The treatment of insomnia is a complex problem, especially in elderly people. Currently, there are effective drugs to induce and maintain sleep due to their antihistamine or GABAergic properties. However, these drugs may worsen the daytime performance and can cause short- and long-term adverse events. A possible alternative is melatonin prolonged-release (melatonin PR) that mimics the natural secretion pattern of melatonin. This agent significantly improves clinically sleep latency and quality, as well as next-day morning alertness, and quality of life. In clinical trials, melatonin PR 2 mg was very well tolerated in elderly patients, with a tolerability profile that was similar to placebo. Short- or long-term treatment with melatonin PR 2 mg was not associated with dependence, tolerance, rebound insomnia, or withdrawal symptoms.