Provigil for shift workers

SnowymtnRN · Jul 6, 2007

It amazes me that people who don't consistently work night shifts think this is a hoax or for money. I went ot my dr crying begging for help because i'm like a zombie after about 6 hours, and then can't sleep!!! I have to do a sleep study, THEN he said we might try Provigil. I think if it works for you then GREAT. But for people who are insomniacs and can't function this is a great alternative!

ERRNTraveler, RN · Jul 6, 2007

It amazes me that people who don't consistently work night shifts think this is a hoax or for money.

FYI... I do work nights, always have.

SnowymtnRN · Jul 6, 2007

FYI... I do work nights, always have.

Wasn't directed to you...just a general statement!

teeituptom, BSN, RN · Jul 6, 2007

FYI... I do work nights, always have.

I also spent 2 decades on night shift

and you read the website for provigil, It does read very bogus like. Just like that other website where the guy smiles all the time.

Silkybo · Aug 13, 2007

I have done nights for years, and have no trouble with it. However, sometimes I have to leave my vampire reality to attend an inservice or staff meeting or dentist appointment or baby shower or something and function in the daytime. EEK. Provigil is kinder and gentler than 6 shots of ulcerating expresso with a protonix chaser. Im all in favor of reality modification via the miracles of pharmaceuticals

Needa Nurse · Aug 23, 2007

i have used provigil 200 mg for night shift for several months, it not only helps stay awake during my shift, it keeps me awake for my 30 mile ride home. it keeps me from driving off the road in the morning.

:sleep: :sleep: :sleep:

kanzi monkey · Aug 23, 2007

I'm a nsg student interested in Provigil because I live with a shift worker who makes my schedule difficult, but my doc wants to send me and my "sleep partner" to a specialist to prescribe it--won't even consider prescribing it. I felt like a deviant for even asking about it. What's the big deal?

Here's a secret about me--I actually have narcolepsy. Meaning, I fall into REM sleep faster than most people put their head on the pillow. I am lucky to not experience waking paralysis, but I have had issues with overwhelming sleepiness--it doesn't come just when I should be tired, but in waves, almost like nausea. A few years back a neurologist sent me to get a sleep study where I was diagnosed--and then she gave me a script for provigil.

I don't take it everyday, and I try my best not to put myself into a situation where I feel the need to take it because I truly haven't slept enough--cause that's not what it's for. And when I DO take it, I feel it. It feels like medicine. Not always bad, usually not bad actually. Occassional nausea, have had the diarrhea, jitteriness, BP's gone up a tad here and there. But mostly the effect is that I just feel different--I know I'm on a drug.

I've gone back and forth with a few different insurances in the last few years, and one of my insurers wouldn't cover it. Since it is absolutely unaffordable, my neuro prescribed me a generic "alternative"--adderall. Sure it was fun once or twice, but I can't take that stuff as medicine. I don't think it's a good option for narcolepsy. Anyway, I'm back on provigil, and it's definitely better than amphetemine. Caffeine doesn't work with that specific part of my brain that occassionally wants to drive me into the deepest of sleeps, and for some reason, provigil does.

My point is, provigil is a weird medicine that is about a good of an alternative for narcolepsy that there is. THere's little addictive potential which is why I think it is becoming popular with noc workers--but regardless, it IS a drug that not much is known about. And I feel a little altered when I take it--completely competent sure, just not completely myself. So, my advise--explore alternatives first. And if you're doctor wants to send you to a specialist before prescribing provigil, that's probably a good thing. She/he probably doesn't know much about it anyway--my most recent primary care NP didn't know half as much about narcolepsy as me. Didn't know much at all about Provigil. She and I had a great talk about it--but I'm happy that my neurologist is the one prescribing the med. :)

-Kan

kanzi monkey · Aug 23, 2007

iT IS SO FUNNY THAT YO MENTION THIS MED, AS i HAD A PATIENT COME INTO THE ER TONIGHT AND THIS IS LISTED AS ONE OF HER MEDS, WHEN ASKED WHAT IT WAS TAKEN FOR HER HUSBAND REPLIED "NARCOLEPSY, THEY DID A SLEEP STUDY AND FOUND OUT THE SHE'S GOT NARCOLEPSY"
QUESTION? CAN YOU FIND OUT SOMEONE HAS NARCOLEPSY WHEN THEY ARE SLEEPING AND IS IT REALLY NARCOLEPSY IF YOU ONLY HAVE IT AT NIGHT?

In the sleep study you're hooked up to an EEG. My test, which is currently the standard, is called the Multiple Sleep Latency Test (MSLT). Basically, I went to the sleep center at night, got wired up, then slept for 7 hours--they wanted to ensure that I was adequately rested for the MSLT. The next day was....well...torturous. I had to sit in a room all day, covered in wires and glue and an O2 sat monitor, under constant surveillance. Every 2 hours a sleep research specialist would pop his head in and say "naptime"--turn out the lights, and I was to "take a nap". 20 minutes later he'd come back in and wake me up--and I wasn't allowed to sleep until the next nap block. I did 5 nap blocks--so I did this for 10 hours.

What they look at on the EEG are sleep patterns--normal sleep patterns involve dipping into an out of 4 levels of non-rapid eye movement sleep, then, after an hour or so, falling into REM sleep where most dreams take place, and your body shuts down certain motor functions to prevent you from acting out your dreams. With narcolepsy, you often skip NREM sleep and move directly into REM--but sometimes not all parts of your body are ready to make such a quick transition. One issue I have is with sleep paralysis and dreamlike hallucinations. It's basically me being aware of my awake and alert self, but being unable to move my body and seeing images in my brain that are really--uhh--trippy. It's pretty scary. Doesn't happen to often thank goodness. BUt anyway, the EEG shows the transition to REM sleep in I think less than 10 minutes or so. For me, I fell into REM sleep under 5 minutes 3 out of 5 of my naps.

So, to answer your question--yes. It is narcolepsy even if it only happens at night, and I think you can ONLY find out their diagnosis when they are sleeping. At this point in time.

-Kan