OSA with Residual Sleepiness on Armodafinil AND Having Issues..

Hi all... went searching for a forum because I don't know what to do at this point. I just moved from NY to SC and transferred from one job location to another and apparently my new region is really strict. I was spoken to the other day for laying my head on my desk for a few minutes during my lunches because passerby's thought I was sleeping while I should be working...

I have a slew of medical issues, including but not limited to, OSA with residual sleepiness (treated via CPAP and armodafinil max dosage), diabetes, depression, and anxiety. I've got a rather extensive prescription cocktail I take daily. The side effects of the meds and the illnesses make me excessively tired, and sometimes, unable to function (mostly the diabetes when I get lows). In NY, I used to be able to lay at my desk when I needed to, no questions asked, even if it was on company time (which I rarely to never did), but never had an issue. They knew my work ethic (I was with them over 2.5 years) and they were great. I transferred here a few weeks ago, laid my head on my desk 2 or 3 times last week because I wasn't feeling well, during my lunches no less, and now I feel like they are looking at me like I'm lazy. I explained to them that I have medical issues and take scripts and I'd get a dr. note if need be, but at this point I feel like it is insane that I need to defend myself this hardcore for laying my head down during my own time.

Honestly, I'm tired of living like this at all. I hear all these stories about how "CPAP changed my life!", yeah? How? Not for me... Now the armodafinil and provigil do not seem to be as effective as they once were. Now I have to find another sleep dr since I've moved and I don't even know if there is anything else I'll be able to take to help me. I'm so tired of living like this. I used to also drink about 6-8 Starbucks shots per day to help stay awake but because of financial difficulties, I've had to stop those. Anyone else have issues like these? What did you do? Any suggestions? I feel lost and resigned at this point, like I'm fighting a losing battle.

Thanks for listening... Tammy.

Some thoughts:

1. The armodafinil and provigil may be preventing you from getting a restful sleep. My thoughts would be to focus on getting a restful sleep, rather than to take drugs to stay awake. How is your CPAP machine working? Are you getting 7-8 hours of uninterrupted sleep each night? Are you using software like SleepyHead to monitor your detailed sleep results?
2. I have had diabetes for nearly 20 years now, and high blood glucose can certainly make you feel tired, especially after a meal when BG tends to go up. How is your A1C? What drugs or insulin are you taking for the diabetes? Maintaining a reasonably constant BG level during the day and night is very helpful.
3. How are your sleeping habits? I find I cannot sleep well at all if I take any caffeine after about 2:00 each day. Here is a link to a website that I have found helpful in reviewing my sleep habits and making some changes. There have a number of tools to use to evaluate sleep.

SleepWell - It's No Dream

Prior to taking the armodafinil/provigil, I was falling asleep behind the wheel, even got into 2 car accidents. That is when the dr said I am part of the lucky 3 % who are not magically cured by the CPAP and who are diagnosed with "Residual Sleepiness" which sounds like a cop out.. but it is what it is. I do get around 8 hours of sleep each night, but rarely is it uninterrupted. I have had trouble sleeping for years, as I have depression/anxiety. No, I do not use software to monitor my sleep, I'll look at it though.

My A1C is 6.1. Currently, I am not taking any diabetes meds or insulin b/c I've been having very significant lows quite often. Since I've moved, my dr said she wouldn't help me any longer (she was a PA @ a PCP office) and I needed to find a endo. I tried to tell her that wouldn't happen for quite some time considering the move... but she refused to help me. So, I had to stop all of my meds I was on. She had me on 3 diabetes meds (Januvia, Metformin, and one more I can't remember right now....). I have a continuous blood glucose monitor though and my sugars are generally normal, around 100, unless I eat something no bueno or I don't eat at all.

Coffee does not really impact me anymore, never really did TBH. I tend to go to bed around 9:30pm-11pm and get up around 6am-6:45am, even on weekends the habits don't change much. But as I said, I have a lot of trouble remaining asleep. I tend to wake up at least once a night, sometimes twice. I fall back to sleep eventually (most of the time).

Also note, I was tested for narcolepsy, they said I didn't have that. And they retested me with my CPAP and said it was "effective" but it just wasn't helping me as it should due to the residual sleepiness. Just. My. Luck.