Modafinil (Provigil) or Armodafinil (Nuvigil)?

[USMCVet]

I'm just trying to get ready for some upcoming appointments. AHI average is still around 1 or below. Average use around 8 hours a night. 100% compliance. I have been on supplemental oxygen for 2 weeks now (? I think it's that long but honestly I forget). Have titration study on 9th where they will likely change me to Bipap machine in hopes of getting me off supplemental oxygen.

The anxiety I was feeling from what I thought was extreme exhaustion is all gone since starting oxygen. My focus and general brain power has slightly improved but doesn't seem to be getting better yet.

I'm still very sleepy all the time and don't trust myself driving more then short distances.

Only medicine I take that causes tiredness is amplodipine besylate which I stopped taking for a few days and it made no difference.

Any other suggestions? Are there any other steps before I discuss Modafinil (Provigil) or Armodafinil (Nuvigil) with a Dr?
Here is last night of data I have.
https://i.imgur.com/05x9U2J.jpg
Here is oxygen data when using oxygen

https://i.imgur.com/Vj5LifA.jpg

[Wulfman...]

viewtopic/t158430/search.php?keywords=provigil

viewtopic/t158430/search.php?keywords=nuvigil

https://www.drugs.com/provigil.html

https://www.drugs.com/nuvigil.html


Den

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[USMCVet]

viewtopic/t158430/search.php?keywords=provigil

viewtopic/t158430/search.php?keywords=nuvigil


Den

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Top two results take me back here?
In all seriousness I have looked a bit through search function which leaves a lot to be desired.

[Wulfman...]

viewtopic/t158430/search.php?keywords=provigil

viewtopic/t158430/search.php?keywords=nuvigil


Den

.

Top two results take me back here?
In all seriousness I have looked a bit through search function which leaves a lot to be desired.

You have MANY more pages of links on the forum to read and then I added two more links to Drugs.com for your review.


Den

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[USMCVet]

I have already read about the drugs and my only concerns as far as drugs themselves is that I have hypertension and NAFLD so fatty liver.

Most of the search results are junk on this site unless you do an advanced search in the title like this one.
viewtopic/t158430/search.php?keywords=N ... mit=Search

Otherwise you read tons of threads that say " my doc won't give me nuvigil" or "nuvigil worked for me" but nothing helpful or any actual discussion on the topic.

[USMCVet]

Case in point lol.
viewtopic/t158430/viewtopic.php?f=1&t=1 ... l#p1066003

[Wulfman...]

Case in point lol.
viewtopic/t158430/viewtopic.php?f=1&t=1 ... l#p1066003

Well, in the 13 years I've been here, I've witnessed LOTS of discussions on both of those medications. Not having used either of them, I default to the forum search function and the Drugs.com site. You're the one (at this moment) with the questions, but I don't have any specific answers for you.


Den

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[USMCVet]

Thanks for trying to help I appreciate it. If it's not known I tend to do lots of research in general.
Also the term "practicing medicine" comes to mind meaning that things change and our understanding of issues and drugs change even year to year.
So a topic could have been covered a lot in the past it doesn't necessarily mean it reflects our current understanding of issues.

Some had issue with my poll on cpap masks saying it's been done before and polls never help. For me my poll changed my mind on what mask to get and I got lucky that it was the perfect one for me which I wouldn't of tried otherwise.

[tedtomato]

Any other suggestions? Are there any other steps before I discuss Modafinil (Provigil) or Armodafinil (Nuvigil) with a Dr?

I am in the same position: CPAP/APAP has fixed the moderate sleep apnea but still tired in the morning. A full sleep study confirmed that I still have 15 arousals per hour that are not related to respiratory issues.

I have been put on Modafinil while further extensive blood tests are done, to see if a deficiency is provoking those arousals, but not much found now.

Modafinil (and other variants) is probably not a long term solution, and it's only treating the symptoms: it's indeed raising blood pressure, and has unknown long term effects. How it works is also still not explained, as it has a direct impact on the brain.

Have you had a full sleep study done?

[USMCVet]

Any other suggestions? Are there any other steps before I discuss Modafinil (Provigil) or Armodafinil (Nuvigil) with a Dr?

I am in the same position: CPAP/APAP has fixed the moderate sleep apnea but still tired in the morning. A full sleep study confirmed that I still have 15 arousals per hour that are not related to respiratory issues.

I have been put on Modafinil while further extensive blood tests are done, to see if a deficiency is provoking those arousals, but not much found now.

Modafinil (and other variants) is probably not a long term solution, and it's only treating the symptoms: it's indeed raising blood pressure, and has unknown long term effects. How it works is also still not explained, as it has a direct impact on the brain.

Have you had a full sleep study done?

Thank you for reply! Here is my original sleep study arousal results.
20 an hour.

https://i.imgur.com/54ZxixN.jpg

I have a new titration study coming up in a week to probably move me to Bipap for oxygenation issues even after getting sleep apnea under control.

I'm still exhausted. I'm not sure if it's another medical issue or I am considering burnout from work as a possibility.

Either way I'm exhausted and cognitive function is definitely diminished work other physical symptoms and I'm just looking for a relief.

For you..... Have you tried getting a pulse oximeter to see if your oxygen is dropping? I had another oximetry test once sleep apnea was under control and oxygen was still bad when sleeping and not ideal while awake.

[tedtomato]

For you..... Have you tried getting a pulse oximeter to see if your oxygen is dropping? I had another oximetry test once sleep apnea was under control and oxygen was still bad when sleeping and not ideal while awake.

I have had a home sleep study, which diagnosed a mild OSA (AHI of 7), and then a full overnight sleep study after being on CPAP/APAP for 8 months, showing an actual AHI of 15.

Both studies included oximeters, but also many other sensors.

If you feel exhausted with reduced cognitive functions, then Modafinil will give you a significant boost. It does to me when I take it, although took several weeks to get to the right dosage. I also ensure that I have at least 2 days off each week, to avoid addiction.

However, I don't think Modafinil is a long term solution.

[USMCVet]

For you..... Have you tried getting a pulse oximeter to see if your oxygen is dropping? I had another oximetry test once sleep apnea was under control and oxygen was still bad when sleeping and not ideal while awake.

I have had a home sleep study, which diagnosed a mild OSA (AHI of 7), and then a full overnight sleep study after being on CPAP/APAP for 8 months, showing an actual AHI of 15.

Both studies included oximeters, but also many other sensors.

If you feel exhausted with reduced cognitive functions, then Modafinil will give you a significant boost. It does to me when I take it, although took several weeks to get to the right dosage. I also ensure that I have at least 2 days off each week, to avoid addiction.

However, I don't think Modafinil is a long term solution.

What did your oximetry sensors and other sensor's show? I have a Bipap titration study on the 9th. If I can get prescription for Modafinil it won't be until 16th.
I probably didn't do a great job explaining my situation but I told my manager that I was making more mistakes and slower then normal and not happy with myself at work and showed her my CPAP compliance which is 100% and that my oxygen was dropping. She has family experience with sleep apnea and oxygen supplemation but seemed surprised with me saying I'm not happy with my own performance.
I'm just so tired and overall it's getting worse despite CPAP and oxygen. Work is even getting slower so I just don't understand it. At this point I won't drive much further then work for fear of an accident.
I want to visit my dad who is almost a 4 hour drive away but I don't feel safe making that drive.

[tedtomato]

What did your oximetry sensors and other sensor's show?

My full PSG sleep study showed that respiratory issues (worse than originally thought) were resolved with CPAP, but there were some other non-respiratory issues, that wouldn't be resolved with CPAP. Those are still not resolved, so even if my compliance using CPAP is good and my AHI is also below 1, I am not going to feel well rested in the morning.

I'm just so tired and overall it's getting worse despite CPAP and oxygen.

The only advice I can provide is to get a full PSG sleep study down (not using CPAP first half of the night, and then with CPAP). You might also be tired for reasons not related to sleeping.

[USMCVet]

I've already had a PSG study done without machine. Friday I have titration study with machine. Currently I'm also on supplemental oxygen and hope a Bipap which they will use in my upcoming study will alleviate that issue. I'm only 33 and my quality of life sucks. In afternoon I go see my RT and plan to ask for his advice on what to do. My spontaneous crying for no reason is gone. Since oxygen I trust my judgement again however I'm still stupid , forgetful , and zone out.

[tedtomato]

Sorry, I don't know in which scenario Bipap is better than CPAP/APAP.

It sounds like you already have a very low AHI achieved with CPAP, and good compliance/tolerance of CPAP 8 hours a night, so not sure why you would be looking for another machine.