【】Chronic insomnia has become common complaints among people today, which leads to health problems and additional financial burdens. Although cognitive behavior therapy for insomnia is considered as the first-line treatment, its limited accessibility, high cost and poor patient adherence limit its clinical application. Traditional pharmacological therapies for insomnia have limited long time efficacy. This review explores innovative anesthetic-based therapies, including pharmacological therapies like dexmedetomidine, propofol, ketamine,esketamine and benzodiazepines, and non-pharmacological techniques like stellate ganglion block, nerve blocks, and acupuncture, thus providing new perspectives for research of the treatment of chronic insomnia.