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Insomnia guide

Insomnia treatment online in Virginia and West Virginia

This guide is for trouble falling asleep, staying asleep, or waking up too early. Care is built around CBT-I (cognitive behavioral therapy for insomnia) and sleep hygiene as the real fix, with non-controlled medication as an adjunct when appropriate. We never prescribe Ambien, Lunesta, Sonata, any other z-drug, or any benzodiazepine, in this visit or anywhere on QuickVisitMD. Any thoughts of self-harm are always directed to 988 and in-person care, not treated online.

Start online

Start a $59 online review for Insomnia (trouble sleeping).

If you're struggling to fall asleep, stay asleep, or wake up feeling rested, online review can help you build a real plan, starting with CBT-I and sleep hygiene, and adding a non-controlled medication like trazodone, hydroxyzine, ramelteon, or low-dose doxepin if appropriate. We screen for sleep apnea, mood symptoms, and mania before recommending any medication, and we never prescribe zolpidem, eszopiclone, zaleplon, or any benzodiazepine, no Ambien, no z-drugs, no benzos, ever.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

Start this visitSee response times

Quick facts

  • You must be physically located in Virginia or West Virginia at the time of request.
  • Starts at $59
  • No insurance needed
  • No app download
  • Physician review around the clock
  • Non-controlled prescriptions can be sent to your pharmacy when appropriate
  • A work or school note can be included when medically appropriate
  • Response times apply 24/7, every day

Common symptoms

  • Trouble falling asleep
  • Waking up during the night and struggling to fall back asleep
  • Waking up too early
  • Sleep that doesn't feel refreshing, or daytime fatigue from poor sleep

May fit online care

  • Adults 18 and older
  • Trouble sleeping without loud snoring, witnessed breathing pauses, or significant daytime sleepiness
  • No depressed mood, loss of interest/pleasure, or thoughts of self-harm
  • No signs of mania (decreased need for sleep with high energy or racing thoughts)
  • Willingness to start CBT-I and sleep hygiene as the core of the plan

Look for another care setting

  • Loud snoring, witnessed pauses in breathing, or significant daytime sleepiness (needs a sleep study first)
  • Feeling down, depressed, or hopeless, or losing interest in things you used to enjoy (needs a mood-focused visit)
  • Any thoughts of being better off dead or of self-harm (this needs crisis support: call or text 988, or text HOME to 741741, or call 911/go to the ER; it is not treated through this visit)
  • Needing much less sleep while having unusually high energy or racing thoughts (needs in-person evaluation)
  • Looking for Ambien, Lunesta, Sonata, or a benzodiazepine. These are never prescribed here

What to have ready

  • What's happening with your sleep, and for how long
  • Whether you snore loudly or anyone has witnessed you stop breathing during sleep
  • Whether you've felt down, depressed, or lost interest in things lately
  • Whether you drink alcohol regularly or work night shifts / drive commercially
  • Your age (this changes which medication is preferred)

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer a few questions to check that this visit fits you, and choose how fast you want an answer (the response window). If your concern still fits this service, a physician reviews it and sends you a secure update after you sign in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

What if I'm having thoughts of harming myself?

Please reach out for help right now. You are not alone and support is available 24/7. Call or text 988 (the Suicide & Crisis Lifeline), or text HOME to 741741 (the Crisis Text Line). If you are in immediate danger, call 911 or go to the nearest emergency room. This visit does not treat sleep concerns when these thoughts are present; instead it connects you with crisis support and in-person care, which is the safest step.

Why won't you prescribe Ambien or a benzodiazepine for my insomnia?

Zolpidem (Ambien), eszopiclone (Lunesta), zaleplon (Sonata), and benzodiazepines are all federally controlled substances with real risks of dependence, next-day impairment, and misuse. QuickVisitMD does not prescribe any controlled substance, on this visit or any other. That's true for every patient, not a case-by-case decision. Instead, we offer non-controlled options (trazodone, hydroxyzine, ramelteon, low-dose doxepin) alongside CBT-I, which has the best long-term evidence for treating insomnia.

What is CBT-I, and why does it matter more than medication?

CBT-I (cognitive behavioral therapy for insomnia) is a structured program that changes the habits and thought patterns that keep insomnia going: things like sleep hygiene, stimulus control, and adjusting time in bed. It has been shown to work as well as or better than medication for chronic insomnia, without the side effects or dependence risk. We provide sleep hygiene guidance and point you to reputable CBT-I resources, like the free VA/DoD 'CBT-i Coach' app, as the foundation of your plan.

Why do you ask about snoring, mood, and energy levels?

Insomnia can sometimes be a symptom of something else that needs a different kind of care. Loud snoring with witnessed breathing pauses can signal sleep apnea, which needs a sleep study before any sedating medication. Low mood or loss of interest can signal depression, which is better treated through a mood-focused visit. Needing much less sleep while having unusually high energy can signal mania, which needs prompt in-person evaluation. Screening for these keeps your treatment safe and appropriate.

Other conditions we treat

Not quite what you have? Here are other conditions we treat.

Adult ADHD (non-stimulant)Anxiety & depressionGrief and adjustment supportPanic attacksPerformance anxietyPostpartum mood support
Technical help

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