CNS stimulant

[Duckie]

I have been on apap for 18 months. I still feel like falling asleep behind the wheel. My sleep Dr. prescribe a CNS stimulant. Has anyone needed this? How long do you need to be on them? I am much more awake on the pills but not sure I like taking them

[Mary Z]

Duckie, some of us never get over the excessive daytime sleepiness. I have been on CPAP for over 3 1/2 years and have been taking Nuvigil or Provigil since before diagnosis. I know many people do not like taking pills. With the alternatives, one of which is driving while sleepy I think it's irresponsible not to take them. If it doesn't matter if you are sleepy and you can stop and take a nap whenever maybe it doesn't matter. I have not had any side effects from my meds, they are not addictive, and they keep me awake allowing me to go about my day without falling asleep at inconvenient times. I can also drive safely which is a big consideration as is working with machinery. I had a MSLT and was diagnosed with hypersomnia.

[cre8vmynd]

Duckie,
And you're sure your therapy is optimal?

I only ask because your post reminded me of an experience a good friend of mine recently had.

He'd been on cpap for ten years but in the last couple of years, has started feeling worse and worse. So he went to his doctor and was prescribed a stimulant to help with his daytime sleepiness. What the doctor didn't do was make sure his pap therapy was doing what it was supposed to.

My friend was given a new machine over two years ago. So out of curiousity I just the other day looked at his data (he had no idea how to do it) and what I found was shocking. His perscribed pressure was 9cm but when the DME gave him his new machine two years ago, they failed to set it up that way. So he wasn't even getting the correct prescribed pressure and naturally, his health was declining. I changed it for him to his prescribed pressure and he just told me he slept great and slept all thru the night.

Just a thought.

Casey

[Mary Z]

Duckie,
And you're sure your therapy is optimal?

I only ask because your post reminded me of an experience a good friend of mine recently had.

He'd been on cpap for ten years but in the last couple of years, has started feeling worse and worse. So he went to his doctor and was prescribed a stimulant to help with his daytime sleepiness. What the doctor didn't do was make sure his pap therapy was doing what it was supposed to.

My friend was given a new machine over two years ago. So out of curiousity I just the other day looked at his data (he had no idea how to do it) and what I found was shocking. His perscribed pressure was 9cm but when the DME gave him his new machine two years ago, they failed to set it up that way. So he wasn't even getting the correct prescribed pressure and naturally, his health was declining. I changed it for him to his prescribed pressure and he just told me he slept great and slept all thru the night.

Just a thought.

Casey

You raise a good point about optimal therapy, but don't address the question of falling asleep behind the wheel.

[cre8vmynd]

MaryZ,
You're right I didn't.

By all means the OP should do whatever is needed to not be falling asleep at the wheel.

As far being on stims, my experience on them says avoid using them LONG TERM. For me, they over time made my daytime fatigue worse, and had a negative affect on my sleep. My doctor said "here, take this" so I did. What he didn't do was look a little deeper, which would have showed that I had SDB and did not need to be on a stim.

Casey

[Duckie]

I have an auto pap. 9 to 20. My pressure varies each night. my apnea is 1.6 per hour average for the last three weeks. The apap therapy is optimal. I will take the drugs because I do not want to fall asleep behind the wheel. They have me on Ritalin now and I will change to Provigil as soon as insurance okay's it.