Cheers guys!
I'm celebrating my (approx) one million year aniversary as a Sonar user and have never had this issue before

But UAC is off - first thing I do because I hate it. I OK through the "Blah Blah Blah..." dialogue and Sonar doesn't actually do anything when I click OK other than taking the box away and start up as normal. This have only showed up once after install previously - as expected (or is that a driver thing that usually pops up?). It's a complete re-install from scratch, which I do twice a year because I have a tendency to mess up my system and it's an old habbit from the XP days. Anyway, registry is fine. No new hardware and there's actually a lot less software installed. I don't think VSTs cause this anyway.
That Ctrl thing is something I will look into however. But don't know what it could do since I'm actually not launching with a hot key. Just the good old double click.