Please help I can't sleep at night at all

Since I started taking tenofovir df, I have not been sleeping at night for close to 1 months. Occurs at night mostly but sometimes during the day. I am afraid of night time now because it’s like passing through a grind.

Does tenofovir df cause severe insomnia.

Sorry to hear that @Johnpaul_Ezeike,

Insomnia has been described as a side-effect of tenofovir, but has also been described in the placebo treatments in clinical trials at similar rates too.

I can also imagine that the impact of the news you have received about your liver health may be affecting your sleep too. Have you got people you can talk to or any counselling support? These might be able to help you through this tough period.


I have been opening up to a lot medical personnel. Apart from what you wrote. Could cirrhosis-induced insomnia be another cause because this started like 1 month ago.

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Dear @Johnpaul_Ezeike,

That’s great that you are able to open up to the medical personnel and I hope you are getting the support that you need. Your suggestion of cirrhosis-induced insomnia could very well be the case, I see that there are many studies describing insomnia to be common in people with cirrhosis.

There has been a trial conducted showing that zolpidem/Ambien might be helpful: Could be worthwhile discussing with your doctors about this.

Hope this helps,

I have discussed this with them, but no remedy. The drug Ramelteon I should have gotten is not available. I took melatonin but didn’t work. Being awake from 1am till 5:30 is crazy, is really a huge marathon. The next day I feel sapped and whatever. Now I have known what insomnia really means. Like yesterday night I didn’t blink till around 6am.

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I’m sorry to hear that Johnpaul. I’m not sure if there are any @HealthExperts who could comment or provide some suggested approaches.


Or maybe @PuallyCHB @PuallyHBV can comment on his experiences with cirrhosis.


Hi @ThomasTu ,

I actually have a draft email response to JohnPaul about this and got sidetracked. Thank you for the reminder.

Hi @Johnpaul_Ezeike ,

Insomnia is no fun. I have had insomnia for most of my life. I have gone days without sleep on a regular basis when I was a network engineer and had to field emergencies usually related to viruses or virus updates that would completely halt or cause issues with company’s servers, workstations and networks. I actually went two weeks without sleep and only a couple of catnaps due to a major disruption with all of our clients. I was the senior engineer, so the buck stopped with me, which meant I couldn’t sleep until the emergency was completely solved.

Since having cirrhosis, the insomnia got worse. I don’t know if it has anything to do with medications like tdf, taf, etv or any of the other numerous meds that I take. Also, seeing as I have had a long history of insomnia, I don’t know how much is the previous insomnia I already had or any of the meds contributing. I do know that cirrhosis has made it worse to the point that I cannot sleep at all if I don’t take my sleeping med which Thomas mentioned in a previous post. Zolpidem Tartrate (Ambien) is the strongest med we have in the U.S. for insomnia. At least, so I am told by my doctors that I am on the strongest med at the highest dose. Ambien allows me to get an average of about 3 hours of sleep per night. People can’t fathom how I can live this way with such little sleep but 3 hours is a heck of a lot better than none. I don’t know if you can get Ambien in your country, but see if you can. I think it would really help your insomnia since I don’t think you mentioned having insomnia prior. Just be careful, when you first start out using it, it can be pretty powerful until you get used to it. Once I walked straight into a glass door, luckily I bounced back off the door with just a couple of bruises.

Funny thing that I had the draft response to you and hadn’t finished it yet. I follow a certain doctor and he sends out information through a newsletter. The topic today was sleep. So I am going to cut and paste the info. Just letting you know that this isn’t from me and I have yet to try the suggested ideas. I am going to try the Shut and Roll method tonight. Also, just because this is from a doctor that I subscribe to, doesn’t mean that it is medical advice. Read it as anecdotal and not fact. The ideas he provides to help you sleep are just ideas and none seem like they could be harmful in the least.

Hope this helps you or anyone else.



What if I told you there was a way to burn more calories… reduce the amount of unhealthy foods you eat… and fend off dangerous health problems…

All without moving a muscle?

I’m talking about getting quality sleep.

Now, you already know not getting enough sleep saps your energy and can put you in a bad mood…

But according to some landmark research from the Annals of Internal Medicine, it turns out not getting enough “zzz’s” is far worse than you might think.

For one, failing to sleep crushes your metabolism by making you insulin-resistant.1

In other words: Lack of sleep turns your body into a fat-storing machine. And that puts you at a higher risk of obesity and other scarier health problems.

Not only that, skipping a good snooze flatlines your “I’m full” hormone leptin and skyrockets your “feed me!” hormone ghrelin.2

Plus, sleep deprivation causes you to specifically crave calories that come from waistline-wrecking ingredients like sugar and fat.

This was proven when researchers performed brain scans on sleep-deprived people.

Once they put junk food in front of them — their brains went bonkers for it.3

And this happened after missing just ONE night’s sleep.


But don’t worry just yet. I’ve put together an easy-to-follow list to help you get that much-needed slumber.

Allow me to introduce you to:

Dr. G’s “Sleep Tight” Tips

Sleep Tight Tip #1: Shut And Roll

This might sound bizarre, but rolling your eyes when they’re shut is a surefire way to fall asleep fast.

You see, rolling your eyes causes your brain to release melatonin — a natural “sleep hormone.” And the more of it your body releases, the faster you slip off into “la la land.”4

Bonus: As you roll your eyes, think about your day — what you did, who you saw, where you went…

Running through your day will let your mind start to drift, and make it even easier to doze off.

Sleep Tight Tip #2: Breathe Through Your Nose (Not Your Mouth)

Sometimes falling asleep can be as easy as taking a deep breath the right way.

Most people subconsciously breathe through their mouth. But this can actually have a “stress effect” on your brain, making it difficult to fall asleep.5

On the other hand, breathing through your nose sends relaxation signals to your brain, helping you drift into a slumber faster.

Sleep Tight Tip #3: Tell Yourself “I’m Not Going To Sleep”

This one may sound a little odd at first, but I can prove how well it works right now. Just say to yourself, “I’m not going to think about carrots.”

What did you just think about? (See what I’m getting at?)

So the next time you’re struggling to hit the hay, shut your eyes and tell yourself: “I’m not going to sleep.”

This reverse psychology works better than you might think. :slight_smile:

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Hi John Paul
I am sure you are one of the people who fell uncomfortable with my absence in the group. I am sorry I am reading this trend late. Remembering that I have been on TDF twice, every time I have initiated the treatment, I have suffered insomnia before getting used.
I can’t remember where, but I read somewhere that high viral load can make some people to go without sleep.

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