Was ex-diagnosed and struggling so hard at work

I was diagnosed in 2010 with IH. Doctor put it as N2 on my paperwork so insurance would give me my medication. I took Nuvigil for almost 14 years. I stopped for my pregnancies and during my last one, I had some mental/emotional issues so I focused more on those than the IH. I never went back on my med and that has caused a lot of issues.

A few months ago, I redid my sleep studies because it had been so long. I was efficiently "ex-diagnosed" and sent on my merry way despite a positive MSLT in 2010 and so many mitigating factors messing up my current tests. My neuro told me to go see my other doctors to investigate the sleepiness.

Well I have and I'm supplementing what needs to be supplemented, my thyroid is normal (I had it checked because I Hashimoto's), I've emailed my OBGYN about birth control causing it, I'm trying to scale back on psych meds, etc. But I am still struggling so damn hard right now.

I am drinking so much caffeine, which can be a trigger for my bipolar disorder, but I feel like I have to do it. I chew gum and eat mints while I teach. I feel like I am one second away from just passing out during class. The urge to sleep is so strong and I feel so bad every single day.

What do I even do now? I'd say get a second opinion but they'll just want new sleep studies and our insurance is high deductible only, which just reset so we can't afford that. My job is about to get new insurance, which I hope is decent, so it may be plausible in the future, just not now. I mean, what do you even do to get through the day? Just drink caffeinated drinks all day long? I even have caffeinated gum! I try to keep my classroom cold but with students, it always gets hotter. Sitting here during my planning period is just hell. If I fall asleep, I could be fired.

Help?