OBJECTIVE: Insomnia is a common condition affecting millions of people across the United States. Most often it occurs in conjunction with other illnesses and is chronic in at least one-third of its cases. Studies have shown insomnia to be an underreported, underdiagnosed and undertreated problem. The purpose of this study is to report the recent patterns of health services and prescription use for insomnia among a state Medicaid population. METHODS: The design was a cross-sectional, descriptive study using Medicaid administrative claims data from calendar year 2003. Recipients with either a claim paid for a medical service with a diagnosis of insomnia, or a prescription claim with an NDC number for zolpidem, temazepam, estazolam, triazolam, quazepam, flurazepam, or zaleplon were selected. Rates of medical services use were calculated based on state recipient population figures for fiscal year 2002-2003. Dollars paid were from the perspective of Medicaid. RESULTS: There was a total sample of 13,161 recipients identified with insomnia, at a rate of 36.9 per 1000 recipients. A substantial majority of medical services utilization occurred in a physician office or outpatient clinic, with very few visits for this condition occurring in the emergency department or inpatient setting. The overall rate of office/clinic visits was 22.4 per 1000 recipients. The highest office/clinic visit rates by demographic groups occurred among recipients between 45 to 64 years of age (66.8 visits per 1000), females (22.5 visits per 1000), and whites (21.5 visits per 1000). The average cost per office/clinic visit was approximately $91. Among the prescription claims for drugs approved to treat insomnia, roughly 98 percent were for zolpidem. This particular drug cost Medicaid approximately $65 per claim. CONCLUSION: Office visit use for the treatment of insomnia varied by demographic groups. Zolpidem was used more extensively than other drugs approved for this condition.