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Insomnia and HIV: A Biopsychosocial Approach 

Insomnia and HIV: A Biopsychosocial Approach
Chapter:
Insomnia and HIV: A Biopsychosocial Approach
Author(s):

Mary Alice O’Dowd

, and Maria Fernanda Gomez

DOI:
10.1093/med/9780199392742.003.0023
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date: 22 October 2019

Insomnia is a common complaint across populations and can influence health in many ways. Individuals with HIV may be at higher risk for insomnia owing to direct effects of the virus, pain, psychiatric comorbidities, and other health- and treatment-related issues and lifestyles. This chapter reviews the physiology of healthy sleep and sleep hygiene and addresses assessment and treatment of insomnia in persons with HIV. Careful interview of a patient and accompanying family or friends with the Epworth Sleepiness Scale or Pittsburg Sleep Quality Index may help define the nature of the insomnia and target interventions. Treatment for insomnia can include a form of cognitive-behavioral therapy designed specifically for insomnia as well as education aimed at restructuring bedtime habits in order to promote better sleep. Medication use, such as benzodiazepines, melatonin, orexin, and non-benzodiazepine hypnotics, in this population must take into consideration the specific risks and benefits these medications may present in persons with HIV.

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