difficulty focusing during meetings, sleeping during meetings

Question

Dear Dr. Frascino. Thank you for all of your help. I have been having difficulty staying awake at meetings in which I am NOT the main participant, and have actually fallen alsleep on a few occasions. I have been warned by my boss to find out what's going on, and get it resolved - or risk losing my job. I get plenty of sleep, and do not have this problem at meetings where I am a main player. I am on prezista, norvir, sustiva, humalog, lantus, zestril, zetia, bactrim and testosterone cypionate. I have been Type 1 diabetic for 40 years. Kidney doctor tells me kineys are fine, but lack of focus could be result of HIV and meds, and recommended Provigil. HIV doctor does not believe problem is result of HIV or meds or diabetes. What are your thoughts - and what med should I take to stay focused? I plan to purchase Adrafinil online if doctor will not prescribe something, as I cannot afford to lose my job/insurance - which is now in jeapardy. Thank you

Answer

Hi,

There are many potential causes for HIV-associated fatigue. In fact we have an entire expert forum dedicated to the topic. Check it out and review the chapters in the archives related to causes of HIV-associated fatigue and treatment of HIV-associated fatigue. The best approach is to identify the underlying cause or causes of the fatigue and specifically treat those underlying conditions. Once those have been attended to, if you're still wiped out, Provigil can be tried. Your HIV doctor should write a letter to your employer explaining your condition and need for many medications and that he is evaluating your symptoms of fatigue and lack of focus. That should prevent any action being taken against you at work. If your HIV specialist is uncooperative, you should consider getting a second opinion from a specialist who will work with you and advocate for you.

Good luck.

Dr. Bob