I also had the narcolepsy issue in classes--so frustrating esp. when it was actually an interesting class with a professor I liked--I always felt terrible about it.

I read this today--maybe it will be helpful...
http://www.drgore.com/invitation/index.php

http://www.drgore.com/misery/index.php

(can you tell I like that guy's site?)
I don't know--sometimes I think we can make things much more complicated than they need to be. Just do the next right thing.