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Oversleeping. Nuvigil poop out? What do I do?


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Can nuvigil poop out? Why am I suddenly wanting to sleep 24/7? I nap 2-4 hours a day and get minimum of 10 hours of sleep at night.

I use a CPAP but it’s never done anything for me. Except drain our bank account $$$. (Even my initial DX of sleep apnea was very borderline)

My sleep dr even thinks I don’t have sleep apnea anymore because of all the weight I’ve lost. But wonders/worries how I’ll get nuvigil prescribed without a sleep apnea diagnosis.

My mood has been lower but no changes to any psych meds recently. I don’t know if I’m sleeping to avoid life?

I doubt it’s my thyroid because I just had that checked a few months ago ish?

Do I call sleep dr and ask for yet another sleep study? To prove I don’t even have sleep apnea anymore so I can stop using the CPAP? I don’t know. Maybe I’d be fine without the nuvigil or my insurance might still prescribe it for “off label” use. Hmmmm.

Or do I wait until I see my pdoc late February? That seems so far away though. 

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I don't have OSA, sleep shift work disorder, or narcolepsy, and I somehow managed to get a prescription for Nuvigil. I have no idea how. I think my GP/NP have me down as narcolepsy without cataplexy. Perhaps your sleep doctor can keep your diagnosis of OSA to "trick" the insurance companies. I think that's what my GP/NP have been doing for certain meds for me.

I do believe it's possible for it to poop out. I will say that brand-name Nuvigil was a miracle drug for me, but generic Nuvigil is absolute hot garbage. It makes me more sleepy I think.

That's strange that the CPAP doesn't do much for you. Maybe your pressure/settings aren't optimized? You may have to have another sleep study for them to optimize your pressure/settings. My dad has OSA and when he was still using his CPAP (he hates using it and doesn't use it anymore), he was constantly having sleep studies for that reason.

You wouldn't be able to take something like a low dose of Adderall like 5 mg twice daily Or Ritalin 5 mg twice daily or something would you? Do you think your sleep doc would prescribe that instead of Nuvigil if you weren't able to get it anymore? Or does that trigger mania/psychosis for you? Just a thought. There's also stuff like bupropion (Wellbutrin) but I think you've taken that before and not had a good experience with it. Some of the TCAs are kinda stimulating, like nortriptyline, desipramine, and protriptyline, especially protriptyline. They can be taken alongside your SSRI or alone (getting rid of the Prozac). I personally found protriptyline to be the most stimulating and the most mood-brightening (at 30 mg/day, 10 mg 3x/day).

I would call your sleep doctor and get a workin if possible and describe to her what's going on. She may know what to do. You may need a higher dose of Nuvigil, which I know you're already on the max, but she can override the quantity limit and get you up to 400 mg (200 mg 2x/day) or 500 mg (250 mg 2x/day). It's very difficult to get the insurance company to go along with it, but it is possible. I've read about someone who takes 500 mg Nuvigil. The other possibility would be for you to go to Provigil and take 600 mg, which I don't know if that's past the quantity limit or not (I think it is). Some people take up to 1000 mg Provigil I think (don't quote me on that!).

I wouldn't wait until your pdoc appointment. Also, your pdoc is so conservative and doesn't really want to do much of anything to help you it seems. Your sleep doc sounds like she'd do a lot more for you.

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On 1/31/2020 at 4:07 PM, mikl_pls said:

I don't have OSA, sleep shift work disorder, or narcolepsy, and I somehow managed to get a prescription for Nuvigil. I have no idea how. I think my GP/NP have me down as narcolepsy without cataplexy. Perhaps your sleep doctor can keep your diagnosis of OSA to "trick" the insurance companies. I think that's what my GP/NP have been doing for certain meds for me.

I do believe it's possible for it to poop out. I will say that brand-name Nuvigil was a miracle drug for me, but generic Nuvigil is absolute hot garbage. It makes me more sleepy I think.

That's strange that the CPAP doesn't do much for you. Maybe your pressure/settings aren't optimized? You may have to have another sleep study for them to optimize your pressure/settings. My dad has OSA and when he was still using his CPAP (he hates using it and doesn't use it anymore), he was constantly having sleep studies for that reason.

You wouldn't be able to take something like a low dose of Adderall like 5 mg twice daily Or Ritalin 5 mg twice daily or something would you? Do you think your sleep doc would prescribe that instead of Nuvigil if you weren't able to get it anymore? Or does that trigger mania/psychosis for you? Just a thought. There's also stuff like bupropion (Wellbutrin) but I think you've taken that before and not had a good experience with it. Some of the TCAs are kinda stimulating, like nortriptyline, desipramine, and protriptyline, especially protriptyline. They can be taken alongside your SSRI or alone (getting rid of the Prozac). I personally found protriptyline to be the most stimulating and the most mood-brightening (at 30 mg/day, 10 mg 3x/day).

I would call your sleep doctor and get a workin if possible and describe to her what's going on. She may know what to do. You may need a higher dose of Nuvigil, which I know you're already on the max, but she can override the quantity limit and get you up to 400 mg (200 mg 2x/day) or 500 mg (250 mg 2x/day). It's very difficult to get the insurance company to go along with it, but it is possible. I've read about someone who takes 500 mg Nuvigil. The other possibility would be for you to go to Provigil and take 600 mg, which I don't know if that's past the quantity limit or not (I think it is). Some people take up to 1000 mg Provigil I think (don't quote me on that!).

I wouldn't wait until your pdoc appointment. Also, your pdoc is so conservative and doesn't really want to do much of anything to help you it seems. Your sleep doc sounds like she'd do a lot more for you.

Well I had a second sleep study with my CPAP and they messed with the pressure, etc and they say during every appointment that the pressure looks fine. I’m tempted to stop it altogether on my own. it does absolutely nothing for me and never has. And I barely had sleep apnea in the first place but because I was tired all the time they said I needed a CPAP machine. And my sleep dr last appointment even said I most likely don’t even have sleep apnea anymore. Because I’ve lost 70 lbs.

Not to mention the cost and the horrible awful customer service from the only place you can get your CPAP supplies from. We just got a $250 bill for barely anything and we have good insurance. And I returned something in November, and no credit to my account yet. They basically stole from me. It was like pulling teeth to even talk to someone about returning this item. I’m just fed up.

At this point I don’t care if I can’t get nuvigil anymore. Maybe my pdoc would prescribe it or my weight dr. I might try without it tomorrow. I do notice a difference between the brand and generic like you do. My sleep dr is really good, but I know she is going to want yet another sleep study (probably another day and night one). And we can’t afford the thousands of dollars that those studies cost right now because we just needed a new furnace.

Would it be awful to stop the CPAP and the nuvigil on my own for a trial? It’s one less med.

 

ETA - my sleep dr even admits that my tiredness stems from my psych meds she believes 

Edited by Wonderful.Cheese
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5 hours ago, Wonderful.Cheese said:

Well I had a second sleep study with my CPAP and they messed with the pressure, etc and they say during every appointment that the pressure looks fine. I’m tempted to stop it altogether on my own. it does absolutely nothing for me and never has. And I barely had sleep apnea in the first place but because I was tired all the time they said I needed a CPAP machine. And my sleep dr last appointment even said I most likely don’t even have sleep apnea anymore. Because I’ve lost 70 lbs.

Maybe you have narcolepsy or idiopathic hypersomnia?

5 hours ago, Wonderful.Cheese said:

Not to mention the cost and the horrible awful customer service from the only place you can get your CPAP supplies from. We just got a $250 bill for barely anything and we have good insurance. And I returned something in November, and no credit to my account yet. They basically stole from me. It was like pulling teeth to even talk to someone about returning this item. I’m just fed up.

Ugh, that's no good at all. I would be pulling my hair out...

5 hours ago, Wonderful.Cheese said:

At this point I don’t care if I can’t get nuvigil anymore. Maybe my pdoc would prescribe it or my weight dr. I might try without it tomorrow. I do notice a difference between the brand and generic like you do. My sleep dr is really good, but I know she is going to want yet another sleep study (probably another day and night one). And we can’t afford the thousands of dollars that those studies cost right now because we just needed a new furnace.

Why would she need another sleep study? Why couldn't she just increase your Nuvigil to a supratherapeutic dose?

5 hours ago, Wonderful.Cheese said:

Would it be awful to stop the CPAP and the nuvigil on my own for a trial? It’s one less med.

I would consult your sleep doc about that before doing that.

5 hours ago, Wonderful.Cheese said:

ETA - my sleep dr even admits that my tiredness stems from my psych meds she believes

*rolls eyes*

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11 hours ago, mikl_pls said:

Maybe you have narcolepsy or idiopathic hypersomnia?

Ugh, that's no good at all. I would be pulling my hair out...

Why would she need another sleep study? Why couldn't she just increase your Nuvigil to a supratherapeutic dose?

I would consult your sleep doc about that before doing that.

*rolls eyes*

Thanks for your response again! :) 

I don’t know. I could have one of those sleep disorders. My daytime sleep disorder study was so messed up. They really messed it up. I was put in a room that was wall to wall with a very noisy daycare next door. So I fell asleep for all 5 “naps”, but it took me 9 minutes instead of 8 minutes to fall asleep for the diagnosis of narcolepsy or other sleep disorders. Why they have a daycare next to a sleep clinic makes no sense to me. So no other sleep disorders are officially diagnosed at this time. Although highly suspected. Ugh.

And my sleep dr is very by the books. She likes to be precise. I know she would definitely want another sleep study for me to stop my CPAP machine “properly” and also stop nuvigil or increase it. And I know she’d never go beyond the max dose. I really do.

So last night I didn’t use my CPAP and no snoring nor anything else like that. Husband didn’t hear a thing and I didn’t wake up. I think I’m seriously done with my CPAP machine. And this morning I only took 50 mg generic nuvigil (instead of my usual 150 mg) and I thought I’d be super tired, but in fact I feel pretty ok. Not really tired at all. We will see how the day goes I guess but, so far so good!

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