Too much sleep??? Provigil???

Xian · Post by **Xian** » Mon Jun 25, 2007 11:55 am

Hello everyone,

I had my three month follow up visit at the sleep doctor. As mentioned before, my issue is that my numbers look good (AHI around 1), except for some leaks (average for my mask in the high 30’s when the Optilife should be in the high 20’s), but I still wake up tired (snooze for 1 to 1.5 hours and feel tired right off the bed…). I do feel better than before therapy (can stay up longer, only feel tired in the afternoon, not waking up in the middle for the night…), but still not as well as expected (no energy to get out of bed, exercise, still craving sugars, have put on about 10 lb in the last 3 months…)

The doctor’s feedback is that I sleep too much! On average about 8 hours/night, with weekend in the 10-11 hours sometimes. He mentioned the name of a condition I might be afflicted with (can’t remember name!), one that cannot be explained or even diagnosed. Basically, you sleep too much, which is apparently worth that not sleeping enough, you never wake up refreshed, more like hung over. I will try to throw myself out of bed the minute the alarm sounds, and exercise at night (apparently better than morning for me…).

Short of feeling better with that, the doc recommended small dose of Provigil (like 100 mg a day), right as I wake up… Said it would help me be alert and functioning sooner and not be tired in the afternoon…. Also says that the med has been around for a long time and is very safe, even though they do not know how it works (!!!)

Any feedback on Provigil (side effects, safety, etc..)?
Any feedback on sleeping too much???

Thanks

Xian
PS: the Doc also recommended an other DME, one I can visit and try masks at so I can hopefully get a mask that fits me better and does not leak (The doc did not think my issues were related to the leaks…)

Guest · Post by **Guest** » Mon Jun 25, 2007 12:50 pm

The condition is probably called hypersomnia. It can be considered idiopathic if there is no cause or reason for the excessive fatigue. It can be related to apnea, but it can also be independent (you can have both). However, 10-11 hours alone really isn't enough to be classified as hypersomnia, unless you are totally tired all of the time. I have hypersomnia and sleep 12-16 hours/day (even using CPAP). When I'm awake, I constantly feel the need to sleep and MUST nap several times a day. Hypersomnia is very similar to narcolepsy except you lack cataplexy and don't go into rem during short naps. If your doc thinks you have it, you should have a full PSG done (if you haven't already) and a MSLG (narcolepsy test).

As for provigil, it has the same effect as a cup of coffee. It only lasts 5-6 hours (for me 4). I can take it and then go take a nap an hour later. I personally find it a waste of time. It really is only good to prevent uncontrollable needs to sleep (aka narcolepsy). I've found a starbuck's late has more kick.

Sarah

lawdognellie · Post by **lawdognellie** » Mon Jun 25, 2007 12:56 pm

Oops. Guest above was me.

Sarah

Xian · Post by **Xian** » Mon Jun 25, 2007 2:58 pm

Thanks Sarah,

Yep, the term he coined was hypersomnia but, clearly, I do not have it as bad as you have it (I can function during the day and if I am tired, I typically do not take naps, or fall asleep at the desk). So, to your point, I am not sure it is "hypersomnia" as much as a term the doc threw at me to keep me quite! In any case, before I go into any type of treatment, I'll try some lifestyle changes (I certainly do not want to take medication if a good cup of coffee could do the trick!). For starter, I will change my alarm clock setting to a later time, and try to get off the bed immediatly (I may try a PeeWee type of elaborate mechanism to have myself thrown out off the bed, literally!) as opposed to snoozing for hours... and take caffeine first thing in the morning (I had quit coffee because I thought it was bad for me... perhaps not!).

Thanks for the info (what are PSG and MSLG?) and the insight on Provigil

christinequilts · Post by **christinequilts** » Mon Jun 25, 2007 5:29 pm

My situation is different, in that I have CSA plus a list of other more neurological sleep disorders that prevent me from getting a great nights sleep. Its better now that I'm on the VPAP Adapt then when I was on the BiPAP ST, as I notice I can get by with less Provigil and am not even taking the Ritalin my sleep doctor also Rx's for 'breakthrough' EDS nearly as often either. One thing I do know is if I wake up in the morning and its pretty close to the time I need to get up, its better for me to get up & get going for the day instead of 'snoozing' for awhile longer. If I don't have a full 1 1/2+ hours to complete another full sleep cycle, there is no sense in going back to sleep- one of the worst things is if I get woken up in the middle of REM sleep. I'm lucky I don't have a set schedule most days, so I don't deal with an alarm clock- just a cat who thinks I should get up at a certain time so he can have my bed all to himself

Actually, I avoid using an alarm clock at all cost and instead rely on a family member to wake me, because a gentle wakeup if I'm in REM or SWS is much better then the jolt from an alarm clock- plus I can say I need 10-20 minutes more sleep time to wake up without having to watch the clock. If I do have to use an alarm clock, I use one with two alarm, setting the earlier time to a soft, gentle music to gently nudge me out of sleep and the second alarm to really wake me up & get out of bed. This is something I've done lone before I was Dx'd with CSA+ other sleep disorders. The only time it really backfired was when one of my cats decided to sit on top of my CD-alarm clock & hit the play button- I heard the music, so I thought it was time to start waking up but suddenly I realized I was hearing songs I didn't usually get to before the other alarm would go off....boy was I mad when I finally looked at the clock & realized it was 3am

Babette · Post by **Babette** » Mon Jun 25, 2007 5:36 pm

I found that Provigil was a life-saver for me. I would have lost my job, and probably done something psychotic if I hadn't gotten it. I seriously felt like I was going to do something dangerous, I felt so trembly and freaked out.

I couldn't tolerate a whole pill. I could only take a half. And for the first few weeks, I was random with taking it. I'd decide every morning how I felt and take it if I wanted it. At one point, I just started taking it consistently, and began having consistent good days since then.

Well, better days. Does nothing for my bitchy personality.

I skipped it yesterday, for the first time in a few weeks, just to see what would happen. Survived. Had a nice quiet day. Nothing big. Wanted an afternoon nap, but it was Sunday, after all. Didn't get one.

I plan to try to quarter the pills and taper off over the next few weeks. My neurologist said that she sometimes prescribes it for people to take BEFORE BED to help them get up in the morning. I found that odd, since it's a stimulant, but she smiled and nodded and said yes indeed. I told her I didn't think I wanted to do that, and was fine with the way I was taking it.

I'm getting up much easier than I ever have before. I don't take it while laying in bed anymore, I just take it when I get up and go to the bathroom.

I find that it doesn't seem to "kick in" with me until after noon. I take it about 7 am. Then I start to feel "stimulated". But in the AM, I'm just rested and perky, not "methed up". Possibly the combination of the coffee and the Provigil has a cumulative effective by afternoon.

My only "side effect" has been a persistent dry mouth during the day that can be annoying. A friend recommended soda pop or Gatorade to combat that, as water doesn't seem to help much. I've found that helps. I don't drink ALOT of soda, just whenever it's HORRIBLY dry and after a glass of water I still feel thirsty. And it's kind of random. Doesn't happen ALL THE TIME.

Cheers,
Barbara

Snoredog · Post by **Snoredog** » Mon Jun 25, 2007 5:50 pm

my guess is Provigil is to keep you awake during the day so you are more tired during the night.

If you are napping all day long from the fatigue then you don't sleep very well during the night when you should be sleeping.

Provigil must be the legal version of "beans" or the diet pill used years ago the truckers used them regularly before they started enforcing strict driving limits to 8hrs.

Xian · Post by **Xian** » Mon Jun 25, 2007 9:31 pm

My sleep doc / neurologist also said that he often recommends that people take Provigil at night before going to bed. I think it was for people with more severe "hypersomnia" syndromes, and to prevent them from oversleeping...

On a different topic, and trying to get a feel for the quality of my sleep (if I apparently sleep so much, how come am I not rested?), I asked him if there was any in-home equipment that lets you record time in the different phases of sleep. His answer surprised me a bit: "there is no evidence that sleep phases 3 and 4 are actually good for you, or restorative" (quoting loosely). He said that, most likely, phase 2 is the important phase... Hummm... He is part of that apparently prominent sleep disorder research group at Northwestern Memorial Hospital in Chicago (headed by Dr. Zee... no joke!), so I am not sure what to think now!!!

Went running tonight, and will change my alarm clock for tomorrow morning (so I do not snooze) and see how it goes. Eventually, I'd like to stop using an alarm clock all together... One step at a time...

Snoredog · Post by **Snoredog** » Mon Jun 25, 2007 9:55 pm

Xian wrote:My sleep doc / neurologist also said that he often recommends that people take Provigil at night before going to bed. I think it was for people with more severe "hypersomnia" syndromes, and to prevent them from oversleeping...

On a different topic, and trying to get a feel for the quality of my sleep (if I apparently sleep so much, how come am I not rested?), I asked him if there was any in-home equipment that lets you record time in the different phases of sleep. His answer surprised me a bit: "there is no evidence that sleep phases 3 and 4 are actually good for you, or restorative" (quoting loosely). He said that, most likely, phase 2 is the important phase... Hummm... He is part of that apparently prominent sleep disorder research group at Northwestern Memorial Hospital in Chicago (headed by Dr. Zee... no joke!), so I am not sure what to think now!!!

Went running tonight, and will change my alarm clock for tomorrow morning (so I do not snooze) and see how it goes. Eventually, I'd like to stop using an alarm clock all together... One step at a time...

mmm... kinda makes you wonder if they don't know what benefits are seen at the different sleepp stages, how would they know Stage2 is any better?

maybe you just need one of these:
http://tinyurl.com/2rdyp6

Xian · Post by **Xian** » Mon Jun 25, 2007 10:14 pm

Hummm... a sleep tracker??? OK Snoredog, was it sarcasm or have you actually tried it???

My sleep doctor actually mentioned that if you wake up someone during deep sleep, they feel groggy and tired, or, as he coined it, "hungover"... just the way I feel (without the fun party to make it worthwhile, darn). So waking up in the right phase sounds kind of nice! Is it worth $149??? (I guess it is not covered by insurance!)

andyomega · Post by **andyomega** » Tue Jun 26, 2007 7:28 pm

I did not like Provigil, it kept me awake too long and then I could not sleep.
I even tried half a pill and the same thing. The doctor was surprised but lucky me, I always seem to get all the side effects of any drug I take.

ffarmer · Post by **ffarmer** » Tue Jun 26, 2007 8:19 pm

I'd like to comment on the Provigil. I have been taking it and it has considerably improved quality of life for me as I can now stay awake all day and keep my job! It is not a stimulant as it doesn't work on the central nervous system, it just affects the area of the brain related to arousal. I take it in the morning and find that it has worn off by the time I go to bed at night. I highly recommend it if you are having trouble staying awake in the day.

Frances

Nazareth · Post by **Nazareth** » Tue Jun 26, 2007 9:06 pm

Xian- here is a list of folks rating Provigil and talking about how it helps them, as well as the side effects, how long they've been taking it, and what they are taking it for- they give ratings to it as well- about 250 entries- seems the consensus is that it causes kind of obsessive clenching of teeth, tongue pressing on lower teeth, diahrea, and crashing when med wears off, strong urine smell, and with some, the drug loses effect over time- but I guess the trick is to take it during week and take weekends off according to some. There's soem other side effects as well- but of course, everyone is different in how they react- some didn't experience hardly any side effects.

http://www.askapatient.com/viewrating.a ... e=PROVIGIL

Guest · Post by **Guest** » Tue Jun 26, 2007 10:46 pm

I tried it... can't say it did much more or maybe even as much as an "engery drink"

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