All it really costs me is a little bit of time and a little bit of momentary performance. Fallout 4 is already a major hog for my rig, and I don't want to make it any worse.
There's no trouble when the game is running in windowed mode, borderless or not, but I really don't like the performance hit associated with windowed mode. I've tried to fix it by clearing all of my settings, but it keeps coming back no matter what I change, wipe, or set to default. So far, Fallout 4 is the only game I've experienced this with, and only on my new monitor. It switches to my desktop like any other fullscreen game. What's confusing is that it doesn't actually change the resolution when I shut the game down, or tab out, there's no black screen. This also happens when I tab back into the game. Whenever I start Fallout 4 up, my monitor goes black for a short period as if it's changing resolution.
It's not severe, but it's a little alarming. This is my first monitor in this range, and everything is working out so far. I recently picked up a new monitor at 1920x1080.