Objective: This study investigated the specific symptoms of insomnia that are associated with depression and anxiety in patients with insomnia.Methods: This study was a retrospective analysis of the data collected from 219 patients diagnosed with insomnia. The Insomnia Severity Index (ISI), Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory (BAI) were used to assess the severity of symptoms of insomnia, depression, and anxiety. Spearman’s rank correlation and multiple linear regression analyses were used to analyze the data.Results: All seven items of the ISI had a significant relationship with symptoms of depression and anxiety. Difficulty staying asleep and problems with sleep interfering with daily functioning had the greatest associations with the BDI-II total score. Problems with sleep interfering with daily functioning also had the highest correlation coefficient with the total BAI score. Multiple linear regression analysis showed that difficulty maintaining sleep and concerns about how others perceive sleep problems were significantly associated with depression. Difficulty falling asleep and problems with sleep interfering with daily functioning were significantly associated with anxiety.Conclusion: This study suggests that specific symptoms of insomnia are associated with depression and anxiety in patients with insomnia. These findings may help clinicians to better understand the relationship between specific insomnia and affective symptoms and develop targeted treatment strategies for patients with insomnia.