I suffered from insomnia from age 10 to about age 69.
I had severe anxiety and PTSD that caused me to be unable to sleep; always was on guard looking for the next dangerous or stressful event about to happen. Anticipatory anxiety was also a nightmare.

Without medications, I would literally go for nights without sleeping and then end up in an ER with panic attacks or worse. Anyone who is sleep deprived long enough will end up in an ER due to panic attacks, psychosis, or other clinical symptoms of sleep deprivation and or anxiety.

It took me 20 years to finally find what worked best for me: propranolol.
It is a heart medication that worked best for my daytime anxiety and sleep when used with hydroxyzine (an antihistamine). I have also taken both Cymbalta for more than 20 years, as well as Buspirone for the last 4 years.

This is all taken for anxiety and PTSD from physical and sexual abuses as a child. I was abused for more than 15 years then sexually assaulted as an adult twice. Therefore I have complex PTSD, severe GAD and OCD.

The other thing I HAD to do was withdraw from anxiety provoking activity and situations. I had to learn what situations I could handle, realize how much I can handle, and learn what to stop doing that provokes anxiety in myself. Even if that means to stop doing things I loved to do. Example: I may love to take long road trips, LOVE driving for hours and hours, BUT arranging trips, paying for trips, sleeping in hotels on those long trips? : they produce anxiety even if I didn't realize it until I examined situations I needed to eliminate.

Now at 70 I think I have the anxiety and PTSD all sorted out. I and am sleeping 8-9 hours a night 9 out of 10 days, and avoid anything that causes anxiety. I have also learned that there will be anxiety producing situations that cannot be avoided or situations I just really WANT to do and with those things I have learned to be in control of how much and when I face them. I keep the anxiety "doses" short so that my GAD, PTSD and OCD symptoms stay in check and I don't lose sleep.