ASV Therapy for Insomnia

Inclusion Criteria: * ≥ 18 years old * Complaint of insomnia when presenting at clinic * Diagnosis of moderate to severe insomnia through the Insomnia Severity Index (ISI) with a score ≥ 15 * Meet diagnostic criteria of Insomnia Disorder (per American Academy of Sleep Medicine) * Naïve to treatment for sleep-disordered breathing (SDB), including CPAP, APAP, ASV; mandibular repositioning devices (MRDs), and any other nasal or oral therapy with a primary indication of treating SDB * Owns a smartphone and is able to install an application for HSAT data syncing. * Able to fully understand study information in English and sign informed consent Exclusion Criteria: * Primary complaint of sleep-disordered breathing or issues with apneas during sleep or excessive daytime sleepiness * Pregnant or planning to be pregnant * Any prior diagnosis of severe respiratory disorder or severe sleep disorder such as restless leg syndrome (RLS), idiopathic hypersomnia, or narcolepsy * High risk for moderate to severe OSA based on STOP-BANG score. * BMI \> 40 kg/m2 * Anticipated changes to start or stop sedative or psychotropic medications during the course of the trial. * Medical history of congestive heart failure (CHF) or other potentially unstable cardiac disease as well as chronic lung diseases or other debilitating medical conditions that manifest as more prominent in the patient's health compared to their sleep complaints. * Daily use of opiate medications * Known contraindications to PAP …