Sleep Disorders Community
continuued sleepiness with treatment
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This patient support community is for discussions relating to apnea, children’s sleep issues, jet lag, insomnia, narcolepsy and snoring.

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continuued sleepiness with treatment

I have been dx with sever sleep apnea which is helped by cpap at 10cm pressure. due to continued excesive daytime sleepiness, repeat sleep study and MSLT showed boarderline Narcolepsy. Missing only had 1 Rem stage in 5 naps but fell asleep before 2 minutes everytime. Still unable to drive any distance and occ fall asleep while talking to someone, Provagil 200mg twice a day, and failed on Adderall (adderrall), Ritalin series did another MSLT. Found I still had periodic limb movements of 13. (was 33 before the cpap i think). Also only 1 Rem but boarderline on 3 other naps where I dreamed but not deep enough to register as Rem so no Narcolepsy dx. Tried Mirapex up to 1mg by week 4. Seemed to help the drunk fatigue on most mornings but when I ran out before refill I got restless legs and arms after 2 days off the meds. Not sure if this was from coming off the med or the med was starting to cause this to start. going in tomorrow to see what the next step/treatment will be. getting tired of being tired. Also still did not help the falling asleep with driving and daytime fatigue. Any suggestions for second opinion on what to try or if Diagnosis of Narcolepsy, what would be done different? Please help.    
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1355118_tn?1298568479
Hi, welcome to the forum, your symptoms are suggestive of narcolepsy and which is also evident by the tests you have undergone. But you can rule out other causes also.

The other possibility needed to be ruled out are Orthostatic syncope secondary to prolonged bed rest may have lead to sudden pooling of blood to lower part of body. This can be exaggerated by when you rise up suddenly from the lying down position.

The other possibilities are arrhythmia, structural anomaly of heart, organic brain disease and TIA. The latter mentioned condition need to be evaluated by ECG and MRI. I suggest you to consult neurologist and get a detailed evaluation.

As for sleep symptoms are concerned, having regular nap for about 20 min during day will help to prevent sleep attacks.

Take care and regards.
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