OBJECTIVES: Using data from the Medical Expenditure Panel Survey (MEPS), we assessed quality-of-life (QoL) scores associated with insomnia and hypnotic use.   METHODS: Dependent variables were the mental component summary (MCS) and physical component summary (PCS) scores from the 12-item Short-Form Health Survey (SF-12).   These summary scores are standardized to 1998 population norms (mean = 50; SD = 10). Multivariate regression analyses were used to compare cohorts while controlling for demographic and clinical characteristics.  RESULTS: Of 104,274 adults in MEPS from 2005 through 2009, about 1.4% (n=1,401) had a diagnosis of insomnia.  Among those with a diagnosis, 45.6% (n = 639) used a prescription hypnotic. The mean PCS scores were 9.2 points lower for subjects with insomnia than without insomnia (PCS: 40.6 ± SE0.5; PCS: 49.8 ± SE0.1, p <0.001), while the mean MCS scores were 6.9 points lower between the two groups (MCS: 44.1 ± SE0.1, MCS = 51.0 + SE0.1; p <0.001). After controlling for demographic and clinical characteristics, the difference remained significant (PCS: 5.1 points lower; MCS: 6.2 points lower; p<0.001). There was no difference in mean scores for insomnia patients who used hypnotics (n = 639; PCS: 40.6 ± SE0.8; MCS: 44.3 ± SE0.6) compared to those not using hypnotics (n = 762; PCS: 40.6 ± SE0.7, MCS: 43.9 ± SE0.5).  CONCLUSIONS: Although patients with a diagnosis for insomnia had significantly lower physical and psychological QoL summary scores compared to those without this diagnosis, differences were not seen for those with a diagnosis and a prescription hypnotic compared to those with a diagnosis and no prescription hypnotic.  Regression was used to control for differences in cohorts, but selection bias may still be a concern.  Using a ‘before and after therapy’ design, with patients serving as their own controls is an important next step.