Insomnia is a symptom requiring medical investigation and the elimination of external and physical causes. Anxiety and/or depression have been shown to be present in most of the patients complaining of inability to sleep. Antidepressant medication with sedating potential is very effective in patients with depressive symptoms when most of the dose is given at bed-time. Most of the sedative-hypnotic drugs disturb the qualitative aspects of sleep and many rapidly produce tolerance. Flurazepam has been shown to be the drug of choice for purely symptomatic insomnia. Except in very transient situational stresses, a psychotherapeutic relationship to investigate the causes of the insomnia may be the most important aspect of the treatment program.