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Trouble falling asleep
Jul 11, 2008

I'm 51 y.o. and have been on ART (Atripla) for 2 1/2 years. I am tolerating the meds well and slowly but surely my CD4 count and % are going up. Last checkup my count was 449, 43% while remaining undetectable. I definetly have some interesting dreams, most of the time I actually enjoy them. My question is this--- I seem to be having a harder and harder time falling asleep over the past several months. Most nights it takes an hour or more of fidgeting and tossing around before I can fall asleep. Occasionally I take a tylenol pm to help, but I would really like to avoid the stress on the liver. Are there any other over-the counter remedies or herbal remedies you could recommend that would be safe under my circumstances? I am also taking lexapro, 20 mg per day. Thanks!

Response from Dr. Henry

Both Atripla (the efavirenz usually) and Lexapro (insomnia listed as a side effect) can contribute to sleep problems. Sleep difficulty is very common in the general population so there can be a wide list of possible factors at work (note all of sleep aid ads on TV). An evaluation by a sleep specialist is often helpful since sleep is so important to general health/well being. Avoiding stimulants (caffeine) and alcohol in the afternoon/evening is important as well as creating a stress free sleep environment. Many over the counter sleeping meds contain benadryl which makes some people drowsy. Melatonin at 1-3 mg /dose seems to help some patients. KH

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