Positives

• A patient reported becoming naturally tired by 8pm and falling asleep with ease most nights after starting Hetlioz WebMD.
  
  
• Trials showed entrainment to the 24-hour cycle with average gains of 195 minutes of nighttime sleep PubMed.
  
  

Negatives

• Patients described extremely vivid nightmares, unusual dreams, and sleep paralysis WebMD.
  
  
• Headache and ALT elevations were the most common adverse events in trials PubMed.
  
  

Hurdles & Side Effects

• A patient noted insurance was billed about $40,000 for a 90-day supply, roughly $520 per pill WebMD.
  
  
• FDA labeling restricts coverage to non-24 sleep-wake disorder, making off-label Long COVID circadian use hard to authorize Hetlioz.