Waking up groggy, having vivid dreams, or lying awake for hours is frustrating. If you’re living with HIV, sleep problems can come from the virus itself, stress, other health issues, or your antiretroviral drugs (ART). Good news: many sleep issues are treatable with simple changes or a med review.
Some ART drugs can directly affect sleep. For example, efavirenz is known to cause vivid dreams and trouble falling asleep for some people. Newer drugs like dolutegravir can cause insomnia in a smaller number of people. Beyond meds, pain, anxiety, depression, and disrupted routines after clinic visits or shift work can wreck sleep. Also check for sleep apnea — pauses in breathing during sleep are common and often go unnoticed unless you snore loudly or feel very sleepy during the day.
Start with sleep basics: keep a regular bedtime and wake time, even on weekends. Make a short wind-down routine — dim lights, no screens 60 minutes before bed, and a quiet 20–30 minute activity like reading or stretching. Cut caffeine after mid-afternoon and keep naps under 20 minutes. Exercise helps sleep but do it earlier in the day.
If medication might be the problem, don’t stop anything on your own. Bring a sleep diary to your clinic (track sleep times, naps, meds, caffeine, alcohol, and how you felt). Your provider may suggest changing the time you take a drug (some people move efavirenz to the morning) or switching to a different regimen. Always check interactions before adding sleep aids: ritonavir and cobicistat can raise levels of some sedatives and benzodiazepines (midazolam, triazolam) — that can be dangerous.
Non-drug options often work well. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a short, proven program many clinics offer or refer out. Low-dose melatonin (talk to your provider first) can help reset sleep timing. Avoid mixing alcohol with sleep meds — alcohol fragments sleep and can interact with ART.
When to get help: if daytime sleepiness makes work or driving unsafe, if you snore and gasps/pauses are noticed, or if mood and memory are slipping — bring this up at your next HIV visit. Your clinic can screen for sleep apnea, review meds, refer to CBT-I, or involve a sleep specialist.
Small changes add up. Try one or two tips for two weeks, track results, and share the diary with your care team. Sleep can improve without sacrificing effective HIV treatment — you just need the right tweaks and a quick medication check.
As a person living with HIV, I recently learned about the potential impact of Raltegravir on sleep quality. Raltegravir is a commonly prescribed antiretroviral medication, and some patients might experience sleep disturbances as a side effect. It's important for us to monitor our sleep patterns and discuss any concerns with our healthcare providers. Ensuring proper sleep is crucial for maintaining our overall health and well-being. So, if you're on Raltegravir and experiencing sleep issues, don't hesitate to bring it up with your doctor.
Callum Laird | Jun, 26 2023 Read More