More Insomnia...

More musings on insomnia. Have today seen a lady whose usual sleep time is 3am. She feels this is by choice. However she's had OSA sypmtoms for years (since she got over 300lbs) and her primary doctor, a sympathetic individual, prescribed provigil 200mg 2 tabs daily when she told the doctor she couldn't afford to see a Sleep Specialist or have a sleep test. Several years ago. I'm sure the drug has cost more than the sleep test would have by now, and it has no indication for use as faux treatment for OSA, but done is done. Unfortunately the lady decided to split the dose and take one in the am and one in the pm. Since it has a long half life, and basically lasts about 12 hours, her bedtime has been delayed. Now she gets up at 10-11am. If she's happy with that, no problem. Still at risk for stroke, car accident, heart attack, heart failure, atrial fibrillation etc. due to the untreated OSA. So now she will be doing that sleep test, and we can find out why she was so sleepy to start with, and then we will treat it. She probably won't need the Provigil.