CPAPtalk.com

Big Daddy RRT,RPSGT wrote:What about nuvigil with my cholesterol drug simvastatin? Am I rotting my liver?

I have no idea.

I think Nuvigil only comes in 150 and 250mg.

Excessive sleepiness can mean a number of things.

Sleep Apnea (not being fully treated)
Narcolepsy
Idiopathic Hypersomnia
Depression (just to name a few)

After five or six years of being treated for depression (I kept telling them I wasn't depressed apart from my being sleepy all the time) I took my medical care into my own hands. I spent a month researching everything I could find and told the doctor I wanted a sleep study.

"A sleep study?" asked the Psychiatrist. "Whatever for?"

LOL

So I got diagnosed with Sleep Apnea (pressure 14). After a year and four sleep studies later, I kept telling them I was still tired.

"Tired?" says the Neurologist. "Whatever for?"

I decide to go to the Mayo clinic. The brain behind the desk says, Idiopathic Hypersomnia. I'm given my first dose of Modafinil (ProVigil). 200mg doesn't do much. They bump me up to 400mg. I feel no change, except the regular headache that only two extra-strength Tylenol can get rid of. But all of a sudden I start doing things. The list of things I do each day keeps getting longer and longer. I keep this up for the next two weeks. I start to think I will be able to go back to work again, but then things go downhill. The list keeps getting shorter and shorter. They try bumping Modafinil to 600 and then 800. No go. If I go a couple days without Modafinil, and then take it...I get a little boost. But it doesn't last long. Now, I spend my days being conscious. It turns out that this is a common problem with Modafinil. With some people, two weeks and their done.

Adding 10 mg of Ritalin to the 400mg Modafinil helps. However, it isn't a solution.

According to one study, most people start out on Modafinil, but end up using Ritalin when all is said and done. Ritalin is less expensive.

I guess for those of us who have excessive sleepiness even after CPAP, we will just have to wait for future meds to come out.

I don't completely understand how one can ever get a diagnosis of Idiopathic Hypersomnia once they have an OSA diagnosis. It's documented in the literature that the EDS associated with OSA does not always remit with treatment. Consequently, I would think that any EDS symptoms in the presence of an OSA diagnosis can forever be explained by OSA and therefore are not "idiopathic". But what do I know.

I have sometimes felt that medications only work for me for a couple of weeks. I've thought of having some kind of rotating system where every two weeks I switch medications. No doctor has really supported my idea, though.

I've used Nuvigil for over a year, and it's made a huge difference in my daytime activity and general 'user-friendlyness' quotient (informal family survey... Pro/Nuvigil are called the personality-improvement drug). I've been paying cash at $260-320/month for this stuff - highway robbery / no insurance / and insurers may call it a psychotherapy drug and won't cover it.

Latest research: buy the generic Modafinil from a company like Canada Edrugs (prescription required), to get the generic from an evidently good-quality manufacturer in India. You just can't get the generic in the US yet - coming in 2012. Don't get stuff from Chinese mfg's - like sites such as 'edandmore' are pawning.
Research the FDA site - it is legal to order online / out of country - you just have to stick to products currently legal and available in the US (Modafinil / Armodafinil are available in the US).

Total savings: little over $1/per pill vs. $8-11/pill for the patent-choked OEM product - around 6-9-times cheaper.

Also, a medical study I researched found that a split dosing regimen is best - 7AM and 12PM dosing. Theoretically, the *dafinil products are not sleep-delaying/inhibiting in nature, they just enhance your wake-time. I've never had it affect my ability to sleep.

Ta for now.

Guest wrote:Also, a medical study I researched found that a split dosing regimen is best - 7AM and 12PM dosing.

Do you have a link to that study? I'd like to read it. Thanks.