Could there be an untreated underlying issue? Seems worth doing a thorough checkup to eliminate Lyme, Wilson's, Sjogren, Lupus, neurological issues like FTD, diabetes, mental illness, eg major depression, or even hormones (low t), thyroid, iron levels, etc. Maybe there is something like modafinil that can give you a boost (with a prescription of course).
There definitely is. Partially managed sleep disordered breathing is one, whatever's up with my gut is two, but healthcare where I live sucks. I wait for months just to be treated dismissively and told I need a shrink for daring to think there's something physiologically wrong with me.
