I have been on atripula for almost a year. More nights than not, I still wake up in the middle of the night. Rarely are the dreams bad. Strange sometimes, but mostly neutral. But my heart is always at 75-80 bpm. My normal at rest rate is u der 60. As directed, I take atripula just before bed. Three times in the past year I missed it at bed time and took it when I awoke. I noticed my heart rate increased for a few hours then also. Should I be worried about the stress my heart is going through? It seems it has only had three nights of rest in a year. What will happen over the years I am on the medication? My family has a histiry of heart issues, though mine has always been strong

Heart rates of 75-80 in setting of waking up from bad dreams would generally not be a serious threat to heart health. Many patients that continue to have annoying dreams from the efavirenz in Atripla consider switching to an alternative drug regimen at least on a trial basis to see if those symptoms improve and how the new regimen is tolerated. There is yet no evidence that efavirenz has a negative effect on heart health over the first 5+ years of use. KH