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This is a difficulty with sleeping, waking early or getting off to sleep. Sleep disturbances are more common among HIV-positive adults and children than in HIV-negative individuals.


Insomnia is commonly caused by psychological or emotional problems such as stress, anxiety, worries and depression, or the effects of stimulants including caffeine. Physical problems, particularly pain, fevers, night sweats and general ill health, can all contribute to poor sleeping patterns. HIV-associated dementia can also alter sleeping patterns. Some anti-HIV drugs can also cause insomnia if the last dose of the day is taken at bedtime. The anti-HIV drug efavirenz commonly causes sleep disturbances and vivid dreams, especially during the first few weeks of treatment.

What to do

Sleeping well or having a good night's rest is essential to wellbeing and every effort should be made to find out the causes of insomnia and either treat or rectify these. Simple practical measures like ensuring a comfortable, warm, noise-free bedroom and avoiding stimulants like coffee or tea during the late evening may help. A hot milky drink about half an hour before bedtime may also be helpful, since this will promote the circulation of brain chemicals which make you feel sleepy. However, taking efavirenz with a high fat meal increases blood levels by 60%, so if efavirenz is taken just before going to bed, avoid full fat milk or ice cream.

If there are problems sleeping, it is useful to take notes of how frequently the problem is occurring, and, if medication has recently changed, what sleeping patterns where like before the changed drugs. This will help a doctor to understand how serious the problem is.

Sleeping tablets should only be used as a last resort and for short periods only, to avoid dependency. Low dose tricyclic antidepressant medication may be helpful. If someone is considering sleeping tablets and they are currently taking anti-HIV drugs, they should consult their doctor about possible drug interactions. Some anti-HIV medications may intensify the effects of certain sleeping pills (e.g. ritonavir prolongs and magnifies the sedative effects of the benzodiazepine triazolam).

Also see Anxiety in A to Z of symptoms.

Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.