One of the more challenging issues in working with an aging private practice is how to manage insomnia safely and effectively. By age 50-55, our livers and kidneys begin slowing down which means we are not breaking down medications as quickly and ending up with higher levels of medication and side effects; many times, these issues can be mitigated by lowering doses but as we age other factors come into play. In this article, I will list the major culprits in prescribing sleep medications to an older population, and then discuss safer sleep options.