Provigil and I

Went to bed early, like 7 or 8PM, I forget. Fell asleep immediately. Slept til about 3am, got up, goofed off for a bit then hit the showers, took a provigil, went out to grab some breakfast at Nick’s Patio, and then off to work by 5:30. Very energetic, highly motivated, spent about 11 hours working on a project using Google Maps. It’s only about 70% where I want it to be, but it already blows the product the execs were looking at out of the water. Too funny. The vendor promised us we’d be “excited” when we saw how good their pricing was for “a minimal solution” (ie, a totally stripped down version of their product because we expressed a degree of shock at the ridiculous price they initially mentioned). “We’ve even gone as low as a $4,000 setup fee and $1,000 a month, though those were companies smaller than you.” C’mon now. $100 a month, we’d probably pay til we had some downtime to write it ourselves. $1000 a month, I’m going to take a look at what it’d take to roll it myself… and it took very little and was a welcome break from my primary project. And I’ll be able to integrate it completely into the user experience, start it off showing locations near their home once they’re logged in to the site, etc.

The competitor’s big selling point was how well their stuff could be customized. Um… guess what guys… if I roll it myself, I can make it precisely the way I want it to be… not just “your choice of fonts, colors, and logo”.

Anyway, it’s 6pm now, I just got home from the office, I’m still pretty lively. Don’t think I’ll be up terribly late tonight though.

went to bed around 1 or so. didn’t fall asleep. gave up around 5 and went into work. Took a provigil. been fairly well awake all day. As I wrote this around 2pm, I’m very ready to go home and sleep, but still fully functional.

*update* — Soon as I left the office and hit the nice cool air and dialed up some flogging molly on my ipod I felt totally refreshed. I wonder if the office being too warm is part of why I feel so groggy even on provigil.

Kinda got distracted and didnt keep good records for a few days.

Can’t remember what the evening of 2/15 or 2/16 was. I’ll check my email at work and see if I can get at least the approximate time I woke up.

2/17 went to bed around 6am, fell asleep soon after, woke up about 1pm, didn’t take a pill.

2/18 went to bed around 4am, fell asleep soon after, woke up around noon, didn’t take a pill, took a 3 hour nap from around 3pm til 6pm

2/19 went to bed around 1AM, couldn’t sleep (nap should have been 30 minutes), finally passed out around 6:30, woke up around 8:30, took a pill. No notable effects. Wasn’t particularly out of it but wasn’t terribly alert either.

2/20 went to bed around 1:30 AM, fell asleep around 2:30, woke up at 10 or so. Forgot to take a pill.

2/21 went to bed around 9:30, fell asleep by 10, must have been really tired, slept til 10AM. Decided to try a double dose of provigil to see if it made any difference. Regretted it within 20 minutes. Have I mentioned that this stuff has a nasty side effect (makes your urine smell horrible)? Well, it does… and taking 2 pills exported a hint of that smell/taste to my mouth. Not a strong amount, but enough that I noticed it til I ate something, which was far more than enough. Beyond that, no noticable difference between two pills and one.

I’m coming to the conclusion that it’s not *supposed* to be a terribly noticable difference, just that it helps you stay awake more easily. Which is good, but it’s pretty subtle. I also realize I’m going to need more help forcing myself to get up early enough to take the blasted pill if it’s going to do anything besides reinforce the hours I’m already keeping.

Went to bed around 1 last night. Maybe 2. I forget. I fell asleep fairly quickly… 15 minutes or so. Woke up at 7, should have gotten up but didn’t… went back to sleep, got up around 8:30.

I wasn’t 100% sure yesterday that I remembered to take a pill, so I made absolutely sure I did today. Not really noticing a difference with it. Guess the first couple days were a fluke? Not sure. Might be that the dosage isnt high enough, or needs to be spread out, half in the morning and half in early afternoon or something. Or maybe I should have gotten up when I woke up just before my alarm went off and I was really wide awake instead of hitting snooze and waking up groggy 90 minutes later. Ah well. I’ll try again tomorrow.

Going to try and force myself to make it to work between 7:45 and 7:55 every morning next week. Might give my coworkers heart attacks though.

Oh. And Ann got the flowers today. The 1800flowers people never called me back. Bastards. She doesn’t do valentine’s day (she didn’t tell me that til after they were ordered…. but I would have done it anyway). But to my view, there are two ways to do flowers. Having flowers delivered to someone at work, is not so much about them getting flowers, it’s about them receiving flowers in front of their peers. People will see them and know someone cares enough about her to send flowers, which raises her esteem in their eyes subconsciously. I can’t take credit for that, really… something I learned from Nicole (she always tells people to only send her flowers for any reason on mondays so she can have them on her desk and get compliments on them all week long). Of course, for N., I think making the other girls in the office jealous that she got flowers and they didn’t was also a small factor, but Ann doesn’t seem to be like that. I dunno. The fact that the students might tease her a little about it may be a small factor.

I hope i haven’t given her the impression that I only give flowers on holidays. I do them ‘just because’ too… particularly if I think they might cheer someone up a bit.

The other way to do flowers, is the way I prefer… choose them myself at a florist, maybe even have some role in the arrangement, and deliver them by hand, in private. Not a gesture for others to see… purely the gift of a special, momentary beauty from one hand to another.

Went to bed around 1:15, fell asleep probably 1:45, might have been earlier. Woke up at 7, it was freezing, pulled the blankets I’d knocked on the floor back up and was out again in a minute or so. Woke up again at 8:30 from alarm noise, hit snooze, went back to sleep, got up at 9, spent some time convincing myself to get out of bed, read some email, finally got up and took my provigil and hit the shower at 9:20 or so.

Not seeing any notable difference today between having taken a pill and any day where I didn’t do so.

As a side note, to hell with 1800flowers.com. I spent all bloody day trying to call them to get the name of the florist actually *delivering* the flowers (because I’m sending them to my friend who’s a teacher, and her school had a snow day today so I was going to get them rerouted to her home), and when I finally get through they tell me they can’t give me that information “for confidentiality reasons”.  Bastards. I tried calling both the local florists for her area and neither one had any record of an order for her, which means it’s coming from one farther away, and that opens up way too many of the blasted places. I can only hope they’ll either call me at some point, or deliver them tomorrow. From now on, screw that. I’ll call a local florist myself and cut out the middle man.

Provigil is listed as having a headache as one of its side effects. I’ve had one all day. Not sure if it’s related or not.

My DSPS has never really bothered me much, except when I get insomnia on top of it and toss and turn til 6am or later. But it’s gotten slightly worse over time… I used to fall asleep fairly easily by 2, and now 4 am is more likely; I used to wake up fairly easily by 8 or 9, now 10 or 11 is more common, and given that my scheduled working hours are 8am til 5pm… well, I tried some of the more common ‘fixes’ like slowly adjusting my sleep schedule by staying up later and later every night while on vacation, exposing myself to bright light in the morning (though I didn’t buy one of those solar lamps), and of course, multiple alarm clocks.

None of it seemed to work well. The adjusted sleep schedule fell apart within a couple of days, bright light seems to help me wake up faster when I DO wake up but doesn’t change when that happens, and the alarm clocks I sleep through or turn off without waking up enough to realize I’ve done so.

 In researching, I ran across a few references to people using Provigil to treat, or at least mitigate, DSPS. It’s a medication I’d heard of before… I’ll talk about it more in another post. Basically it’s marketed as a “wakefullness promoting agent” which has almost no side effects and is non-addictive (well, everything’s addictive but it’s not addictive like, say, methamphetamines).  This seemed appealing to me, as I’ve always hated the idea of sleeping pills (the primary alternative seemed to be taking ambien to force myself to sleep early), and I worry about becoming addicted. One addiction is far more than enough, thank you very much.

So… I went to my doctor to talk about it. He was quite familiar with the topic, which surprised me a bit for some reason. He was open to the idea of Provigil but seemed to favor the Ambien slightly more. When I explained to him how I feel about sleeping pills, he agreed to try the provigil first and see if it did the job. He was concerned, though, about other possible sleep problems, so he sent me for a sleep study. I’ll write about that later, it was interesting.

Took a couple of months between my first appointment and my followup to go over the test results, and another 3 weeks after that for my insurance company to process my prescription and send me my first 30 day supply. This stuff is *expensive* — about $9.50 per 200mg pill. Through my insurance, it’s only $60 for a 30/60/90 day supply (same price for whichever). Since we’re just trying it out, the doctor had the prescription at 30 days. Not too bad I suppose, but still expensive. There’s no generic version available in the US yet.

So… we’ll see how this goes. Wish me luck.

Was tired by the time I got home, but didn’t go to sleep right away. Ended up getting a second wind of sorts, ended up going to bed late… like 3:30… laid there til 5. Gave up. Got up. Realized I hadnt eaten dinner. Ate a bowl of cereal. Went back to bed around 5:30, asleep around 6, slept til about 7:30, felt fairly awake but hit snooze button til 8:15. Got up, took pill and hopped in the shower. Not usually this awake in the morning, especially with this little sleep. Decided preference for upbeat music… listened to Dean Martin all the way in, pretty much skipping over everything but “Mambo Italiano,” “Standing on the Corner (Watching All the Girls Go By)”, “Ain’t that a kick in the head,” and “That’s Amore.”

Not nearly as hyper as yesterday, but I guess 90 minutes of sleep probably has something to do with that. Energy is coming more in spurts, not a constant. Of course, I took it 3 hours earlier today, too… so I guess 12:30 in the afternoon today is probably approximately equivalent to 3:30 yesterday.

Not buying that this stuff could keep you awake and functional for 48+ hours as some magazine articles have indicated. Well, not on the recommended dosage anyway, and I suppose being wide awake for 48+ hours is somewhat beyond recommended. So maybe.

He’s a night owl. He’s not a morning person. He doesn’t do mornings.  Sure, that fits lots of people. But when it’s really extreme, chances are the person might have DSPS.

The “normal” internal clock makes people fall asleep somewhere around 9 to 11PM and wake up somewhere around 5 to 7. That’s their “sleep phase.”

Someone with a delayed sleep phase might not be able to sleep until 2 or even 4 in the morning. For them to go to bed and fall asleep at 9pm is as realistic as an average person doing so at 5pm.

The thumbnail explanation I’ve found works for most people is this: Delayed Sleep Phase Syndrome is sort of like permanent jet lag. Pretty much everyone knows what jet lag is and can sort of extrapolate what it’d be like if it didn’t go away.

It’s worth noting that there’s also an Advanced Sleep Phase Disorder, where people fall asleep earlier and wake up earlier (say 6 pm til 4 am). From what I’ve seen in admittedly spotty research, it’s less common than the delayed version, and seems to have a less severe impact on the lives of people who have it (people who go in to work early are viewed as productive, after all. )

Key characteristics of DSPS

1. Sleep-onset and wake times that are intractably later than desired
2. Actual sleep-onset times at nearly the same daily clock hour
3. Little or no reported difficulty in maintaining sleep once sleep has begun
4. Extreme difficulty awakening at the desired time in the morning
5. A relatively severe to absolute inability to advance the sleep phase to earlier hours by enforcing conventional sleep and wake times.

–International Classification of Sleep Disorders

You can read more about Delayed Sleep Phase Disorder and other sleep disorders here:

• http://www.sleepdisorderchannel.com/dsps/
• http://en.wikipedia.org/wiki/Delayed_sleep_phase_syndrome
• http://en.wikipedia.org/wiki/Circadian_rhythm_sleep_disorder

As I promised yesterday — well, this morning — here’s my initial sleep diary.

Thursday 2/1 Went to bed around 1 AM, fell asleep around 2:30, woke up around 9:00
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Friday 2/2 Went to bed around 11pm previous night. Fell asleep around 3. Up at 6am. Heading to chicago with Ann, had mom call and wake me up.
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Saturday 2/3 Went to bed around 3AM I think. Time zones had me confused. Woke up around 6, fell asleep again around 7:30, slept til around 9.
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Sunday 2/4 Long drive home, then into the office. Exhausting day. Left office around 12:50 AM, got home, spent an hour or so unwinding, went to bed at 2:30 or so, woke up at 10
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Monday 2/5 Worked til 1 or so again, went to bed around 2:30, asleep around 3:15 I think, woke up at 10:45
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Tuesday 2/6 Went to bed around 12:30 AM, fell asleep around 3, woke up around 9:30
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Wednesday 2/7 Went to bed around 1am, fell asleep around 4:30, woke up about 10:45. Think I got up to use the bathroom around 6. Should have stayed up.
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Thursday 2/8 Went to bed around 2am, fell asleep around 3, woke up around 10.
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Friday 2/9 Went to bed around 1am, fell asleep around 3:30, woke up around 10.
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Saturday 2/10 Went to bed around 7am, fell asleep within minutes, woke up around 3pm
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Sunday 2/11 Went to bed around 4am, fell asleep around 4:30, woke up around noon.
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Monday 2/12 Went to bed around 1am, fell asleep around 5:45, woke up about 11:15. Package at the door when I left for work — provigil arrived. Took a pill and went into work.

Initial impressions of Provigil:
About 60-90 minutes after taking it, I noticed a sort of odd dichotomy. On the one hand, I can tell I haven’t slept enough, I could easily lay down and fall asleep, and my back and neck are sore; but on the other, I’m… how to describe it… bouncing off the walls is a little too strong a term, but I’m much more energetic. Euphoric is probably too strong a term as well. I’m finding myself drumming my fingers alot on the desk, bouncing my leg, I don’t exactly feel more motivated to work but I feel like I could get more done faster. It’s a little annoying, actually, I’m not a particularly “bouncy” person and there were moments when I felt like I was “bouncing up and down like a jack russel fucking terrier“. It seemed like a bit too much. It seems mostly to have worn off around 5 or so, and as I type this now at 7:30 I’m not feeling much of anything. Still noticing a little ‘bounciness’… but that might be normal, I have a tendency to bounce my leg sometimes without noticing for hours at a time anyway, though today is the first time I recall doing it in months. I’ll get someone to wake me up early tomorrow, take it again and head into work and see how the day goes.
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Hi there. My name’s JC, I’m a 29 year old web jockey, and I have a sleep disorder called “Delayed Sleep Phase Syndrome.”

After consulting with my doctor, we’re going to try and treat the disorder with a drug called “Provigil,” (“Modafanil” is the drug, Provigil is its brand name) by attempting to reset my natural internal clock.

The doctor asked me to keep a sleep journal, and for a couple weeks before the medication arrived from my insurance company’s pharmacy, I was jotting down notes on what time I went to bed, fell asleep, and woke up. The medication arrived today, and I took it for the first time. I decided to take notes on the effects as well, because it seemed fairly significant, much moreso than I anticipated. And on the way home, I decided to make a blog for the process instead of just notes. I’m sure there are other people out there like me, who have to work banker’s hours on new york time, when their body thinks they’re in japan. Maybe this will help someone. At any rate, it’s more fun than just jotting crap down on paper.

It’s 2AM. I’ll post my original log notes tomorrow.