CPAP, Provigil and still have daily "sleep attacks"

Can someone help me? I have been using my CPAP machine for 2 months after having 2 sleep studies that said that I have low level sleep apnea/hypopnea. I've been to an ENT and my family DR. My family Dr. recently prescrived Provigil to help with the sleep attacks that I still seem to have every day. I would occasionally have the "attacks" if I was really tired or under stress. I still feel that I don't sleep well and this has been going on since my anti depressant dosage was reduced a year ago. My family Dr. doesn't feel that this has anything to do with my problem of not sleeping properly but I do. It just seems funny that alot of these sleep problems started after the reduction in my dosage. The Provigil helps some but I am still sleepy during the day. I haven't felt "right" for a year now....ever since my anti depressant was reduced. I am soooo frustrated and want to get a good night's sleep and stay AWAKE during the day. Can anyone suggest another type of Dr. to see?

Thanks! Kelly

You need to get another opinion maybe a therapist.I started my machine about a mont hago weaned of my anti depressant and I am doing really well. I take provigil as needed.When the doctor stops hearing you its time to move on. I had a doctor who treated me for depression and chronic fatigue I went for a second opinion and well I have got my life back.Good luck to you

You're probably right with the connection. I took Paxil for four years for anxiety, and was always a good sleeper.

I developed a sleeping problem about 3-4 months later.

Although I have a confirmed Apnea problem which is being treated, I'm still exhausted during the day, even though my AHI is less than 2.0.

I think these SSRI's are being over prescribed and are doing more damage than good.

http://www.quitpaxil.info

Sounds like thyroid and perhaps other things should also be checked. There are numerous causes for these symptoms. Don't rule out anything that hasn't been properly tested. I am hypothyroid which has some very similar symptoms as sleep apnea. Make sure your doctor is actually testing for different things that cause your symptoms. Don't let him just guess at it. My experience is that doctors don't test for anything unless I specifically ask for it. That's very unfortunate, but we must take control of our own healthcare and insist that the doctors look for other causes of our symptoms if they are not resolved.

Tom

Have you had a daytime sleep study to rule out Narcolepsy??? Sleep attacks sound like Narcolepsy rather than OSA!

I am taking Provigil as needed - some days none, some days one and somed ays two. On the days I take two, it has to be pretty early in the day or it will affect my sleep that night but one is more easily overcome. What is your dosage? My understanding is that it is started at a low dose because some people turn into scurrying chipmunks with the slightest whiff of it and then the dose is bumped up if necessary. That is what I had read about it and how my doc handled it. We also strategized against addiction. The amounts and time periods for refills pretty much preclude that. It should not be an every day medication, IMO.

Zees Pleez wrote: My understanding is that it is started at a low dose because some people turn into scurrying chipmunks with the slightest whiff of it and then the dose is bumped up if necessary.

Actaully they start with a low dose to avoid side effects- especially headaches. It also makes sense to take as low of dose as possible- no need in taking more medication then you need with anything. Its not unusal with a lot of meds to slowly titrate up to an effective dose.

Zees Pleez wrote: We also strategized against addiction. The amounts and time periods for refills pretty much preclude that. It should not be an every day medication, IMO.

I have to disagree here- there are situation where it does need to be taken daily. I will agree that most people who with sleep apnea who still have EDS even though they are compliant may not need it daily but in my case I have severe CSA that is only partially responsive to BiPAP ST (stilll had 30+ events per hour with BiPAP ST during titration). No matter what I am going to have EDS with that many events and there are not any other treatment options so I need Provigil to function. I waited 6 months after starting BiPAP ST to add in Provigil and I started at 50mg per day slowly up to 400 mg per day if needed. Most days 200 mg is enough- a really quiet day 100mg will do but there are days where the full 400mg is not enough. My doc recently added a low dose of ritalin to help for those times later in the day when taking more provigil will interfer with my sleep which actually has helped me lower my Provigil dose most days.

My apologies, Christine. I should have used less absolute language. I do believe that you should avoid taking it every day if possible. If you are likely to fall asleep at the wheel if you don't take it, then the risk of becoming dependant gets weighed against the potential danger to yourself and others. Then there is the gray area where peopple function better with it. At one end of the spectrum is the "I will lose my job if I don't perform better" and then it is warranted. But a lot of people use it to get that elusive extra hour we all wish we had or to keep pushing yourself when your body says stop (it is a banned substance in the sports world). It's tough; I will admit there have been a couple of times that I really didn't feel that bad but had a long and busy day ahead of me and took it to make it easier even though I would have been okay without it. If that gets to be a standard habit, well...

"Sometimes, I think it's a shame when I get feelin' better when I'm feelin' no pain" - is that from Gordon Lightfoot?

It is always difficult to walk the fine line of taking a medication like Provigil for true symptoms or just convience. I struggle with that a lot more before my doc added ritalin in as an option. SOmething about knowing you have a safety net to speak makes it easier even if you don't end up needing it.

I do worry about people asking for Provigil or other similar meds to treat the symptoms of apnea without figuring out what is causing it or getting proper treatment. Too many doctors find it easier to write a script for a med then actually look for the root cause of the problem & too many people would rather just take a med then use an xPAP.