Insomnia is a prevalent sleep disorder associated with multiple health problems. Prescription sleep medications include among others, benzodiazepines and non-benzodiazepine receptor agonists. This study evaluates the economic burden associated with treated and non-treated chronic insomnia patients in Europe (UK, Germany, France, Spain, Italy), using real world data. Data from the 2020 EU (UK, Germany, France, Italy, Spain; N=62,319) National Health and Wellness Survey (NHWS), which is a patient-reported survey administered yearly to a demographically representative sample of adults (with respect to age, sex, and region), were used. Respondents who self-reported a confirmed diagnosis of insomnia (and no other sleep difficulties) and being on treatment (DT, N=812) were compared to diagnosed but untreated respondents (DUt, N=1601) and to patients self-reporting having experienced insomnia but undiagnosed and untreated (UdUt, N=6221), in respect to work productivity, activity impairment (WPAI), and health care resource (HCRU), using ANOVA tests. Compared with DUt and UdUt, DT patients reported significantly greater overall work productivity impairment (37.63% vs. 36.20% vs. 28.41%), as well as activity impairment (44.16% vs. 40.89% vs. 29.82%). DT patients also reported higher HCRU (past 6 months) with a mean of 0.65 emergency room (ER) visits and 0.23 hospitalizations vs. 0.47 and 0.23, respectively, for DUt and 0.31 ER visits and 0.14 hospitalizations for UdUt patients. Despite treatment for insomnia, this study suggests that the economic burden of insomnia is high, with substantial insomnia-related absenteeism, presenteeism and reduced overall productivity, as well as higher HCRU. There is a significant unmet need for treatments with better outcomes for insomnia patients.