Doc recommends stimulant ? ?

[mrnetwurm]

Just had my first 30-day check-up with my sleep doc. My average AHI is down to 1.5 and she felt the
CPAP therapy was working as it should.

When I explained that I was greatly improved, but still tired on some days, she said that she prescribes
a stimulant for people that are not getting where they need to be with CPAP alone.

She wants me to return in another 30 days and she will write the script if needed.

Anyone else ever heard about this ? ?

[Pugsy]

Yeah. Sometimes offered as Provigil and Nuvigil.

http://en.wikipedia.org/wiki/Modafinil

Legal speed and something to be fully informed on if you go down that road. Not without side effects but it has its place in the grand scheme of things.

[apneawho]

My pulmonologist offered Nuvigil, but after reading up on it I didn't want to take the chance that I would have difficulty falling asleep at night. I don't have any problems falling asleep at work or at the wheel. I imagine if someone did have that much dozing off they would need Nuvigil.

[djr1215]

I was offered Nuvigil last year and didn't take it. But the daytime sleepiness and brain fog were getting so bad (even with average AHI of 0.5) that I finally gave in a couple of months ago. Now I wish I had started on it last year. The first few days were bad - so if you do start this, try to start it on the weekend just in case. The first night I did not sleep at all - none. But after the first few days it all evened out and I'm sleeping even better than I was. My doctor doesn't want me to take them on weekends if at all possible, and I can really tell the difference on Saturday and Sunday.
I was worried about arrythmias (since I was already having some problem with that), but since starting Nuvigil the arrythmia has stopped. I don't know if that's coincidental or what, but for me, it's a happy side effect!

[Mary Z]

I have been taking the 250 mg dose for quite a while. Perhaps start at the 150 mg dose and take it early in the morning to prevent insomnia. If you wait until after 9:00AM unless you have a very late bedtime I would skip that dose. It is a wakefullness drug, I have no speed like side effects. In fact I have no side effects. It will help you lead a more normal life if you are having trouble staying awake at work, driving, at meetings, watching TV. It does not give me energy- just helps me stay awake.
Well, to be on the safe side if you are sensitive to meds perhaps start with 1/2 tablet and as someone suggested start on the weekend.
Doctors generally don't prescribe this stuff lightly.

[SleepingBearDoNtWake]

I have tried the stimulant, and it didn't seem helpful to me, but than again, I terrify the doctors when I walk in, because nothing ever works for me and the way it should. They know to expect the unexpected with me!
For me I just had headaches as a side effect. I didn't have any more energy than usuall, so I stopped taking it.
I would just advise you to read up about it and talk with your doctor. Each person is unique, and if it works for you and improves your life, It may be something worth trying.
Good Luck!

[archangle]

Get the pills, try them at least a day or two. You can always put them away in the medicine cabinet for use if you need them later.

Assuming they're not hideously expensive.

[mrnetwurm]

Thanks to all. I will give it a try. My doc also requested a thyroid check. I am gaining about 1lb per week and have
put on 25 lbs this year so far. Just can't get the energy to exercise and the weight keeps coming.
Currently 5'11" and 225 lbs (47 years old)

[Pugsy]

Assuming they're not hideously expensive.

They can be pretty much hideously expensive. Especially Nuvigil as it is newer. Insurance companies sometimes balk at allowing it to be a covered item. Depending on dosage I have seen costs reported to be $150 to $300 a month.

[archangle]

Thanks to all. I will give it a try. My doc also requested a thyroid check. I am gaining about 1lb per week and have
put on 25 lbs this year so far. Just can't get the energy to exercise and the weight keeps coming.
Currently 5'11" and 225 lbs (47 years old)

A thyroid check is a good idea. Unless they give you more than you need, the drug is really safe with few side effects. Cheap, too. Low thyroid does a lot of slow damage to your organs as well.

[JayC]

I tried these pre-cpap.

Didn't help provide a connected alertness I was lacking. So I stopped the doc led experiment. Proper quality/quantity of sleep is that key for me! And I am still working on those issues even though cpap is providing some improvement!

Mostly, I wasn't much of a napper, so staying awake wasn't the issue.....staying connected and not spacey was.

I think being able to really describe (to yourself and your docs) the character of the fog/tiredness/fatigue ---whatever it is for you--- is going to be key in getting to things that help you. Then you can use available tools wisely......be they nutritional or pharmacutical or exercise and schedule or all of the above

All the best with this...
J

[howkim]

I've taken Provigil on and off for a couple of years. I don't consider taking Nuvigil, because it lasts so much longer in the body than does Provigil. It's helping me stay alert for my very intellectually demanding job.

[djr1215]

Assuming they're not hideously expensive.

They can be pretty much hideously expensive. Especially Nuvigil as it is newer. Insurance companies sometimes balk at allowing it to be a covered item. Depending on dosage I have seen costs reported to be $150 to $300 a month.

Yes, they are, but Nuvigil has a program where they will pay part of it. I got the 1st month free. the 2nd month the notice I got from my pharmacy as that it was going to be $390, but after applying the Nuvigil credit it was $40.00. Be sure to ask your doctor about the program - they should give you a brochure with a savings card. If they don't have it, go to the Nuvigil website for one.

[josh816]

Go here http://www.nuvigil.com/home-consumer and click on Try Nuvigil Free. They'll give you a coupon for a free trial, then you save up to $50 each month off your copay.

[SleepingBearDoNtWake]

You can get free drugs or reduced cost drugs though many of the companies programs. You just usually go to the website and look hard for the infomation. I have had to do it a few times, and it took time to fill the forms etc.

No on to your tiredness. If you asked me why you were tried I would say to "what do you hink is causing it" Then I would ask about your cpap therapy and how that was going. Other adieas I would ask about is life and all the stress in it and how you handle that. Do you suffer with Depression, and axiety, Then I would say get a good blook test of everything that you can get checked. For me I have had my B vitamins check, cholesteraol check, iron, hormones. I just found out that my body isn't really making any testostrone, so I have to start using a cream. Neverous, because of the side effects, but this has been missed in all of my other tests that came by fine. Also don't forget the thryoid.
You have to take care of your care, find good people and talk with them and come up with the best plan thMikeat you can, and just keep going.