I do have daytime sleepiness. I am sleeping with cpap machine because i was desaturating during night time but i still want to fall asleep whilst driving and sitting quitly
Person's Gender: Female
Person's Age: 46
I will wait to see if you come online
Hello is it cold down there?
not to cold
I'm in NYC, we're in a heat wave for a week or more
so let me ask you, have you tried medications to take for excessive daytime sleepiness (eds) ?
no not yet
no is using cpap
ok is there a history of narcolepsy? is that a possibility? family history?
no family history although thinking of it my aunt also used to fall asleep
well the medicine we use here in the US for this has changed
it used to be called modafinil (provigil)
but now they have come up with a newer, improved version called eumodafinil (Nuvigil)
I don't know what version you would have in SA
here is a webpage on modafinil the older version
is there not special investigations one should do
well not really, not if you have obstructive sleep apnea as this is a common side effect of that problem
now like I mentioned, if you feel that diagnosis could be wrong
then there is a MSLT or multiple sleep latency test
that checks if you have narcolepsy
or another sleep disorder like excessive daytime sleepiness (eds) or idiopathic hypersomnia
but the botXXX XXne to all of it is that you end up using the same drug
what would the other symptoms of it be?
it would be good to have a diagnosis
for narcolepsy, sorry?
symptoms of what?
let me get you some webpages, on narcolepsy , hang on
Narcolepsy has a triad of symptoms.
excessive daytime sleepiness, hypnogogic hallucinations (vivid dreams at night) and sleep paralysis
you can have this with cataplexy, which is where an emotional disturbance during the day makes you fall instantly asleep
1/3 of people with narcolepsy have it with cataplexy.
anyway, the MSLT will test to see if you have narcolepsy if you have the clinical triad.
it is a special sleep study, where you stress yourself all night, and then come into the sleep lab in the morning and try to fall asleep
they have also identified gene testing for narcolepsy, but it really isn't needed, unless you can 't be sure of the diagnosis, but there are criteria based on how you do on the MSLT
there are two medicinal ways to treat this, by keeping you up more during the day with stimulants, like modafinil, which promotes awakefulness without too much stimulation like amphetamines.
or by giving you a stronger sleeping aid at night to make you sleep deeper in non_REM sleep
do you have any questions?
are you there?
yes was reading on sites
oh, no problem, I cannot tell if you leave or not
i actually dont have cataplexy vivid dreams .
yes, my guess would be you have Obstructive SA, as that is more common
it is more the execcessive sleepiness?
and that is what they told me,
yes, commonly Obs SA has EDS
if driving feel like falling asleep
the med is the same
one thing you have to consider is a fugue state
do you know what that is?
repetitive visual stimuli, like driving on the expressway the same trip over and over, do you aren't paying
attention lets you drift off into other thoughts, and you miss your exit,
that isn't it correct? you actually fall asleep?
what is fague state. did fall asleep twice?
no, you have EDS excessive daytime sleepiness.
if you fall asleep
driving a lot . was today in theatre?
what should i do for thar
what should i do for thta
so you need a medicine. Nuvigil, starting dose is 50 mg in the morning, and you increase to the 150 mg size if you don't feel awake enough.
what should i do for it? is there a relationship with insulin resistance.
usually the 50 mg works
if you don't have Nuvigil in SA, then it is Provigil
200 mg in the morning, increase to 350 mg if needed
?ok wil try.
I did give you a webpage that explains how the drugs work. they are safe, essentially non addictive
they are expensive here in the US because there is no generic
newer meds, no generics yet
the other drug is dexadrine or amphetamine, but that can effect your heart and is more addictive
you have to keep increasing your dose, so I would not recommend it
sure, please rate my service is you can as that is how I get compensation, come back anytime to discuss they
discuss this further, ok? Dr Frank T
General Adult Neurologist. Board Certified. Experimental Neuroimaging and Neurodiagnostics