Insomnia disorder is becoming increasingly common worldwide. It has become a major public health issue affecting health and social functioning. Compared with general population, clinical evidence for drug treatment in special populations such as elderly people, children and adolescents, pregnant women and patients with comorbid respiratory diseases is relatively insufficient. Moreover, due to differences in comorbidities or other physiological factors, this group of people is more sensitive to drug side effects. Therefore, it requires more individualized medication strategies during treatment. This review summarizes recent advances in the drug treatment of insomnia disorder in the special populations and synthesizes the medication use principles for special populations. It aims to provide reference for individualized medication for insomnia disorders in special populations, thereby improving sleep and daytime function.