Elderly people often suffer from insomnia which is responsible for high comorbidity and lower quality of life in this population. Somatic and psychiatric pathologies must be screened as primary sleep disorders. Chronic sleep disorders and benzodiazepine abuse might be avoided by an early treatment of causal factors. We wished to propose here a practical approach of the insomnia in the elderly going from the diagnosis to the treatment by advancing the not pharmacological approaches, while specifying at best the place of different drugs available and their limits.