Insomnia on New Regimen
Posted: Apr 30, 2008
QUESTION:
My doctor has started me on a new drug regimen of Raltegravir,Enfuvirtide, Etravirine, Truvada, Darunavir and Ritinavir. For the first time in ten years I now have a good T-cell count and an undetectable viral load. Unfortunatley, I now suffer from Insomnia. Are any of these drugs or combination of drugs causing this? I have tried Lunesta and Ambien and they are not working. I am afraid of addictive sleeping meds due to my past. None of the OTC drugs help. What can I do?
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RESPONSE FROM: 
I wonder if one or more of these medications may be interacting with any other meds you are on, leading to insomnia. If there are no culprit concomitant meds then it could be a reaction to your regimen. Given what is at stake, I would be hesitant to mess with your HIV meds. Instead, I would avoid all caffeine - even that cup o joe in the morning.
Next, you need to make sure you have great sleep hygiene. That is using your bed for sleep and sex (not necessarily in that order) and not reading, eating or watching TV. Bed is for sleep is the message your brain needs to get. When you are having trouble sleeping, do not lay awake tossing and turning. Get up go somewhere else in the house and read or knit or whatever. Then return to bed to try again.
If the above does not work, I recommend trazodone. This is a good sedative that in the right dose should induce sleep without addiction.
DW
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