Arizona man,

I looked up you prior posts. Your concussion of 40 years ago is likely just a starting point for your current symptoms. Your severe obstructive sleep apnea is likely the cause of your PCS like symptoms.

My father died from sleep apnea induced dementia about three years ago. He progressed downward for almost 40 years. He had central sleep apnea, no obstructions or snoring.

The nightly anoxic events slowly cause anoxic encephalopathy. The resulting brain fog and other cognitive and memory problems slowly build.

The Provigil is likely just masking your need for good REM sleep with a properly oxygenated brain. Your daytime sleepiness is not the same as the difficulty concentrating experienced by many with PCS. The PCS brain is often highly distractible.

What are you doing to treat your OSA besides CPAP? Laser surgery, other surgeries, dental appliance?