Who here is on Provigil?

[thesleepermustawake]

Hello

Went back to my sleep doctor for a follow up and as I was complaining about still feeling tired and needing naps, she put me on 200mg of Provigil (modafinila) to help with the sleepiness.
I took the first dose today and I feel a great improvement in my energy level.
I'm curious about other people's experience with this drug, especially those of you who have been on it for a while.

thanks!

[The Latinist]

I have not been prescribed modafinil, but my doctor mentioned it as a possible intervention if my daytime tiredness (17 on Epworth scale) did not improve with CPAP therapy. I'm curious, though, about how your CPAP therapy is going. What are your pressures like? What's your average AHI since you started treatment? Are you experiencing large leaks?

[thesleepermustawake]

My AHI is consistently below 5, more in the 2-3 region.
Leaks have been a problem but this past week, not really an issue.
I've been on the CPAP for a month now I think, with no real improvmeent to daytime sleepiness

[jencat824]

I tried Provigil 14 yrs ago when I was diagnosed with Narcolepsy after 6 months of CPAP therapy. I took a couple of doses & found I didn't sleep AT ALL for 2 WEEKS. Needless to say, I never took it again. It also made me feel very jittery.

Fast forward 12 years later, I found this forum, learned to read my own data & I found I had a very bad case of mouth breathing. Fixed that & I no longer suffer Narcolepsy spells. If my Dr. had been properly reading my data, he should have seen the mouth breathing, and suggested all the remedies for that.

Are you monitoring your data? I would say look carefully for anything that could be affecting your daytime sleepiness. Although I very badly failed the MSLT (test for Narcolepsy) I wonder if I would now, since I've found this forum, learned to read my data & optimized my therapy by changing masks & working on my mouth breathing.

I know Provigil works for some people, and you may be one of those, but if you can attain the same result by working thru issues you may have by reading your own data, that would be better than taking such a strong drug.

[Pugsy]

From what I have read the main complaint from Provigil (or similar) users is that the effect lessens over time meaning after a few weeks it no longer seems as effective as it first did.
It can for sure cause insomnia issues which in turn makes daytime sleepy issues worse...and makes for a nasty little circle of cause and effect occur. The half life of it is such that when you go to bed at night some of it is still in your system and that messes with your sleep quality at night.

[cdean]

Hello

Went back to my sleep doctor for a follow up and as I was complaining about still feeling tired and needing naps, she put me on 200mg of Provigil (modafinila) to help with the sleepiness.
I took the first dose today and I feel a great improvement in my energy level.
I'm curious about other people's experience with this drug, especially those of you who have been on it for a while.

thanks!

I was a test subject in the original research to test the effect of Provigil on cpap users. And, I took Provigil for years at a lower dose to good effect and no side effects until the price skyrocketed several years ago. It never had an effect on my ability to sleep at night when I wanted to sleep. If I can make an analogy to erectile dysfunction drugs . . .they do not cause an erection but allow one to occur. Likewise, Provigil did not force me stay awake, rather it allowed me to stay awake and alert with good energy when I wanted to.

Keep in mind, maladaptive sleepiness and/or low energy is a symptom which is caused by something and it is better to remedy the cause than mask the symptom if possible.

1. Could your cpap therapy be improved? Are you using SleepyHead software to see how well your sleep apnea is actually being treated?
2. Have you had your thyroid function tested?
3. Do you get a 1/2 hour of aerobic exercise several days per week (maybe like walking 3+ MPH)?
4. Have you been evaluated for depression?

[andy88488]

From what I have read the main complaint from Provigil (or similar) users is that the effect lessens over time meaning after a few weeks it no longer seems as effective as it first did.

That was my experience with it. I felt much more focused and alert, but the effect faded very rapidly.

[thesleepermustawake]

I was a test subject in the original research to test the effect of Provigil on cpap users. And, I took Provigil for years at a lower dose to good effect and no side effects until the price skyrocketed several years ago. It never had an effect on my ability to sleep at night when I wanted to sleep. If I can make an analogy to erectile dysfunction drugs . . .they do not cause an erection but allow one to occur. Likewise, Provigil did not force me stay awake, rather it allowed me to stay awake and alert with good energy when I wanted to.

Keep in mind, maladaptive sleepiness and/or low energy is a symptom which is caused by something and it is better to remedy the cause than mask the symptom if possible.

1. Could your cpap therapy be improved? Are you using SleepyHead software to see how well your sleep apnea is actually being treated?
2. Have you had your thyroid function tested?
3. Do you get a 1/2 hour of aerobic exercise several days per week (maybe like walking 3+ MPH)?
4. Have you been evaluated for depression?

Interesting, so as a test subject, I'd expect the lab to provide it for free to you! Is that why you stopped taking it? Do you still feel tired then?

[thesleepermustawake]

From what I have read the main complaint from Provigil (or similar) users is that the effect lessens over time meaning after a few weeks it no longer seems as effective as it first did.
It can for sure cause insomnia issues which in turn makes daytime sleepy issues worse...and makes for a nasty little circle of cause and effect occur. The half life of it is such that when you go to bed at night some of it is still in your system and that messes with your sleep quality at night.

I can only hope that it's not the case for me. I felt really good for the first time in a long while today.
Maybe by the time it loses efficacy, the CPAP therapy will have started being effective for my daytime sleepiness

[thesleepermustawake]

I tried Provigil 14 yrs ago when I was diagnosed with Narcolepsy after 6 months of CPAP therapy. I took a couple of doses & found I didn't sleep AT ALL for 2 WEEKS. Needless to say, I never took it again. It also made me feel very jittery.

Fast forward 12 years later, I found this forum, learned to read my own data & I found I had a very bad case of mouth breathing. Fixed that & I no longer suffer Narcolepsy spells. If my Dr. had been properly reading my data, he should have seen the mouth breathing, and suggested all the remedies for that.

Are you monitoring your data? I would say look carefully for anything that could be affecting your daytime sleepiness. Although I very badly failed the MSLT (test for Narcolepsy) I wonder if I would now, since I've found this forum, learned to read my data & optimized my therapy by changing masks & working on my mouth breathing.

I know Provigil works for some people, and you may be one of those, but if you can attain the same result by working thru issues you may have by reading your own data, that would be better than taking such a strong drug.

My Sleepyhead data is pretty good, I use tape to avoid mouth breathing and leaks are around 20-30. AHI is also good.

[peke]

I took Nuvigil 150 mg for one week then 250 mg the next week. The 150 mg did not work at all. The 250 mg worked for two days, then it didn't work. It did make me feel jittery. I haven't tried Prodigal and don't know the differences between the two.

[codinqueen]

I used it successfully for a few years, but had to stop because my high deductible insurance this year makes it unobtainable at $500.00 for 30 of the 250 mg tabs. I was able to use the manufacturer's coupon (from their website) for the past few years to make it cost me $50 when I had a co-pay on it. This yr I have to pay $1500 before there will be a co-pay for Rx or Dr. It was a big help to keep me from falling asleep at my desk, & never kept me awake at night or made me jittery. I was cutting the tabs into 4ths so I could pay $50 for about 4 months of therapy, but there is no way I can pay $500 now. I have been on CPAP now for a few years, am very compliant every night, but still have extreme daytime sleepiness. I would still be taking it if the price wasn't out of reach. I miss it, been off it now for about a month.

[peke]

I have taken Dexedrine since 2007. It has worked for me. Since the dme switched my machine, the Dexedrine is no longer working. I think it is because I am not sleeping well at night. I used to take 15 mg, now I take 30 mg and it is not working, The company that makes it had to stop because they only had so much product. Dexedrine is in Adderall and other ADD/ADHD drugs so the company used up all of its allocation. I had to take generic Adderall which is amphetamine salt combo and it did not work at all. The ingredients are very different. My new doctor does not want me to take it because of potential heart problems. I understand, but if I can't stay awake to drive, a car crash would affect more than just my heart.

She didn't give me any Provigil to try. She wants me to try Zyrem which she said costs $1000.00 per month! I will stick with my Dexedrine at less than $5.00 for three month supply.

Zyrem is the date rape drug! I can't imagine taking it. What if there is a fire? I would not wake up. It lasts about 3 hours, then I would have to set my alarm clock to wake up and take the second dose. I can't believe companies have not made a great drug for a great night's sleep.

Question: I have Narcolepsy, but why do I struggle all day to stay awake, but at 7:00 p.m. I am wide awake?

[kteague]

Since the dme switched my machine, the Dexedrine is no longer working. I think it is because I am not sleeping well at night... She wants me to try Zyrem...
Question: I have Narcolepsy, but why do I struggle all day to stay awake, but at 7:00 p.m. I am wide awake?

Peke, maybe you could start a thread about your situation so it doesn't get lost in a discussion on a medication. I'm wondering what has been done by your doctor to assure that your new machine is effectively treating your sleep apnea. I would hope they would not prescribe heavy duty drugs without first seeing if there is something else needing addressed. I'm sure some people people here could help walk you through checking this out. Also wondering if your apnea was therapeutically treated at the time you had your MSLT to test you for narcolepsy. As far as you being sleepy during the day but not at night, any number of things could be behind that. I know when my OSA treatment was not effective, I avoided sleep. I feel like it was a survival mechanism to avoid that which was not only miserable but dangerous.

Regarding Provigil, I took it for a while. I did feel some benefit but could not take enough to help much because it made me so jittery. I could take the dose and still sit down and fall sleep for 2 hours. A person's benefit may depend on their sensitivity to the drug and on the dose they can tolerate. In my situation, due to legs movements I still wasn't getting good sleep at night. No stimulant can substitute for sleep. I am not against stimulants when necessary to function; I am concerned when stimulants are prescribed in lieu of investigating for a cause.

[zoocrewphoto]

From what I have read the main complaint from Provigil (or similar) users is that the effect lessens over time meaning after a few weeks it no longer seems as effective as it first did.
It can for sure cause insomnia issues which in turn makes daytime sleepy issues worse...and makes for a nasty little circle of cause and effect occur. The half life of it is such that when you go to bed at night some of it is still in your system and that messes with your sleep quality at night.

I can only hope that it's not the case for me. I felt really good for the first time in a long while today.
Maybe by the time it loses efficacy, the CPAP therapy will have started being effective for my daytime sleepiness

Have you been able to check on the length of any apnea events? My mom had an ahi of 3.4, but her events were all long.

Also, do you wake up much during the night or sleep pretty solidly? How many hours of sleep do you get per night?