Inadequate sleep can contribute to increased inflammation in people living with HIV. Researchers looked at the effects of short-term sleep deprivation on immune activation and inflammation and assessed the function of the adenosine pathway, a compensatory mechanism that reduces inflammation and increases the urge to sleep. Twenty people on stable antiretroviral therapy with viral suppression first had one week of regulated sleep and then stayed awake for 24 hours. Blood samples were collected to measure biomarkers of immune activation, inflammation, cell cycling and adenosine pathway activity. CD8 killer T-cell activation increased after sleep deprivation, and there was a trend toward greater monocyte and macrophage activation, but no differences in levels of IL-6, TNF-alpha or soluble CD14. Plasma adenosine levels were similar before and after sleep deprivation, indicating that the compensatory pathway did not kick in. These findings suggest that getting enough sleep may be particularly important for people living with HIV.