Summary: Insomnia is the most common type of sleep disorder in older adults. General practitioners and organ specialists working with geriatric patients should routinely evaluate the quality and quantity of sleep and the presence of daytime symptoms indicative of insomnia. Sleep disturbances increase the risk of somatic and psychiatric morbidity and mortality in elderly patients. Insomnia contributes to an increased risk of self-treatment and use of medical services, accident rates and poor quality of life. In old age, insomnia usually coexists with multimorbidity, polypharmacy and geriatric deficits which may be predisposing, precipitating and maintaining factors of unhealthy sleep-related behaviors and abnormal circadian rhythms. Patient education, identification and modification of factors that may contribute to insomnia and poor sleep hygiene practices constitute the basis of comprehensive nonpharmacological treatment of insomnia. Pharmacological, symptomatic treatment of insomnia is allowed only after the implementation of non-pharmacological measures as a short-term auxiliary approach. Commercially available hypnotics and antidepressants with beneficial effects on circadian rhythms in older adults are associated with an increased risk of side effects and should be used with caution following analysis of potential interactions and risks in this population.