• Up to 70 percent of people with HIV experience difficulties with sleep.
• To alleviate sleep problems, it’s important to create a positive sleep hygiene routine, including going to bed at the same time each night.
• If problems persist, talk to your doctor about interventions that might help.

If you or a loved one with HIV are having chronic sleep problems, it’s important to know you are not alone. Research shows that up to 70 percent of people with HIV have trouble sleeping, and that many people living with HIV need a specific intervention to help them improve their sleep.

Consistent with the research, many myHIVteam members report having trouble falling or staying asleep. “I woke up at 2 a.m. again, but I fell asleep at 6 p.m. yesterday,” wrote one member. “I'm trying to get back on the normal sleep schedule, falling asleep at 10 p.m. and waking up at 6 a.m., but so far I’m having no luck.”

Another myHIVteam member shared, “Been a pretty good day ... other than an ongoing issue of not being able to fall asleep when I want. I used to make sure I was in bed and ready to sleep no later than midnight, and I would fall asleep quickly. The last few weeks, I’ve been going to bed at the same time, yet I don't fall asleep till three or four hours later, and then feel exhausted when I get up. I just want my normal sleep cycle back!”

When you have any type of chronic health condition, getting regular sleep can be difficult. Furthermore, people living with HIV may also have co-occurring sleep conditions, such as insomnia or obstructive sleep apnea. Your primary care doctor can screen you for these conditions, so be sure to communicate your concerns to your health care team at your next checkup or earlier.

Poor sleep can also impact your adherence to HIV treatments, your quality of life, and your productivity at work. If you have noticed such changes as a result of your disrupted sleep patterns, you may benefit from employing new strategies to help you get more rest.

Why Is Sleep Disturbance Common for People With HIV?

There are several reasons why people with HIV experience sleep issues. HIV treatments such as antiretroviral therapy are sometimes associated with worse reported sleep. This may be a direct result of insomnia caused by the medication, which can resolve over time, or it may be from one or more other side effects from the drugs. Physical symptoms may keep you awake at night, such as diarrhea, cough, and pain.

Additionally, there may be other, indirect reasons for sleep disturbance in people with HIV. For example, mental health issues like anxiety and depression are associated with having a chronic health condition. They can also cause trouble sleeping.

Whatever is causing your sleep troubles, there are steps you can take to help alleviate them. You can try many of these strategies on your own at home. However, you should consult with your primary care physician if you continue to have trouble sleeping.

Getting Better Rest

Research has shown that sleep hygiene is a critical factor in people with HIV being able to get a good night’s sleep. It’s a good idea to understand sleep hygiene, and how you can improve your own.

Positive sleep hygiene refers to the action of setting yourself up for a good night of sleep by taking steps ahead of time to improve your sleep quality and duration. One good way to start is to avoid spending time in bed when you aren’t sleeping — that way, you’ll associate your bed with sleep.

Maintain a Regular Sleep Schedule

To get your body in the habit of sleeping through the night for a set number of hours, it’s important to try to go to bed at the same time each night, regardless of whether it is a weekday or weekend. Going to bed and waking up on a routine schedule can help you get your sleep back on track.

Several myHIVteam members have recognized that it can be difficult to sleep on a regular schedule. “I did not sleep well at all last night, and I would think about taking a nap, but my doctor told me that if I want to get back on a normal sleep schedule, not to take naps,” wrote one member.

You won’t always be able to follow a routine perfectly, but having the foresight to plan a sleep schedule is a great first step to getting better rest.

Focus on Relaxation

Being unable to fall asleep can be stressful and frustrating. “Cannot sleep tonight. Ugh,” wrote one myHIVteam member. “I’m tired, but not falling asleep.”

This is a common experience for many. The Sleep Foundation recommends focusing on relaxation and mindfulness rather than on the end goal of falling asleep. Some relaxation techniques you could use include diaphragmatic breathing, visualization exercises such as a body scan, or muscle relaxation techniques.

Some methods will work better than others for each individual, so it’s important to listen to your own body above all else. What works well for someone else might not work for you, and vice versa.

Ease Yourself Into Any Changes

When you’re making any major changes to your schedule, it’s important to do so gradually. Be patient with yourself as you get adjusted. Especially when it’s difficult to fall asleep, you may not feel motivated to go to bed early instead of staying up to work, watch TV, or socialize.

Exercise can be beneficial for promoting sleep, but you should try exercising at least four to six hours before you go to bed. You might try taking a warm bath shortly before bed or having a light snack. Avoid consuming anything before bedtime that could disturb your sleep, such as a heavy meal, caffeine, nicotine, alcohol, spicy foods, or chocolate.

It’s perfectly OK if you have off days. It’s most important to be as consistent as you can, have patience, and work up to your goals slowly and on your own timeline. If none of these interventions work, talk to your doctor about whether a sleep aid might be a good idea. It’s important to weigh how any medications might interact with your HIV treatment plan.

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Connect With Others Who Understand

You’re not alone with HIV. There are many supportive resources for people diagnosed with HIV and their loved ones, including the online community at myHIVteam. Members provide each other with continual social support, advice, and understanding.

How do you regulate your sleep schedule while managing HIV? Do you have any tips for others about getting better rest? Leave a comment below or start a conversation on myHIVteam.