I was diagnosed about a year ago after my first really big flare. (Based upon labs and symptoms- joint swelling/ pain, raynauds, malar rash, sun sensitive skin rash, nose/ mouth ulcers, and overwheling fatigue)- went the prednisone/ plaquenil route and responded well. Symptoms are generally improving and getting off prednisone (which is a topic for whole other post). The main issue at the moment is the overwhelming tiredness/ "hit a wall" type fatigue. I work and am a mom- I have cut back on everything to conserve energy, balance rest w exercise, eat well, try to get enough rest at night-> but am still struggling with fall asleep in my tracks tiredness and constant yawning. Based on some research, I asked my rheumy about Nuvigil. It helps a lot- I can get though work days and put my kids to sleep. I don't take on weekends. Problem is insurance doesn't cover it and it is very expensive. Any advice?