I have chronic fatigue syndrome (1994), Narcolepsy/mild sleep apnea (2005). I started on sodium oxybate and for the first two weeks, I felt better than I had in 10 years. However after the initial 2 weeks, I continue to wake up unrefreshed. The medication still helps with catatplexy though and I am able to sleep without waking up for the two 4 hours segements. My last sleep study showed 2.% TST in stage 1, 61.5 % TST in stage 2, 35.3 in stage 3, 0% in stage 4 and 1.1 in REM. Previous studies have never shown any stage 4 sleep and up to 86% in stage 2. I know my am cortisol was 3.6ug/dl (N=8.7-22.4) but the doctors didn't do anything with that. My questions are: 1. Where should I go for help to figure out how to wake up more refreshed? 2. How can I help heal my chronic pain issues if I do not have stage 4 sleep and very little REM sleep? 3. Is there anything I can do to increase stage 4 and REM sleep? 4. Could the cortisol level be a culprit in all of this? Thank you in advance for the multiplicity in questions. I am not sure where the next steps were. Karen