Has anyone had their Dr. prescribe Provigil for OSA?  and if so, do you still need CPAP?

Thanks

Provigil promotes wakefulness and is an oral medication.  As far as I know, it doesn't change the fact that your airway is compromised during sleep, so cpap would still be necessary.  With Provigil, you just wouldn't have the daytime sleepiness that goes along with OSA.

For a small percentage of OSA patients, Excessive Daytime Sleepiness is persistant, even with optimal cpap therapy.  If this is the situation, the sleep physician may order a repeat sleep study, followed by a Multiple Sleep Latency Test (nap test).  After verifying adequate sleep was obtained the prior night, the patient is given repeated opportunities to nap during the day, recording how quickly you fall asleep at each nap.
A drug screen will also be done after the naps.
   If EDS/hypersomnia is verified following the MSLT - then the physician may prescribe Provigil.  Provigil (modafinil)  is very expensive, and most insurance companies will require precertification to pay for it.  This may take 4-8 weeks, and if you fill the prescription prior to approval, be prepared to pay for it out of pocket.  Blue Cross will only approve it for a maximum of six months, and you must recertify each time...I don't know about other carriers policies.
  Taking Provigil isn't a panacea, and isn't instead of cpap.  It can augment cpap therapy for those few people who have residual EDS/hypersomnia with proven cpap complaince.

Okie wrote:

For a small percentage of OSA patients, Excessive Daytime Sleepiness is persistant, even with optimal cpap therapy.  If this is the situation, the sleep physician may order a repeat sleep study, followed by a Multiple Sleep Latency Test (nap test).  After verifying adequate sleep was obtained the prior night, the patient is given repeated opportunities to nap during the day, recording how quickly you fall asleep at each nap.
A drug screen will also be done after the naps.
   If EDS/hypersomnia is verified following the MSLT - then the physician may prescribe Provigil.  Provigil (modafinil)  is very expensive, and most insurance companies will require precertification to pay for it.  This may take 4-8 weeks, and if you fill the prescription prior to approval, be prepared to pay for it out of pocket.  Blue Cross will only approve it for a maximum of six months, and you must recertify each time...I don't know about other carriers policies.
  Taking Provigil isn't a panacea, and isn't instead of cpap.  It can augment cpap therapy for those few people who have residual EDS/hypersomnia with proven cpap complaince.

Okie,

Excellent...........could not be put better by....anyone.

I attended a lecture by Dr. Catherine Crowe (Sleep Specialist) concerning 'Residual Daytime Sleepiness'. She referred to a small number of patients, who despite being cpap compliant also suffered daytime sleepiness. In some cases it might not be possible to cure this. She specifically mentioned Provigil as an additional method of helping with this, she hoped in the short term until the sleep lab could sort it out. It is a stimulant.

She stressed the short term nature of any prescription for this drug, as it may be addictive and was certainly not a cure for OSA as it has no benefit for cardiac problems usually associated with OSA.

I also read an article recently which stated that the Pentagon purchased a large supply of Provigil in preparation for the Iraq war. They were for pilot use so that they could stay awake for long periods to fly numerous sorties. It was reported that they could keep pilots awake and functional for up to 40 hours at a time with the drug.

Daniel