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Author Topic: Trouble Sleeping, New Regimen Ideas?  (Read 1528 times)

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Offline RobbyR

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Trouble Sleeping, New Regimen Ideas?
« on: January 23, 2013, 06:14:58 PM »
This is a bit long, so bear with me! This is probably a common complaint, and well, I have given it the college try, and more than several chances, but I am thinking I've finally reached my limit with Atripla. I hate to part with it in a way because it's been the first medication I started on, and has kept me healthy, but a year into it, I began having trouble falling asleep at night, at first it was an occasional night, now, it is basically every night. This is intolerable. I've been on it for two and a half years, but these sleep problems only started about a year into it, and have gotten worse. Last night I literally tossed and turned all night, and I even tried taking it much earlier!  I have reached my limit with this crap. It was awful. No matter how tired I felt, I just could not fall asleep. I never had sleep problems before starting meds, so I have to think it's the Atripla.  Sometimes I have wild cool dreams, but I need more than 4-5 hours of sleep a night! And sleep problems don't run in my family. Basically lately I take my Atripla right before bed, lay down, and then lay there and toss and turn and have these hot flashes for an hour or two, sometimes longer, before I can fall asleep.

But last night, the hot flashes were even worse, (maybe because I was awake) and my heart raced and I felt like I couldn't relax myself. The hot flashes and racing pulse, like I had drunk Red Bull or something kind of scared me. Ugh. So tomorrow I am going to see my GP, and am going to ask if I can change regimens. In the meantime, I am going to consider trying something like Trazodone or a benign non-addictive sleep aid, until I can change my HIV med regimen. I am taking a low-dose Paxil for anxiety, and it makes me drowsy at times, but I still can't sleep. I suspect maybe the Atripla has causes some kind of anxiety/moodiness, aside from the insomnia, but who knows. I know before I started atripla, or even when I was first on it, I never had anxiety/moodiness like this, so I suspect it's related. I guess the only way I can find out if my sleep problems are caused by atripla is to change regimens?

A few weeks back, I tried Complera, but my insomnia got worse! Plus, it killed my appetite and made me feel very depressed. So I decided to give Atripla one last try, but it seems I have reached the end of the line with it. One interesting thing I noticed was that on the brief time I was off Atripla, while my insomnia didn't improve, I felt REALLY bad, like tired, and depressed, and out of sorts, and jittery, like I did when I quit smoking. It was like a terrible withdrawal feeling. As soon I went back on Atripla, these symptoms stopped, my appetite returned, and I felt like my normal self again, except for the periodic insomnia. Is there any such thing as Atripla withdrawal? 

At any rate I am not certain I don't have an underlying sleep issue, that has nothing to do with Atripla, but of course I can't prove that. I just know I never had these problems before I started meds. I just want to be able to go to bed and fall asleep when I lay down for once! Any suggestions for good alternative regimens that are easy on sleep, for someone who has already been on meds for 2 years? I just want to get my energy back and not feel so moody and down all the time! Thanks a bunch to anyone who can contribute!  8)
« Last Edit: January 23, 2013, 06:19:13 PM by RobbyR »
Started Atripla August, 2010.

Offline Miss Philicia

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Re: Trouble Sleeping, New Regimen Ideas?
« Reply #1 on: January 23, 2013, 11:03:47 PM »
I would consider Prezista + Truvada (there will also be the small norvir booster added so it's far from a one-pill-a-day combo if that really matters to you). But as long as you have no resistance mutations for Prezista it will be all of those pills all in one dose though you will need to time it with some food, but the food issues need not be a full meal, a light snack is fine.
« Last Edit: January 23, 2013, 11:06:34 PM by Miss Philicia »
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Offline Ann

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Re: Trouble Sleeping, New Regimen Ideas?
« Reply #2 on: January 24, 2013, 09:35:57 AM »
I second Miss PeePee's suggestion of Prezista, Norvir and Truvada. Four pills, once a day, with the only caveat being that you need to eat a little something when you take it. The Prezista needs stomach acids but a small snack will do the trick. I take mine when I eat in the afternoon. By the way, the stomach acid issue also means that you should not use antacids for approximately two hours either side of taking Prezista.

I've had excellent results with this combo - my CD4s went from being in the 3 and 400s to over 1000 in six months, VL UD.

You don't need to worry about lipo issues with this combo either (I've read your other various posts on this same basic "which combo" issue) even though it's PI based. The meds that caused lipo are rarely used today in developed countries. 

You've mentioned Isentress a few times, but you need to be aware that it causes insomnia in some people. It's also a twice-a-day med.
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline RobbyR

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Re: Trouble Sleeping, New Regimen Ideas?
« Reply #3 on: January 24, 2013, 05:30:12 PM »
Miss P and Ann, thanks for your comments. I am definately considering changing regimens. I did manage to get some Trazodone today, so I will try that as needed for sleep. Hope it helps. I have heard nothing but good things about it so far, so am looking forward to testing it out. I think the Prezista, Norvir, Truvada combo sounds pretty easily tolerated. I may ask for it when I see my ID doc next time, if I decide to ditch the Atripla. My GP told me I may not have given the Complera enough time to work when I tried it, so I guess that's still an option too. Does Norvir now come in non-refridgeratable tablets?

Don't know why PI regimens have gotten such a bad rap, but it seems all the guys I know prefer NNRTIs. Interestingly, I told my GP doc about when I had tried the Complera, and was off Atripla a few days, and it felt like I was having withdrawal symptoms. She said it could in fact have been the THC-like effects from the Atripla leaving my system and causing me to feel like I was having a bad withdrawal! Perhaps more research should be done into how the body responds when you stop atripla for another regimen. In any case, for now, I am going to stick with the Atripla for a while longer, and take Trazodone if needed for sleep at night.
Started Atripla August, 2010.

Offline Ann

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Re: Trouble Sleeping, New Regimen Ideas?
« Reply #4 on: January 24, 2013, 07:07:00 PM »

Don't know why PI regimens have gotten such a bad rap


Because of Crixivan and its terrible lipo problems, that's why. Crix is no longer in use anywhere that I know of, not even developing nations.

Norvir (and to an extent, Kaletra) also played a part in giving PIs a bad name. Norvir was once used as a main drug with a much higher dose and it was notorious for causing diarrhea. Now it is only used in a very low dose as a boosting agent and most people don't have the diarrhea problem with it. I have hiv-related diarrhea problems that have not been exacerbated by the Norvir boost I'm currently taking.

Norvir is now widely available in regular tablets rather than gel-caps that needed refrigeration. I don't think they even make the gel-caps any more.
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Miss Philicia

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Re: Trouble Sleeping, New Regimen Ideas?
« Reply #5 on: January 24, 2013, 07:21:14 PM »
Saquinavir, which was the very first PI, got a bad rap because it was rushed to market in 1995 and was quickly found to be badly absorbed by patients leading to resistance issues -- this is what happened to me.
"Iíve slept with enough men to know that Iím not gay"

Offline RobbyR

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Re: Trouble Sleeping, New Regimen Ideas?
« Reply #6 on: January 24, 2013, 08:00:27 PM »
And it is good that they make regular Norvir now! I had a friend who was on it a few years ago, before I started treatment myself, and he had to keep them in the fridge. Oh what will they think of next lol
Started Atripla August, 2010.

Offline Ann

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Re: Trouble Sleeping, New Regimen Ideas?
« Reply #7 on: January 24, 2013, 08:02:04 PM »
Saquinavir, which was the very first PI, got a bad rap because it was rushed to market in 1995 and was quickly found to be badly absorbed by patients leading to resistance issues -- this is what happened to me.

Thanks, I forgot about that one.

There were some pretty nasty NRTIs back in the day too - Hivid (ddC) was so bad it hasn't even been manufactured since 2006. Some of our LTS have PN caused by this med, and/or other NRTIs like Zerit (d4T) and Videx (ddl). From what I've read, Hivid was probably the worst.

We're very lucky to have the relatively side-effect-free meds that are available today. People really went through hell in the early years and many LTS are still dealing with the damage today.
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

 


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