Although HIV patients taking antiretroviral therapy often describe insomnia as a side effect of the medication, the reviewers found few published studies that examined this side effect. With the exception of one medication called efavirenz (Sustiva), Reid says there is not enough evidence to suggest that antiretroviral drugs contribute to insomnia.

Reid and colleagues identified only two studies of treatments for insomnia in HIV patients, including one study of acupuncture therapy and one study of the effects of caffeine withdrawal. The studies were small and had mixed results, the researchers say.

"There is a range of pharmacologic and behavioral treatments available for insomnia," Reid says. Behavioral treatments, he adds, "are as effective as drug treatments in persistent primary insomnia, but they have yet to be evaluated in people with HIV."

Reid and colleagues says further research is needed to learn whether insomnia adds to the disabling burden of HIV, especially in patients who have not yet developed symptoms of AIDS. Reid also says researchers should study how a patient's living conditions, along with his or her alcohol, drug and caffeine use, could affect insomnia risks.

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Contact: Steven Reid
steve.reid@nhs.net
Center for the Advancement of Health
22-Mar-2005