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Pati­ents often report dif­fi­cul­ties fal­ling asleep and stay­ing asleep. Upon clo­ser inquiry, exter­nal fac­tors can some­ti­mes be the cau­se. Simp­le solu­ti­ons such as ear­plugs or a sleep mask can some­ti­mes help in the­se cases. Asses­sing the cau­se is important becau­se dif­fi­cul­ties fal­ling or stay­ing asleep that do not meet dia­gno­stic cri­te­ria of insom­nia dis­or­der are not neces­s­a­ri­ly impro­ved by the pro­gram.