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Problems Sleeping after medications and diagnosis

Apr 18, 2004

Hello there.

I want to get information about sleeping problems. Since my diagnosis in 10/2002 (I also have AIDS and on my third regimen that I adhere to tightly. I want to live as long as possible.) I have been having very vivid horrible nightmares that I wake up from screaming or crying. Not helping my partner deals with the situation but he is so loving.

I have trouble getting to sleep and if there is any strange noise while I sleep I wake up and cant get back to sleep. I have had sleep studies and nothing-wrong there. My HIV doctor says I need to stop the sleeping pills and get a white noise machine. The anti-depressants the doc prescribed me made me worse (hives and reactions to other meds) so they are not helpful. (I take almost 45 pills daily so who know all the cross reactions; plus I am on my third regimen in over 1.5 years and my T-cell count are still dropping)

No mental health counselor has helped me get better sleep and the different anti-depressants do not function. What can I do?

Response from Dr. Horwath

It's difficult to answer your question without more details. For example, you noted that you take 45 pills/day, but didn't mention which ones, including which antiretroviral medications that you are taking. Some medications, including antiretrovirals, can cause insomnia and nightmares. This is true of Sustiva, which is commonly associated with side effects such as insomnia, depression, nightmares, confusion, hallucinations, and mood lability. If your symptoms are an adverse reaction to a medication, then the best approach is probably to discuss with your doctor whether there is an alternative medication for you.

If needed, there are several medications that can be helpful for insomnia in people with HIV infection. Among the commonly used medications for sleep are trazodone, doxepin, Ambien, and Restoril. If you had an allergic reaction to one of these, then chances are that you could tolerate another.

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