It definitely sounds like you should be treating your sleep deprivation first and foremost. I wonder how long you have been on the same medication? Is it time to discuss with your pdoc some changes? Have you tried sleeping medication? I personally have been on ambien for almost four years and it works wonders for me. (I just worry that I've lost the ability to put myself to sleep and don't know when I'll know when it's time to come off. I just know it's not right now.)