It’s 04:44am. I’m laying in bed. Wide awake.

I can hear the distant whoosh of cars on the main road, the hum of fridge freezer, that irritating high pitched noise that you’re not sure if it’s your ears or something buzzing or something else making it, and most disturbingly of all – my own thoughts.

I’ve been trying to get to sleep since midnight. I did all the right things – I had a relaxing bath, drank some water, took my pills, turned my phone off, turned my computer off, turned the lights off and got comfy. Sadly the sandman didn’t want to pay me a visit.

Laid there in total darkness I tried to clear my mind of all thoughts. But as soon as I’d done that they flooded back again. What am I going to do about money? What’s going on with that guy I like? Did I have plans for tomorrow? What do I need to do for work tomorrow? Oh god work tomorrow. Did I put my headphones on charge? Did I take my meds?  Whilst all the time thinking “WILL YOU JUST SHUT UP – I NEED TO SLEEP”.

At 3am I  realised sleep clearly wasn’t happening and at 4am I completely gave up all hope of achieving any sleep.

The medication I take to control my HIV, ATRIPLA, is made up of three drugs Emtricitabine, Tenofovir and Efavirenz. Apparently Efavirenz is widely know to cause insomnia – I’ve never been the best sleeper, but I can’t imagine that this is really helping matters. Some people have suggested that I move to another drug combination that doesn’t include Efavirenz but these aren’t available in single pill from the NHS and I don’t know how well I’d cope with multiple pill treatment – plus I don’t really want to burn my bridge with ATRIPLA if I don’t have to.

It’s now 5am. I have to get up for work at 7:30. Do I try and sleep for that 150 minutes, or do I just get up and go into work early? Whatever I do, however, I can confidently say that my Thursday will be a complete write-off. I’ll be heavily reliant on bad instant coffee to keep me awake at work, but it won’t be proper awake, it will be Zombie Tom – lights are on, but nobody is at home.

I really envy people who, like my pets, can just put their head down and go to sleep straight away. That’s never something that’s worked for me, I’ve always found it hard to get to sleep and it’s just getting harder as the years and pills continue.

Here’s a quote from  D.D. Barant that seems appropriate:

“I’ve got a bad case of the 3:00 am guilts – you know, when you lie in bed awake and replay all those things you didn’t do right? Because, as we all know, nothing solves insomnia like a nice warm glass of regret, depression and self-loathing.”

I hope you have a better Thursday than I’m going to.

Best wishes,



  1. I stopped taking Atripla as I hadnt t had any sleep in months. I switched to Eviplera and it totally changed my life, no more insomnia, best thing I ever did.

  2. Atripla is a great pill, but as with everything there are side effects, another one being it’s highly unsuitable for people with a history of depression, and put Gary in a really bad place when he was on them. I was on different meds years ago and was prescribed zopiclone continuously for over 3 years (It’s only licensed for 7 days continuous use) If it’s getting to be a regular thing, have you thought of suggesting amitryptaline to your GP? It’ll boost any pain relief your taking, lift your mood and certainly help you to sleep without leaving you unable to function the day after. Just a thought.

    Hope you get something sorted soon!

  3. Bechod!
    I don’t feel your pain of not going to sleep, but I do keep waking up at 3am and being awake for about an hour and then falling asleep again which is making me grumpy. Maybe my brain is empathising with you, for about an hour!

  4. Sorry this is a bit irrelavent and out of date…but I used to try the hot bath to go to sleep thang and it never seemed to work – and then one day I read about how it then takes you longer to go to sleep because your body has to cool down from the bath before it can go to sleep. I can’t remember the exact details, and I’m sure you can google it, but the gist of it was its better to be cool before you try and sleep than warm. Anyway, I really do hope you can get some sleep xx


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