<p>This study qualitatively examines the lived experiences during early recovery from alcohol dependence with comorbid insomnia in Ukraine and Germany. The primary aim was to explore the perceived causes of insomnia and alcohol dependence from the patients’ perspective, as well as their expectations regarding the diagnostic (secondary aim) and treatment (tertiary aim) process. Twenty-seven individual semi-structured interviews were conducted (12 in Ukraine and 15 in Germany). All interviews were digitally recorded for transcription, and the transcripts were analyzed using thematic analysis to identify themes. Themes emerging from the transcripts were stress-related (due to family/relationships, work, or a combination of both) and alcohol-related (detoxification, relapse, and consumption) factors as the most frequently cited perceived causes of insomnia. Stress-related (family, work, or combination of both) and societal-related (friends) factors were the most frequently cited perceived causes of alcohol dependence. Patients wanted to be asked and to understand why they were unable to sleep. They also wanted to have their insomnia symptoms taken seriously by validating their concerns rather than dismissing them, as well as being treated with medication. This qualitative study sheds light on patients’ perceptions of the perceived causes of their insomnia and alcohol dependence, which may facilitate more effective communication in clinical practice and support faster initiation of treatment.</p>