Better waking through chemistry

An overextended, overmedicated insomniac turns to Provigil, the skyrocketingly popular pill that's been a godsend for the narcoleptic, the jet-lagged and the just plain dog-tired.

By Larry Smith

Nov 12, 2004 | This fall I hit rock bottom. I woke up after four hours each night, my unconscious roiling with thoughts of a new job, my first mortgage, family drama and what, really, there is to eat for breakfast that's tasty and not bacon. On one groggy morning, I was again late for work and nearly fell down a flight of subway steps. What I needed was a week on an island, a foot massage, or maybe a kick in the head. What I got was Provigil, a wonder drug for the sleep deprived.

You can blame the Internet, Starbucks, bin Laden, or your neighbor's barking beagle, but we're a nation of tossers and turners. Our battle with shut-eye goes all the way back to the turn of the 20th century, when Thomas Edison began to mass-manufacture an inexpensive carbon light bulb, and families could keep their homes lit longer, for cheaper. "Edison thought people used darkness as an excuse to be lazy and unproductive," says Dr. Stanley Coren, a sleep expert and psychology professor at the University of British Columbia in Vancouver. "Since then, as a society we have been constantly sleep deprived." In 1913, the average person enjoyed a whopping, wonderful nine and a half hours of sleep -- the ideal, according to Coren. Now most of us get seven and a half, tops.

Can't turn back time, so what's an insomniac to do? I've asked friends, consulted docs, and surfed the Web: The causes and fixes are commonly, eagerly spouted. Go to bed and wake up at the same time every day (impossible). Avoid caffeine in the afternoon (working on it). No alcohol for six hours before you go to sleep (get real). Make your bedroom a sanctuary for restfulness (not easy when your desk is planted 10 feet from your bed). I've tried to put myself to sleep by going through the alphabet and remembering all the women I've kissed letter by letter (Note to self: search for a set of triplets named Quinn, Ula, and Xena). I've tried Ambien and even more potent sleeping pills. Failures, all.

With slumber so elusive, it was time for plan B: To do better with less sleep. Would Provigil come to my rescue?

Provigil, the ask-your-doctor-about-it ready name for a drug called modafinil, has been on the market since 1998, produced by the drug giant Cephalon. It was invented by French researchers as an antidote to narcolepsy, which six years and skyrocketing sales later -- $290 million in 2003, up from $207 million in 2002 --remains its intended use. But who's kidding whom? One analyst from Bank of America Securities has estimated that fewer than 20 percent of Provigil's users medically drool in the middle of dinner. The rest of us just walked off the red-eye and have a big presentation, need to stay up all night to finish a project, or are fighting a war in Iraq.

Even though Cephalon does not have approval to market the drug for any use besides narcolepsy, physicians have been prescribing Provigil for fatigue (as well as depression), finding that it peps up people without the side effects of stimulants such as Ritalin, Dexedrine and Adderall. As it doesn't give you an instant high, and can't be chopped up and snorted like Oxycontin, Provigil hasn't surfaced on the streets. Nor does it seem to have turned into a party drug for bored teens.

Next Page: The initial Provigil rush kind of reminds me of Ecstasy

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