How to go off caffiene with hypersomnia

[gonefromhere 32]

I was diagnosed with obstructive sleep apnea 3 years ago, and use my cpap faithfully (I had daily Migraines that have disappeared with cpap). I was told that I would go through an adjustment period and then start to have more energy and no longer be so sleepy during the day. That never happened, so this spring I did some more sleep studies and the doctor says my sleep apnea is under control. He diagnosed me with idiopathic hypersomnia (medical for "you sleep a lot and I don't know why").

I manage the hypersomnia with modafinil (a stimulant) and caffeine. I'm hoping that losing weight with the sleeve will give me more energy so I don't need to sleep as much, but right now I'm trying to figure out how to get through the pre-op diet and immediate post op period when caffeine isn't allowed.

My current routine is

0530a 100mg modafinil

0700-1000 40 oz of coffee

1200 100mg modafinil

200p 40 mg caffeine (penguin mint)

400p 40 mg caffeine (penguin mint)

I'm meeting with the surgeon on 12/6 and will ask if modafinil is allowed post surgery, but do any of you have hypersomnia? How have you stayed awake without caffeine?

[gonefromhere 32]

Any suggestions? I start my pre-op diet on 12/9 and am considering just going cold turkey and being miserable that weekend so I can be functional for the next two weeks.

[ella37 455]

Any suggestions? I start my pre-op diet on 12/9 and am considering just going cold turkey and being miserable that weekend so I can be functional for the next two weeks.

I have hypersomnia as well. I wish I had some suggestions but really all you can do is wean. I went cold turkey and it is miserable but there's so much going on that first week that makes you tired all the time it's hard to tell what side effects are from what. Good luck!

Edited November 29, 2016 by ella37

[theantichick 2,204]

Discuss this with your surgeon. There are times when the medical needs of a particular patient require modifications to the surgeon's standard protocols. It is my understanding that caffeine is mostly problematic because it is slightly dehydrating. Some surgeons are OK with caffeine intake if the patient can offset the potential Fluid loss with extra Water intake.

For example, surgeons generally agree that NSAIDs (ibuprofen, aspirin, naproxen) are not allowed after VSG surgery. My surgeon agrees that the risk is outweighed by the benefit of treating my autoimmune disease, so I am allowed to take NSAIDs as needed, but I have to stay on a PPI to minimize the risk of ulcers.

Every patient is different, and good surgeons can work with the individual needs.

[gonefromhere 32]

@@ella37 Yeah I assumed I would be pretty tired right after surgery (I'm taking a week off work and teleworking the second week). I'm mostly concerned about the pre-op period (weaning vs cold turkey and still being able to work) and weeks 3-4 post surgery (before caffeine is allowed again)

@@theantichick I meet with the surgeon on 12/6 and will be sure to ask about this specifically in context of my hypersomnia. I have a huge list of questions to ask! Thanks!

[seeingme 91]

I have narcolepsy, and also OSA and use Apap. My OSA seems to be under control, but I'm still wiped out. Once you get off caffeine completely, and a few weeks out, you'll be more wakeful without it than you are hooked on it. When you're hooked on caffeine you get tired when you don't have it. When you get off it, and your body is no longer craving it, you'll feel much better.

Provigil, though a stimulant, works differently than other stimulants. It may not be the right medication for you.

[gonefromhere 32]

@@seeingme Thanks for the response! I have completely gone off caffeine in the past (when I had daily Migraines I tried just about everything) and didn't notice a change in wakefulness.

My sleep doctor said if I didn't like modafinil/Provigil then he could prescribe something stronger (ADHD medications) but because of my family/social history I don't want anything addictive. Are there other medications that aren't addictive?