The article examines the problem of primary insomnia in older adults in Spain, focusing on its prevalence and health consequences. It highlights that, unlike secondary insomnia, primary insomnia has no identifiable cause and may be related to factors such as stress, emotional distress, travel and shift work. Using data from the Spanish National Institute of Statistics, the prevalence of insomnia in older adults is analysed, highlighting a higher incidence in women and the 75+ age group. The importance of addressing this problem is emphasised, as insomnia in older adults is associated with serious consequences such as depressive episodes, increased risk of falls, cognitive impairment and reduced quality of life. The study aims to comprehensively examine the management of primary insomnia in this population, evaluating the efficacy of various pharmacological treatments, such as cognitive behavioural therapy, benzodiazepines, benzodiazepine receptor agonists (Z-drugs), antidepressants, melatonin and other options. The pros and cons of each treatment are discussed, including special considerations for older adults. The article highlights the importance of future research to improve the understanding and management of chronic insomnia, underlining the need for large-scale studies of high methodological quality to establish appropriate pharmacological management.