If your insomnia has become chronic -- 3 or more nights a week with too little sleep for 3 months or more -- then your quality of life suffers, at home and work. As you seek treatment to return to your restful sleep, remember that it can cost you thousands of dollars each year. It’s important to manage your treatment expenses and look for safe self-help options.
Getting a Diagnosis
Your regular doctor may diagnose your chronic insomnia during your annual physical or a special office visit. Your doctor will get detailed medical and sleep history, do a physical exam, and may take a blood sample to check for conditions related to poor sleep.
If you have private insurance that considers a physical to be preventive care, a regular doctor visit may cost you nothing. State Medicaid programs also may cover the checkup at little or no cost. But if you are uninsured or have Medicare (which does not pay for annual physicals), a regular doctor visit in the U.S. usually costs $100 to $200.
Tip: The American Academy of Sleep Medicine (AASM) has an online database of nearby sleep specialists; check first with your health insurer to make sure the center and its doctors are in-network. A consultation visit typically costs $150 to $300 before insurance.
The sleep specialist then may ask you to complete a questionnaire and keep a detailed log of your sleep patterns for a week or two. If the cause of your sleep problems remains unclear, your doctor may then recommend a sleep study called a polysomnogram, or PSG. (Note that PSGs are tried less often in an insomnia diagnosis than with other sleep disorders).
A PSG usually is an overnight test at a sleep center. During the test, monitors measure the start and length of your sleep stages and interruptions, and track your vital signs. As for cost, online research shows overnight PSGs priced at $1,000 to $2,000 per night, most of which private insurers and Medicare cover. You can also ask your doctor about tests you can do at home.
Tips: Verify in advance if you need to show certain symptoms for the PSG to be covered. Also, if you don’t have insurance, the AASM has a web page listing organizations that could offer financial help.
Therapies That Can Help
If your problem with falling asleep has been long-lasting, your doctor may turn to cognitive behavioral therapy (CBT) before prescribing drugs. The goal of CBT is to identify thoughts and behaviors that interfere with your sleep, then to develop habits to overcome them. For example, a therapist might have you set consistent bedtimes and avoid naps, leave your bed if you can’t fall asleep, and practice relaxation techniques.
In the U.S., a session of therapy like CBT typically costs $100 to $200. Check whether your insurance plan covers any or all of the cost.
When Medication Is Needed
Sleep medications are not a first choice for treating insomnia, and your doctor will not want you taking them all the time. They are typically used along with CBT. However, your doctor may recommend them occasionally and only for short periods.
Medications often prescribed for insomnia include:
- Eszopiclone (Lunesta). Like other prescription sleep medications, this should be covered by private insurance, Medicare, and Medicaid. However, a copay (typically 30%) will apply. And, if you don’t have insurance, you have to cover the entire cost. That’s why it’s smart to shop online for the best price at competing pharmacies. You can find a standard 30-day prescription for eszopiclone online for as little as $9.90 after discount coupons (a $2.97 copay).
- Ramelteon (Rozerem). The best online price is around $64.40 ($19.32 copay).
- Zaleplon (Sonata). An online search finds it at $9.30 ($2.79 copay).
- Zolpidem (Ambien, Edluar, Intermezzo, Zolpimist). You can find a 1-month prescription online as inexpensive as $10.20 ($3.06 copay).
- Doxepin (Silenor). The best deal online was $8.87.
- Suvorexant (Belsomra). The best online price for this medication was $381.35.
- Lemborexant (Dayvigo). It is another expensive drug, with the low online price at $294.11.
- Benzodiazepines, a class of anti-anxiety drugs sometimes prescribed for other uses like insomnia. One common benzodiazepine, diazepam (Valium), can be found online for just $5.96.
Alternatives to Traditional Medicine
Doctors don’t recommend taking over-the-counter, nonprescription sleep medication because of their possible side effects. Some people like to take melatonin supplements. Melatonin is a hormone your body produces that promotes sleep. But you should ask your doctor before taking it.
An online search found a bottle of 60 melatonin lozenges for just $3. Even at a low price, you might save money by checking with your doctor and health insurer. Under the Affordable Care Act, certain OTC products like sleep aids must be covered 100% if a doctor prescribes them.
Valerian is another sleep aid you can buy without a prescription. As with melatonin, check with your doctor first. A bottle of 60 valerian capsules was priced online recently for $3.19.
Treatments and therapies that can help with chronic insomnia include:
- Acupuncture. Your doctor can refer you to a qualified local practitioner. Find out if your insurance plan covers acupuncture only for pain relief or also to help with sleep disorders. One study reports the median U.S. out-of-pocket prices are $112 for a first session and $80 for each follow-up session.
- Yoga. Your gym may offer classes for free. If not, you may pay $10 to $25 per session at a local studio.
- Tai chi. The local YMCA or community center might have lessons for just $10 to $15. But private sessions could cost you $50 to $120 each.
- Meditation. It’s easy to find free sessions offered in your community or online.
Missing Time at Work
According to the American Psychiatric Association, an average person with insomnia loses 11.3 days of work productivity per year. If half of those days were for missed time and half for lower productivity, and you earn $80,000 per year -- and if you already used up all your vacation, sick, and personal days for the year -- then your insomnia would reduce your pre-tax income by about $1,585.
