You are pretty much in the same ballpark as the new doc.
The new doc spent about 1 hour with me reviewing my case, seemed very knowledgeable, and knew about topics that most docs may not be up-to-date about such as CBT, fibromyalgia, etc.
Regarding the OSAHS and PAP treatment, with the PAP, my Stage 3 sleep was 30%, versus almost 0% without the PAP in the first study. That improvement and that I do feel a little better since using the PAP. So the doc thinks that there is OSAHS and that it's being successfully treated, and therefore I will continue the PAP.
New doc thinks that the remaining symptoms are probably caused by an additional sleep disorder, such as insomnia/difficulty maintaining sleep, delayed sleep phase syndrome, idiopathic hypersomnia, possibly even narcolepsy.
The suggestion was for me to continue to take the Clonazepam, practice strict sleep hygiene, etc. I was somewhat frustrated as I am and have already been doing those things. I am on my third day of the strict sleep hygiene routine and feel awful. I was not successful today as I was "passed out" from 8am to noon.
I am supposed to take the Klonopin (Clonazepam) only one time per day, before bedtime. I "like" it because it seems to be the only thing that helps with my headache, which is a facial headache, plus it makes me feel really good. The one time that I did not take it, I had the worst nightmare of my life, and the next morning I experienced a significant amount of anxiety upon awakening - very unusual. I told the new doc that I was worried about it. The doc said that I need to continue on it, and that if there are problems then I would be "weaned" off of it for a "vacation time period".
The new doc also wants me to undergo a third sleep study this time with the multiple sleep latency test. I balked, because 1) I was too tired to think clearly and make decisions, and 2) even if I am diagnosed with one of these other disorders, then the treatment options will be the same ones that I am already doing now!
I am still mulling over doing the third sleep study. The doc is looking for insomnia, inability to maintain sleep, delayed sleep phase syndrome, hypersomnia, and narcolepsy. I am being treated for the first 4 conditions already by following strict sleep hygiene practices and I have Provigil. If I follow the sleep hygiene, and don't get better, then why doesn't the doc just trial the meds for narcolepsy on me? rather than doing third study?
I am going to wait a week before making any decisions. I am very frustrated and not thinking clearly.