Sleep is also important for emotional and mental functions. Sleep loss can affect concentration and impair the ability to perform tasks involving memory, learning, logical reasoning and mathematical calculations. A recent study suggests that chronic lack of sleep may even make the aging process more difficult. For people living with HIV, sleep disturbances may result in potential decline in quality of life. For example, sleep disturbances may cause daytime fatigue and affect functional status and quality of life.
Many HIV–positive individuals with daytime fatigue also have medical sleep disorders. Thus, proper diagnosis and medical treatment of the sleep disorder may produce significant improvement in quality of life. Complaints of sleep disturbance have also been associated with depression and pain, both of which may also make it harder to fall asleep or lead to nighttime or early morning awakenings. Insomnia, which is difficulty falling asleep or staying asleep, is also widespread and underdiagnosed in HIV–positive individuals.
Although most of the FDA–approved HIV antiretrovirals can cause fatigue, it is interesting to note that most of them have been shown to cause some type of sleep disturbance as well. In clinical studies, many of the available drugs caused insomnia less than 1 percent of the time. One major exception, however, is Sustiva (efavirenz), which lists some type of sleep disturbance as a more common side effect, especially during the initiation period for the drug. Regardless of which drug may be causing a sleep disorder, a change in dose scheduling, nutrition or exercise may alleviate this side effect. Check with a healthcare professional, treatment advocate or nutrition advocate before making changes to your medication regimen.
According to a report in the November issue of Pediatrics, HIV–infected children appear to have a higher than normal rate of sleep disturbance than children who are not HIV–infected. HIV–infected children participating in the study woke up more frequently, stayed awake longer, and reported a greater level of tiredness. Prompt diagnosis and interventions to promote sleep may improve the quality of life and prevent additional compromise of immune function in people living with HIV. Healthcare providers who treat HIV–positive individuals need to be aware of medical sleep disorders as treatable causes of daytime fatigue and insomnia. Often, they pay attention only to measurable physical symptoms such as fever or weight loss, granting more attention as measurable symptoms change and the individual becomes sicker.