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Permalink Reply by Larry Barsh on March 4, 2012 at 9:03am

It would be important to have the possible nasal blockage evaluated by an ENT physician.  If your nasal airway is blocked, CPAP won't work well because it depends (most of the time) for air pressure to be supplied through a nasal mask.  CPAP properly utilized should control (control not cure) apnea symptoms regardless of how long the problem was undiagnosed.

If after you have nasal airway evaluated and given CPAP a fair chance, you find that it still does not help, oral appliances that hold the jaw in a forward position, designed and titrated by a properly trained dentist (like the members of snoringisntsexy.com) can help.  

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Permalink Reply by Mary Z on March 4, 2012 at 11:04am

After four years on CPAP only recently have I become able to put away my Provigil.  My doctor told me the same thing without statistics- some of us never get over the excessive daytime sleepiness.  It is called hypersomnia as opposed to narcolepsy and there is a day time test they can do called a multiple sleep latency test, but I would not go through it again unless I suspected narcolepsy.  She must not suspect narcolepsy.

see:

http://en.wikipedia.org/wiki/Hypersomnia

http://www.mayoclinic.org/hypersomnia/treatment.html  (you have to cycle through the headings at the top of the page).

 

I took Provigil or Nuvigil since before my diagnosis of OSA.  I could not drive, would fall asleep in therapy (lots of wasted money- she got paid for me sleeping and would cut our sessions short becauuse I couldn't stay awake), fell asleep eating breakfast, long afternoon naps, naps right after getting up.  I was horrible.

So, in short, your doc was right.  If you're not against drugs and want your life back, ask for a prescription for Nuvigil or Provigil, or she may prescribe  another stimulant.  She may have sample packs.  For me, Provigil was not a stimulant except for keeping me awake.  There were no "speed" like side effects.  Sigh, I was hoping to get motivated to clean the house.  If you are sensitive start with a low dose- 1/2 of a 100 mg tab 0f Provigil, or a 150 mg tab of Nuvigil.  I didn't have to do this.

 

Good luck , no one knows how miserable this is unless they have the experience.

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Permalink Reply by dolores martin on March 4, 2012 at 1:43pm

Larry Barsh said:

It would be important to have the possible nasal blockage evaluated by an ENT physician.  If your nasal airway is blocked, CPAP won't work well because it depends (most of the time) for air pressure to be supplied through a nasal mask.  CPAP properly utilized should control (control not cure) apnea symptoms regardless of how long the problem was undiagnosed.

If after you have nasal airway evaluated and given CPAP a fair chance, you find that it still does not help, oral appliances that hold the jaw in a forward position, designed and titrated by a properly trained dentist (like the members of snoringisntsexy.com) can help.  

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Permalink Reply by dolores martin on March 4, 2012 at 1:49pm

I do not think there is blockage of my nasal passages as I recently had a ct for sinus problems allergies.   I have many problems with my bite and have dental implants.   There was a problem with one of them and I am currently working on getting new ones.   The dentist is working on stabilizing my bite and a dental appliance at night would only make it worse   Thanks for the input.

Larry Barsh said:

It would be important to have the possible nasal blockage evaluated by an ENT physician.  If your nasal airway is blocked, CPAP won't work well because it depends (most of the time) for air pressure to be supplied through a nasal mask.  CPAP properly utilized should control (control not cure) apnea symptoms regardless of how long the problem was undiagnosed.

If after you have nasal airway evaluated and given CPAP a fair chance, you find that it still does not help, oral appliances that hold the jaw in a forward position, designed and titrated by a properly trained dentist (like the members of snoringisntsexy.com) can help.  

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Permalink Reply by Larry Barsh on March 4, 2012 at 1:56pm

 "I have lost my copy of the sleep study by was told I had air blockage in throat and I think it was my nose,..."

Just responding to your comment.  Sorry about any misunderstanding. Can you breathe comfortably through your nose?

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Permalink Reply by dolores martin on March 4, 2012 at 2:03pm

Thanks for replying.   I have been using provigil for a few years and they do not seem as effective as when I first used them.   My dr gave me a months supply of Nuvigil but it was not as effective at that time. it was during the period that my provigil was helping.  Happily for me, it did actually give me enough energy to clean my house and actually have a life but that does not seem to happen these days.   I recently found out that I have severe allergies,   I had them before and they went away after a few years of desensitizing shots.   I just found out that I have them again, I had moved to a new area.   I am about to start shots again and I hope that will help with the fatigue.

I know I do not think I  have narcolepsy as although I am tired all day, I rarely am able tofall asleep when I try to take a nap.   Again, thanks for  replying/

Mary Z said:

After four years on CPAP only recently have I become able to put away my Provigil.  My doctor told me the same thing without statistics- some of us never get over the excessive daytime sleepiness.  It is called hypersomnia as opposed to narcolepsy and there is a day time test they can do called a multiple sleep latency test, but I would not go through it again unless I suspected narcolepsy.  She must not suspect narcolepsy.

see:

http://en.wikipedia.org/wiki/Hypersomnia

http://www.mayoclinic.org/hypersomnia/treatment.html  (you have to cycle through the headings at the top of the page).

 

I took Provigil or Nuvigil since before my diagnosis of OSA.  I could not drive, would fall asleep in therapy (lots of wasted money- she got paid for me sleeping and would cut our sessions short becauuse I couldn't stay awake), fell asleep eating breakfast, long afternoon naps, naps right after getting up.  I was horrible.

So, in short, your doc was right.  If you're not against drugs and want your life back, ask for a prescription for Nuvigil or Provigil, or she may prescribe  another stimulant.  She may have sample packs.  For me, Provigil was not a stimulant except for keeping me awake.  There were no "speed" like side effects.  Sigh, I was hoping to get motivated to clean the house.  If you are sensitive start with a low dose- 1/2 of a 100 mg tab 0f Provigil, or a 150 mg tab of Nuvigil.  I didn't have to do this.

 

Good luck , no one knows how miserable this is unless they have the experience.

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Permalink Reply by dolores martin on March 4, 2012 at 2:16pm

Yes, most of the time except when my allergies are really bad.  I just got a new Icon cpap machine with a heated hose and it really is great.     I just sent off my first set of data to the dr.   I hope to get feedback next week.  I am also trying to find out how I can get the software reader so I can monitor my self.  Thanks.  

Larry Barsh said:

 "I have lost my copy of the sleep study by was told I had air blockage in throat and I think it was my nose,..."

Just responding to your comment.  Sorry about any misunderstanding. Can you breathe comfortably through your nose?

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