Compare Sleep Apnea Medications: Side Effects, Cost, OTC vs Prescription

Written by Rebecca Farley | Reviewed by a licensed U.S. pharmacist | Posted December 03, 2020 | Updated November 19, 2021

Sleep apnea is a common sleep disorder that happens as a result of minor respiratory failure. Sleep apnea can either be obstructive — something is literally blocking the windpipe — or central, which means the body fails to remind itself to breathe, a cruel twist on a classic joke. People with sleep apnea often snore or make other signs of respiratory distress while sleeping. Respiratory distress disrupts sleep, leading to exhaustion, fatigue, or drowsiness during waking hours in the short term. In the long term, sleep apnea comes with a host of consequences, including high blood pressure (hypertension) and diabetes. According to the Cleveland Clinic, it occurs in nearly 25% of males and 10% of females. A 2017 study found that it was increasingly prevalent among male veterans.

Sleep apnea is a common condition with many treatments, some cheaper than others. Because sleep apnea has many causal factors, treatments range from lifestyle changes to oral devices to prescription stimulants. First-line therapy for Obstructive Sleep Apnea (OSA), according to the American Sleep Apnea Association, is oral appliance therapy, which involves sleeping with an oral appliance that keeps the airway unobstructed. A higher-level treatment: Positive Airway Pressure machines, expensive Rx-only gadgets. Prescription stimulants are also very expensive with obvious hairy side effects, while lifestyle changes can take a lot of work without much change.

Sleep Apnea Medication Costs

The cheapest sleep apnea medication is available over-the-counter. Unisom or Sominex both retail for under $10 at chain pharmacies like Walmart. Prescription sleep aids are much more expensive. Modafinil, one sleep aid, averages over $500 for a month’s worth of the medication, according to GoodRx.

Comparing Sleep Apnea Medications: OTC vs. Prescription

Drug (generic name) Strength Quantity U.S. Price PharmacyChecker Discount Card Price OTC or Prescription? Percentage Discount
Modafinil (generic) 100mg 30 tablets $567.32 $20.82 Rx only 96%
Armodafinil (generic) 250mg 30 tablets $476.97 $20.16 Rx only 96%
SUNOSI (Solriamfetol) 150mg 30 tablets $790.20 $658.46 Rx only 17%
Sominex (Diphenhydramine) 50mg 32 tablets $5.97 N/A Over-the-counter N/A
Unisom (Doxylamine succinate) 25mg 32 tablets $7.89 N/A Over-the-counter N/A

Average prices of prescription drugs calculated by GoodRx. Over-the-counter medication prices from big box pharmacies like Target, Walmart, and CVS. PharmacyChecker Discount Card Prices based on pharmacies near the ZIP code 85351.

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Can I buy prescription medication for sleep apnea from PharmacyChecker-accredited international pharmacies?

Prescription medications for sleep apnea are stimulants, which fall under the FDA’s controlled medicine umbrella. In other words, the FDA will not approve of you bringing a prescription stimulant over a border, though the agency does turn a blind eye to personal imports of less addictive drugs. PharmacyChecker does not verify any mail-order pharmacy that markets controlled medications. This includes drugs like Adderall, Ritalin, Xanax, and Valium.

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Will my insurance cover prescription medications for sleep apnea?

Most health plans do cover armodafinil and modafinil, but higher-end drugs like Sunosi, which is a more recent FDA approval, may be harder to get covered. In some cases, you may have to get reauthorization after a year of treatment.

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What is oral appliance therapy?

Oral appliance therapy is the first-line therapy for OSA. It will be the first thing your doctor offers after you have been diagnosed with OSA. These appliances are generally cheaper than Continuous Positive Airway Pressure (CPAP) machines, which are several hundred dollars. In general, because they are so cheap, your health insurance will cover oral appliances.

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What is a PAP machine? Can I get my insurance to cover a CPAP machine?

A Positive Airway Pressure machine is an appliance that supplies continuous air to the windpipe during sleep. Per the American Sleep Apnea Association, PAPs can be continuous (CPAP) or bilevel (BiPAP). These pressure machines deliver instant relief to those suffering from sleep apnea. They are not cheap! PAP machines can be up to $1,000, although the average price is closer to $850, according to the American Sleep Association. A travel-sized PAP can be as little as $200.

CPAP machines are technically medical devices, not prescription drugs, although you will need a prescription to purchase one. Coverage for CPAP machines is listed as “durable medical equipment (DME) coverage” in your plan’s info sheet. Most health plans allow for some coverage of DME, but this varies greatly from plan to plan. DME can range from canes to wheelchairs to colostomy equipment — in general, if you need to use a DME, you should build your health insurance plan around it. That is, if you plan on using health insurance at all.

Medicare will cover 80% of the cost of the machine, but enrollees will have to buy the tube and the mask, both essential components of the device. Additionally, Medicare will require that you rent the machine, not purchase it.

Without health insurance, CPAP machines can be several hundred dollars, although you may find a low-tech one for around $300.

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Where are my sleep apnea medications manufactured?

Modafinil and armodafinil sold in the U.S. are manufactured in India.

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