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actually GETTING a stimulant


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I have clinical hypersomnia. I know hypersomnia is a catch-all-diagnosis for other sleeping disorders like DSPS and narcolepsy. But no im actually a real hypersomniac. I need 12-14 hours of sleep a day. If i wake up before "my time" my blood pressure is low, my temp is low, my melatonin is high and i fall asleep during normal activities like driving. Which is bad very very bad (im to the point where if it happens again i will get my license revoked for however long they decide).

Anyway...

A stimulant would really help. I cant sleep 12 hours a day with a job and part time school. Not happeneing. SO when I do wake up "like a normal person" a stim would really really help.

My pulminary doctor prescribed me provigil. And of coarse provigil is only FDA approved for narcolepsy. And i technically dont have narcolepsy. so i was denied by the insurance co. Im suppossed to get a letter of why ive been denied and then my pulminary doctor would retry the insurance. i can not pay the 600$ a bottle for this med. no way.

so...what do i do?

im calling my doctor on monday to see if HE got the letter because i never did. and if he re entered the prescription. that should answer some questions. but its kind of lost hope. i mean...i was on provigil for ADHD at one time and it got taken away because i was denied by the insurance. so is the only way to get this med is to actually be narcoleptic? or how does that work?

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Provigil is FDA approved to treat excessive sleepiness resulting from: Narcolepsy, Shift Work Sleep Disorder, or Obstructive Sleep Apnea. It's used off label for a lot of other things, but your insurance company can deny coverage unless you have a diagnosis of one of the above conditions.

Did you have an overnight sleep study to diagnose the hypersomnia? Did you have a daytime sleep study to rule out Narcolepsy as the cause of the hypersomnia?

If your pulmonary doctor knows your insurance company denied the Provigil, perhaps he would be open to trying you out on a different stimulant?

~ May

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I'm wondering why a lung (pulmonologist) doctor is treating this. I thought neurologists treated sleep disorders. Maybe that has something to do with why the medication is being denied??

If you are sleeping while driving you shouldn't drive. Period. Not only are you at risk of dying, but you are also putting others at risk of having YOUR car careening into them and killing them and/or their kids. I know it is nearly impossible to get anywhere these days without a car, but seriously, I'm surprised they let you keep your license if you've already been cited for something like sleeping at the wheel.

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I'm wondering why a lung (pulmonologist) doctor is treating this. I thought neurologists treated sleep disorders.

It's not at all unusual for a pulmonologist to treat sleep disorders. Obstructive sleep apnea (one of the major sleep disorders), is primarily a problem with breathing so it's pretty common for people that come to pulmonologist's for other breathing issues to also end up with sleep apnea. Most sleep doctors have first specialized in something else before added the sleep medicine, so long as the doctor is board certified in sleep... so that they... know what the fuck they are doing, it should be all good!

The falling asleep behind the wheel thing... can go a lot of ways. Sometimes you can get away with it a few times, before they yank a license. It's scary.

scarykid - I do hope that you've made the driving problem very clear to your doctor, that's an issue that really needs to be addressed. S9 is right, not only can you hurt yourself - you can seriously injure innocent people.

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You could try seeing a neurologist for a narcolepsy diagnosis. It's a long shot. Most docs don't dx something someone doesn't have, but if you are close enough ????

Can you switch insurance? Some employers offer more than one insurance option. If it's an option available to you, see if Provigil is allowed for a condition you have. I know that mine will approve it for ADHD if a doctor justifies it's use over other stims.

And, there is the option of another stim. Maybe a real low dose would be all you need????

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I have clinical hypersomnia. I know hypersomnia is a catch-all-diagnosis for other sleeping disorders like DSPS and narcolepsy. But no im actually a real hypersomniac. I need 12-14 hours of sleep a day. If i wake up before "my time" my blood pressure is low, my temp is low, my melatonin is high and i fall asleep during normal activities like driving. Which is bad very very bad (im to the point where if it happens again i will get my license revoked for however long they decide).

Hypersomnia is one of my nastier depression symptoms. I'll second getting that sleep study done, because there could be more going on.

Even better than a stimulant (for me) has been taking a strongly noradrenergic antidepressant ( Wellbutrin was simply amazing for sleep ;) ) , desipramine or Vivactil should also work) My guess is that I sleep too deeply and that my respiratory rate drops too low while sleeping otherwise.

im calling my doctor on monday to see if HE got the letter because i never did. and if he re entered the prescription. that should answer some questions. but its kind of lost hope. i mean...i was on provigil for ADHD at one time and it got taken away because i was denied by the insurance. so is the only way to get this med is to actually be narcoleptic? or how does that work?

Check with your insurance company, but I think you may need a formal diagnosis of narcolepsy to have Provigil covered. For a diagnosis of narcolepsy or ADHD, a stimulant should be covered, because they're still the best meds to try for these two problems. Stattera, an SNRI, may be covered for an adult with ADHD. Wellbutrin and the noradrenergic tricyclics can be prescribed for ADHD, but they're mainly used in treating depression and some other oddball things.

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My insurance company will cover it, but only with a prior authorization (which would most likely only be approved for narcolepsy). I have idiopathic hypersomnia and got coupons for 2 weeks of free Provigil but no guarantee that it will be covered after that.

Wellbutrin has actually been helpful to me and I am finding I don't need the 12 hours of sleep plus a 2-3 hour nap 5 hours after I wake up. I can now get by on 8 with a 30 min nap. My dosage is at 150mg now but I bet my alertness would be even better at 300mg.

My sleep study was boringly normal but at least we know now that I don't have sleep apnea (not even mild).

Maybe your doctor could prescribe Ritalin in both the IR and SR doses. That would probably be covered.

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