Background <p>We spend approximately one third of our lives sleeping. Sleep disorders are not only a&#xa0;frequent consequence but also a&#xa0;cause of various diseases and therefore also represent an important preventive and therapeutic issue in general practice.</p> Objective <p>The aim of this study was to investigate the prevalence of insomnia symptoms in urban and rural areas in Schleswig–Holstein, Germany.</p> Methods <p>This cross-sectional study was conducted between November 2023 and December 2023. A&#xa0;total of 5000 adult residents from rural areas (the islands Helgoland, Fehmarn, Amrum, and Föhr) and from an urban area (Kiel) were invited to participate in the survey. Data were analyzed using descriptive statistics, and inferential statistical methods were used for group comparisons.</p> Results <p>In total, 1427&#xa0;individuals participated in the survey (response rate: 28.5%). The mean age of participants was 56&#xa0;years, and 55% were female. Frequent or very frequent difficulties initiating sleep were reported by 19.3% (<i>n</i> = 275) of participants, while 33.2% (<i>n</i> = 473) reported frequent or very frequent difficulties maintaining sleep. At least two nocturnal voids (nocturia) were reported by 30.4% (<i>n</i> = 434). Overall, 18.3% (<i>n</i> = 261) rated their sleep quality as poor or very poor. Sleep medication was used occasionally by 8.3% (<i>n</i> = 119) and regularly by 2.5% (<i>n</i> = 36) of participants. The use of digital applications (e.g., sleep apps) was categorically rejected by 44.6% (<i>n</i> = 611). Overall, a&#xa0;significant regional difference was observed in the intention to use digital applications, with higher acceptance in urban area.</p> Conclusion <p>The results demonstrate a&#xa0;high prevalence of sleep-related complaints in Schleswig–Holstein that should be explicitly addressed in general practice consultations.</p>