Cognitive-behavioral models for both insomnia and pain are well established. Few studies have addressed the cognitive-behavioral aspects of these conditions occurring together with a unified model. Worry, rumination, catastrophizing, monitoring, misperceptions, dysfunctional beliefs, and safety behaviors are reviewed. Sleep hygiene among those with co-occurring pain and insomnia is also discussed. It is proposed that more concerted efforts are needed to develop an integrated cognitive-behavioral model to address insomnia and pain as a complex integrated phenomenon.