This desire is uncontrollable , so people fall asleep suddenly, and might stay asleep for quite some time – from a few seconds to more than an hour. This condition can be very dangerous, if the person does something at this point of time, like drives a car. for example.

There are four symptoms, which are very common for this disorder.

• excessive sleepiness
• cataplexy
• hallucinations
• paralysis

This disease happens in about 1 in 2000 people, and everybody can get it at any age. If you experience any of these symptoms, you need to see your doctor, as there is a treatment available for this condition.

Dexedrine has been the standard treatment for narcolepsy, and it has had military applications as well: the United States Air Force supplied it to most air crews during the Persian Gulf War… Dexedrine interferes with normal sleep, leaving its users feeling hung over when they awaken. This so-called sleep inertia often prompts the user to take more pills, and a vicious cycle ensues. Provigil preserves normal “sleep architecture.”

Even as sleep disorders increase, firms are pushing their employees to disrupt their normal sleep patterns in order to provide services around the clock. Mentions that this may provide competitive advantages. The capability to resist the mental and physiological effects of sleep deprivation will fundamentally change current military concepts of “operational tempo” and contemporary orders of battle for the military services.

Surprisingly, there is very little hard data showing that prolonged sleep deprivation truly has deleterious effects on us… In the absence of such basic medical knowledge, sleep experts caution about the use of drugs like Provigil as a substitute for sleep. Briefly discusses the popularity of caffeine…

“Provigil looks much better than caffeine,” Dr. David Dinges, a researcher on sleep deprivation at theUniversity of Pennsylvania concludes. “Wakefulness becomes effortless.”

“This is the third of five FDA approvals that we will be pursuing over a 15-month time period,” said Dr. Paul Blake, Executive Vice President, Worldwide Clinical Research & Regulatory Affairs at Cephalon. “Cephalon is a pioneer in developing compounds for improving wakefulness, and this on- schedule filing allows us to reinforce our leadership position in the treatment of disorders of sleep and wakefulness,” added Dr. Blake.

Stick to a regular bedtime schedule. Try to get out of bed at the same time each morning, even if it’s a weekend or holiday.

Avoid napping during the day.

Avoid stressful activities and vigorous exercise for two hours before going to bed. Do exercise regularly, but earlier in the day.

Before going to bed, try relaxation techniques, such as deep breathing, yoga, or meditation.

Make sure your bedroom is dark, quiet, and cool. Use earplugs or eye shades if needed.

The level of arousal is controlled by an intricate interplay between distinct wakefulness – and sleep-promoting nuclei situated in the hypothalamus and brainstem and the interconnections between the nuclei and the neurotransmitters involved have been mapped.

Wakefulness-promoting nuclei include the orexinergic lateral hypothalamic/perifornical area, the histaminergic tuberomammillary nucleus, the cholinergic pedunculopontine tegmental nucleus, the noradrenergic locus coeruleus, the 5-hydroxytryptaminergic raphe nuclei and possibly the dopaminergic ventral tegmental area.

The major sleep-promoting nucleus is the GABAergic ventrolateral preoptic nucleus of the hypothalamus. Currently available and future drugs exert their therapeutic effects in the three major classes of sleep disorder (insomnia, hypersomnia, parasomnia) by modifying neurotransmission at distinct sites within the arousal-controlling neuronal network. This enables classification of therapeutic drugs for sleep disorders on the basis of their modes of action: drugs that interact with the GABAergic sleep-promoting system, drugs that interact with different wakefulness-promoting systems and drugs that modulate the level of arousal by mechanisms that do not initially involve the basic network (e.g. melatonin, adenosine).

The development of novel therapeutic drugs for sleep disorders is based on the synthesis of molecular/cellular mechanisms and the sites of action within the arousal-controlling neuronal network.

Barbara Sahakian, professor of clinical neuropsychology at the University of Cambridge, said British students are buying prescription drugs such as modafinil and Ritalin from suppliers as far afield as India.

One in 10 Cambridge undergraduates has used cognitive-enhancing drugs – while another third said they would use them if they had access to them, a recent survey showed.

One in five academics also admitted taking the drugs in a recent poll for the science journal Nature.

But fears are growing that students who order the medication online without a prescription could be exposing themselves to unknown health risk or buying counterfeit drugs.

Prof Sahakian, who was asked to look at the issue by the Advisory Council for the Misuse of Drugs, said: “I’ve seen students teat open the envelope from Mumbai in excitement. But when you are accessing drugs over the internet it’s completely unsupervised. You might be on other drugs or have some pre-existing condition that means you shouldn’t be taking it.”

Modafinil is prescribed in Britain to treat serious sleep disorders such as narcolepsy. In the US, it is used in the military to enhance alertness.

Studies show the drug increases motivation and ability to sustain concentration over a long period, but it can be dangerous for people with high blood pressure.

Philip Harvey, Professor of psychiatry at Emory University in Atlanta, said he takes the drug to deal with jet lag.

“From Atlanta, I can get to Europe by 6am and give a 9am presentation. It lets you go and come back in the same day,” he told The Times.

Prof Sahakian used a speech at the Forum of European Neuroscience in Amsterdam to call for a Government policy review on smart drugs.

John Harris, director of the Institute for Science, Ethics and Innovation at the University of Manchester, last year said students should be given smart drugs to help boost their performance.

Most of us know very well that these neurotransmitter chemicals live between our axons or nerve endings. They are the substance through which nerve firings occur. We also know that some of our damaged axons do not fire strongly enough to pass signals to the next due to demyelination.

I’ve spoken on HealthTalk programs about the central nervous system as a complex electrical system, which is affected greatly by heat. The way the drug may work on dopamine may help many of us as we (in the northern hemisphere) move into summer.

It seems to me (and this is just me) that if a couple of cups of coffee helped us in this way, Starbucks stock would be through the roof.

There is something else to consider about fatigue. Many doctors and researchers see fatigue as two separate issues – one physical and the other cognitive – and prescribe different doses for each (on average 100mg for physical and 300 mg for cognitive). Again, not something that coffee or caffeine would address.

The drug is not cheap and as it is “not approved” for use in MS patients (I’ll explain if anyone needs off-label prescriptions detailed), can be very expensive. I had to go through several hoops to get my prescription paid by my insurance.

Most of my contemporaries who use Provigil or other anti-fatigue meds self-dose, with their doctors being fully aware. (Note: Don’t self-dose, self-medicate or take yourself off a drug to “see if it’s working” without your doctors knowing about it. Yet another reason you should have a good working relationship with the doctors and nurses at your provider’s office.) Some nibble at a tablet all day; some take one in the morning, one at noon and not later to salvage sleep; still others (myself included) use it for special occasions (or, in my case, tradeshows).

I think of these drugs as a withdrawal slip from my energy bank. I can take Provigil for a few days (four at tops) and “borrow” energy from later in the week. I’ll make it through the event, but I’m going to pay for it later. It’s just one more way I am taking control of my disease when I can or really need to.

Sometimes I shake my head in wonderment at what we have been told, heard or think for ourselves about MS. I wanted to get that out of the way and open the discussion about Provigil, Amantadine and other drugs you might use for fatigue.

I’d also like to open the floor to discussion about rumors and third-hand information you hear about MS treatments. It seems there are a lot of misunderstandings out there and we should address them.