Before my treatments started (Mestinon and IVIg), I was lucky if I could get through an 8-hour workday without passing out at my desk. And by the time I got home, I'd be so tired, I had no choice but to take a nap, otherwise I couldn't function the rest of the evening. I can't say if that's typical or not, just my experience. Once I started my treatment, I immediately had more energy. In fact, the day following my first dose of Mestinon, people at work remarked that I didn't look like I was ready to pass out. Even these last two weeks, when my symptoms have flared up, I'm not as sleepy as I was when I was going untreated.