After this weeks earlier misadventure, I was able to see a specialist on Friday. Or more accurately able to see the specialist's nurse practitioner and the specialist himself for less then 5 minutes. Through some universal irony and my insurance's byzantine referral process, the specialist for sleep I'm seeing happens to be the same specialist I've been seeing for the last twelve years for sleep apenea. They reviewed my history, the worsening insomnia, the worsening sleep deprivation symptoms and agreed that a new sleep study to try and figure out what's going on is in order. I was given a script for
provigil and cautioned about driving while feeling fatigued.
Yesterday I test drove the new neurochemistry. My sweetie convinced me that the wisest course would be to take the stuff in a safe setting with another adult present, and nothing on the line like having to function for work, or get my ass too or from work without killing anyone. The test was a success, a categorical success, as in I'm really not sure how i made it through the last three years without this stuff.
The first time in a long time, I was focused and alert. On 100mgs I got a little over 10 hours of unfettered alertness. I had gotten about 4 hours of actual sleep the previous night, but I was wide awake, energetic and functional. I was still aware in the periphery of my consciousness that I was tired, but it didn't actually drag me down.
What I wasn't expecting was the effect on my mood. It's amazing how good I feel without the crushing weight of fatigue grinding me down. Chronic sleep deprivation can mimic symptoms of mental illness and I've been the functional equivalent of depressed for a very long time. I think I can clearly say that the depression was an artifact of sleep deprivation and depression is not the etiology of my insomnia. Though I don't believe this will solve the feelings of being overwhelmed and burnt out at work, it may make these things bearable of the time being.
I've not noticed much in the way of side effects. Mostly there is a slight tendency to over do things ("Honey you're squeezing me a little too hard"), that might be a result of the dopaminergic effects. Maybe some dry mouth, but thats it so far.
I understand this is not a panacea, I'm still not sleeping well (if much at all), I don't know how much of the other effects of long term sleep deprivation this mitigates. However as a stop gap measure, I'll take it. I can function, I feel alive, it feels good.