Insomnia is a subjective complaint of poor sleep that may lead to problems with daytime functioning. Sedatives and hypnotics have been the treatments of choice for decades. Benzodiazepines have shown the most evidence for effective treatment. However, they have serious side effects which include falls, confusion, rebound insomnia, tolerance, and potential for abuse. There have been newer medications that have sought to be just as effective without the inherent side effects. Thoughts of treatment length, acute versus chronic, continue to be discussed. Diagnosis and management can be complex especially when patients have multiple comorbid conditions. This chapter will discuss the uses of hypnotics and sedatives for the treatment of insomnia. As well as outline appropriate management strategies for effective treatment outcomes.