The National Institute for Health and Clinical
Excellence (NICE) guideline for treatment
of insomnia suggests non-pharmacological
interventions should take priority. This article
discusses the rationale for this and grounds it in
the evidence for and against pharmacological
intervention. Different defi nitions of primary
insomnia are elaborated alongside current
understanding of normal sleep. Prescribing
decisions are considered against this backdrop
and it is concluded that optimal treatment
will take place within an evidence-based
concordant partnership.