Expert bodies have long advised that use of hypnotic drugs should be limited to short courses for acutely distressed patients and should generally be avoided in elderly people. Despite this, more than 10 million prescriptions for hypnotics continue to be dispensed each year in England alone, mostly for benzodiazepines and drugs with similar actions such as zaleplon, zolpidem and zopiclone (so called 'Z-drugs'). Around 80% of all such prescriptions are for people aged 65 years or over, and many patients remain on the drugs for months or years. Such prescribing carries many potential hazards for patients, including risk of dependence, accidents and other adverse effects on health. Here we review how the risks from hypnotic drugs can be minimised.