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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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interrupted sleep with Sustiva
Jul 6, 2003

I have been on Sustiva for over three years and I still have wierd dreams everynite. I feel tired even though I sleep 8 hours or more a nite. I wake up a couple times each nite from these dreams. Taking naps does not help and I can not take the pill in the morning because I can not function. Do you think I should consider switching my medication or is there something else I might be able to do to get a good nites sleep.

Response from Dr. Henry

Considering a trial switch off Sustiva seems like a reasonable option. Your HIV doc and you need to review your past treatment history to see what drugs are available for switching. The most common switch is a trial of nevirapine. If you weren't on any NNRTIs previous to the Sustiva then that switch often will work OK. Nevirapine has its own set of issues (rash, liver) but generally doesn't interfere with sleep. For sleep problems related to Sustiva I often prescribe trazadone (low dose ie 25-50 mg) which often is helpful. Low dose amitriptyline also can help some patients. KH

Outlook on this cocktail
Ototoxicity and hearing loss

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