Insomnia is a complaint that often presents a challenge to primary care physicians. Unfortunately, insomnia has no simple objective diagnostic test, so physicians must rely on other techniques to make a diagnosis. One key to diagnosis is the ability to elicit information quickly and accurately. Sleep history, sleep logs, actigraphy, medications, and when needed, referral to sleep specialists, can aid management. Many nonpharmacologic and drug therapies exist for treatment. Over-the-counter medications and supplements may have some limited utility. Newer agents that target specific receptors are being developed and may offer benefit to patients in the future.