Insomnia is underdiagnosed and undertreated in older patients. Self-treatment with alcohol or over-the-counter products containing first-generation antihistamines is common, resulting in suboptimal sleep patterns. For these patients, identifying sleep hygiene issues can raise awareness of sleep patterns that need to be changed. Cognitive behavioral therapy has proven efficacy as first-line treatment for insomnia. Not all patients, however, respond to nonpharmacologic treatment alone. Therefore, supplementing a patient’s nonpharmacologic treatment with a pharmacologic agent might become necessary. The risks of the pharmacologic agent need to be balanced with its benefits, and the patient’s age and sleep pattern should be taken into account when selecting the optimal dose. The desired results of this activity are to update primary care practitioners on current treatments options for insomnia in the older adult.