Abstract: Insomnia is a common sleep disorder that significantly impacts daily functioning and overall health. Traditional treatments, including Cognitive Behavioral Therapy for Insomnia （CBT-I） and pharmacotherapy, are widely used； however, anesthesiology, as an emerging treatment modality, has shown promising potential due to its precise drug management and unique technical advantages. Anesthesiologists can offer personalized treatments using sedative-hypnotic drugs and nerve block techniques, particularly for chronic and refractory insomnia. Innovations such as propofol, dexmedetomidine, and stellate ganglion block have been shown to regulate sleep architecture, improve sleep quality, and quickly reverse sleep deprivation, breaking the vicious cycle of insomnia. Despite these promising results, challenges remain, including technical complexity, the need for standardized protocols, and long-term efficacy evaluation. In the future, with the standardization of anesthetic techniques, multidisciplinary collaboration, and the integration of emerging technologies, anesthesiology is expected to play a greater role in insomnia treatment.