A med to sleep - A med to wake!!!

[Afterhours]

Is anyone else having issues with NuVigil keeping you awake far longer than it should? I find that NuVigil keeps me from crashing and burning @
work but then sometimes prevents me from sleeping @ bedtime. The problem is it makes me feel like a million in loose change, more like I used
to feel before Apnea and RLS set in. Thoughts? Apprec!

[Pugsy]

That's a nasty side effect from the half life of the dosage. Enough of the drug is still in your system at bedtime.
Each person can and will have a different reaction to however much of the drug is remaining in their system at bedtime.
Just depends on a person's own body and how it reacts.
Either dosage or time it is taken (or maybe even both) would need to be altered so that the half life effect is minimal so that it doesn't keep you "wired" up at bedtime.
I have a similar issue with my pain meds despite it coming with a "may cause drowsiness " sticker. If I take it after 6 PM I am too "wired" to sleep until 2 AM. I don't really feel wired but I sure can't go to sleep.

[chunkyfrog]

Here we go again. Does EVERYBODY need a drug to get to sleep?
--or stay awake. How does this happen? I can understand unmanageable pain; or anxiety, but..aw, geez.
This is what I am using CPAP for. --and it works.
Please don't hate me because I refuse to support Big Pharma unnecessarily.
Ok, end of unsympathetic rant.

[ems]

CF - Many people need meds to sleep for one reason or another. If you don't, you're one of the lucky ones. CPAP/BIPAP alone does not produce sleep.

[chunkyfrog]

I still feel that many docs are more inclined to keep someone on a drug, rather than delve down to the root cause,
or work to eliminate the need; as that might be 'too much work'.
The past history of docs having a closet full of "free" samples may have created an atmosphere of chemical dependency
(by docs as much as patients)!
Of course, I know there are quite a few people who need, really NEED drugs, but I know of quite a few personally who
would now be a lot better off if they had been better cared for, rather than being doped up and left like that.

[avi123]

NuVigil=

Armodafinil(ar moe daf' i nil)


Why is this medication prescribed?

Armodafinil is used to treat excessive sleepiness caused by narcolepsy (a condition that causes excessive daytime sleepiness) or shift work sleep disorder (sleepiness during scheduled waking hours and difficulty falling asleep or staying asleep during scheduled sleeping hours in people who work at night or on rotating shifts). Armodafinil is also used along with breathing devices or other treatments to prevent excessive sleepiness caused by obstructive sleep apnea/hypopnea syndrome (OSAHS; a sleep disorder in which the patient briefly stops breathing or breathes shallowly many times during sleep and therefore does not get enough restful sleep). Armodafinil is in a class of medications called wakefulness-promoting agents. It works by changing the amounts of certain natural substances in the area of the brain that controls sleep and wakefulness.


Comment,

I suffer from some RES (Residual Excessive Sleepiness) during the daytime. But NuVigil is not for me b/c:

1) I am not young enough to take the stimulating effects of this drug especially on the heart.
2) It does not go with Rxs that I take such as Xanax, Paxil, etc.

[Sir NoddinOff]

In a perfect world, it would be great if these drugs did their job, left the body and had no side effects. Unfortunately (personal experience speaking here) it's easy to get locked into a spiral of increasing dosages, ineffective results, mental fogginess and fear based decisions - plus there can be many potential serious side effects, including medical complications associated with prolonged usage. As a side note: Certainly there are many folks that must take meds under doctor's orders for their medical conditions or even for sleeping, that stands to reason, (although, I'd require some serious justification from that particular sleep doctor!)

I'm not your doctor and I'm not here to judge anybody, but please note that I'm simply glad to offer this personal testimony and to say that I was able to taper off them completely, in what amounted to a not terribly difficult one month journey. These days I'm a lot happier and healthier. I'm also not saying all this to preen or gloat - I'm merely offering up some of my personal life story in hopes that if even one person critically examines these drugs and cuts back or eliminates their usage, then I'm a happy guy.

[49er]

Is anyone else having issues with NuVigil keeping you awake far longer than it should? I find that NuVigil keeps me from crashing and burning @
work but then sometimes prevents me from sleeping @ bedtime. The problem is it makes me feel like a million in loose change, more like I used
to feel before Apnea and RLS set in. Thoughts? Apprec!

Afterhours,

As one who used to take Adderall which caused insomnia, I definitely empathize. Would it be possible to cut the dose so you could still get some benefit while enabling you to sleep?

You said you are awake longer than you should be. Do you eventually fall asleep? How is the quality?

49er

[49er]

I still feel that many docs are more inclined to keep someone on a drug, rather than delve down to the root cause,
or work to eliminate the need; as that might be 'too much work'.
The past history of docs having a closet full of "free" samples may have created an atmosphere of chemical dependency
(by docs as much as patients)!
Of course, I know there are quite a few people who need, really NEED drugs, but I know of quite a few personally who
would now be a lot better off if they had been better cared for, rather than being doped up and left like that.

That was definitely my experience with the first sleep doctor. Instead of suggesting that I work out my mask issues which I definitely think has impacted my cpap treatment, she wanted to prescribe meds.

I definitely agree with you that doctors seem to resort to the prescription pad way too quickly.

Having said that, I do recognize that for some people, meds are the only option. As long as they are fully informed about the risks/benefits, then I have no problem with that.

49er

[lliann]

ah yes, I was shocked when this(nuvigil) was suggested. First time I was adamant. No way.

Eventually, there came a time when I could barely function. I couldn't make it through a full day at work and I would reach a point where my hands would go in slow motion- like I was already heavily drugged.. So I agreed to try it. (this was the free 30 day supply before I realized is was a tier 3 drug and was not gonna get an auth from the ins and the cash price is over $400.

I know for me a little goes a long way so I took 1/2 of a 150. The side affect for me is get very VERY chatty. I would only take the 1/2 on those days I absolutely could not stay awake at work. I didn't use them off hours, because I could nap then. I was very aware that it's an addictive substance.(it looks like a duck, quacks like a duck, its a duck, Folks) I know the bottle said to take it everyday, but I wanted to managed this experience carefully . I have seen what addicition does to people.

They suggested ritaIin It was cheaper and "supposedly would work the same.Well, I tried one and I felt like I had a family of Lithiuians marching through my arteries for the day.Not for me. So we fought for Provengil (lost to the ins) and I bit the bullet for cash.

When I started on my vpap, I stopped taking them at all (I am talking maybe 2 times a week a 1/2 pill 75mg) but I was also concerned that here I am trying to sleep with my new headdress and I didn't want to be talking to my tubes all night long.

But lately I have hit a new stage and I am very very tired again. (this is why I am interested in learning if there are some long term affects we will deal with even if we are successfully using a cpap system) Frankly I think the new regime is making my body go apeshit. And I don't even know what I mean but I feel better and yet not better

Anyway, long story short, I tried them this week. Broke a pill in thirds.(they are 250's. It was cheaper to get that dosage and then slice and dice them) Gets me through the mid day slump(not by much) . It was a small enough amt that it did not impact my sleep.

I am not a fan of drugs.. I tend to resist them but the tiredness from this sleep apnea is unlike anything I have ever known. I am barely functional these days. I am able to get through a day at work (or when I can't I go home to bed using Fmla) but my ability to do anything sustaining is squat. So while I consider the pills a last resort, the truth is the last resort is here. And it sucks.

But it is what it is.

[MaxDarkside]

Armodafinil (Nuvigil) Half-life 12-15 hrs
http://en.wikipedia.org/wiki/Armodafinil

That means the dose you take at 8 AM is still HALF THERE at 8-11 PM. At the next 8 AM, one quarter of the previous day's dose is still "on board". If you re-dose each 8 AM, it is conceivable that your Armodafinil levels could accumulate. I suppose in a few days, or a week, you could be like loaded and wired, 24/7. Do you take it each morning? (I've never had it myself)

[Sir NoddinOff]

That means the dose you take at 8 AM is still HALF THERE at 8-11 PM. At the next 8 AM, one quarter of the previous day's dose is still "on board". If you re-dose each 8 AM, it is conceivable that your Armodafinil levels could accumulate. I suppose in a few days, or a week, you could be like loaded and wired, 24/7. Do you take it each morning? (I've never had it myself)

Good point Max. Is it just me, or do I hear angry kidneys and livers all around the world screaming HELP! The brain cells are probably too stoned to care. JUST JOKING FOLKS, DON'T SEND ME ANY FLAMIN' PM's.

[lliann]

No, I don't think I have taken it 2 days in a row. probably because there is some half life still lurking.(but it doesn't affect my falling asleep for some reason) I am strictly trying to get though to 11-2 hump. I guess I volley between that or fmla. trying not to overuse either one and yet trying to still perform my job. I would prefer none of this and only go there when I have the debilitating tiredness that I can't overcome. But even with both options, I am beginning to think I can't hack it much longer.

For example. Last week we had a 2 hour meeting about a new software program. Now I already know I can't sit and do nothing and stay awake. So I marked every time I nodded off. (asked my coworker to watch). 31 times. Its actually painful trying to stay awake. Not in the traditional sense of pain but in the shear discomfort of it. I looked up the disability option but I think I am too old for that (the criterion increases with some ages) and just a year too soon to retire.

I know the cpap is helping me and yet I feel more tired each day. I just want to know the what and the why. I can deal with it if there is an explanation. Its just not knowing the parameters of the whole of this disease.

[lliann]

That means the dose you take at 8 AM is still HALF THERE at 8-11 PM. At the next 8 AM, one quarter of the previous day's dose is still "on board". If you re-dose each 8 AM, it is conceivable that your Armodafinil levels could accumulate. I suppose in a few days, or a week, you could be like loaded and wired, 24/7. Do you take it each morning? (I've never had it myself)

Good point Max. Is it just me, or do I hear angry kidneys and livers all around the world screaming HELP! The brain cells are probably too stoned to care. JUST JOKING FOLKS, DON'T SEND ME ANY FLAMIN' PM's.

Not flaming, but happy to educate like many others here. If there is one thing I know about and am not in denial about, are drugs and what they can do.(I have never done drugs, not even recreationally) Which is why I refused these at first and only agreed to try them in a very limited way. My amt is not enough to get stoned. (no more than when people think people taking Prozac are using mood altering drugs) The semantics can be misleading.

I would prefer to not "need' them and only have one scenario where I will utilize them.

That said.......when I work with addicts, my question is always What is your intent? There are times when anyone, even a drug addicit, may need treatment. I do generally believe doctors are (jeez, I don't even know what word I want to use) They want to solve things and don't always understand that the solution, if not monitored, can create a whole other issue. Thats why I split the pills. For me. Its just another area where one must be proactive and truthful.

But I would hesitate to make any one feel badly about using prescribed meds if their need is real and their intention is true. I suspect I have done more damage to myself not accessing the help available then accessing.

I have no agenda on this. I am clear about what I do and know.

[MaxDarkside]

Dr. says he'd prescribe me Nuvigil or Provigil. Instead when I need a bit of boost due to grog, I reach for pseudo-ephedrine with a half-life of 4.3–8 hours, but then the 12 hr release stuff rather complicates the half-life calculation. As an experiment, I've been taking one 1/2 12 hr caplet at 8 AM, the other half at noon which gets me shy of bed time (I can feel it wear off) and I sleep well, *BUT* my grog seems to be worsening over time (a pseudo-ephedrine rebound, perhaps?) so starting tomorrow for a week, none of that, and I'll just deal with the grog for a while. I'll try to see if the pseudo-ephedrine is causing a rebound worsening the grog. Gotta watch out for them meds, they can treat short term, but can cause the problem to worsen too.

I do not recommend this or any drug for anyone. Talk to yer doc. If my wife takes pseudo-ephedrine, she did once recently, with her hyper-adrenal problem, she about exploded. Ephedrine is adrenaline. Pseudo-ephedrine is a diastereomer of ephedrine, that means the same compound, just twisted a certain way.