7-8 and perceived poor health, 11 and has been associated with medical problems including heart disease, 12 hypertension, 13 and musculoskeletal problems. 12 The daytime consequences of chronic insomnia often include increased healthcare utilization, increased risk of depression, 14 poor memory, reduced concentration, poor work performance, and perceived or real risk of failure at work. 15 The economic implications of insomnia and