Karen,
I am by all means no professional when it comes to fatigue but I certainly am a person to try different modalities to see what works. :)

Maybe trying other options than meds for sleeping well? Obviously, talk to your doctor first before doing anything and see if it's a good idea to try for yourself. We know, that what could be good for one person may be bad for another.

Here is a question you may have posted but maybe not...has you doctor checked your thyroid? Hyperthyroidism often shows signs of hyperness but some people have the opposite effect and feel exhausted. Insomnia or difficult in sleeping also is a symptom of hyperthyroidism.

Herbal treatments(talk to your doctor first)...he may be able to recommend herbs that may help sleeping...

Diet-(talk to your doctor first)-recheck your diet and timing of eating. I dont know your patterns but reevaluate what you are eating and when. Maybe changing times of eating and/or content of what you are eating can effect sleeping patterns.

Exercise- (talk to your doctor first) Is there any? Is there enough? I know that some of us are not as mobile as others but there are exercise your doctor could give to you for you to do that suits you individually. Could be ROM exercises if that what the doctor says.

Environment-sounds like you changes physical environments of your bed ...how about lighting? Is it dark enough? Do you eat in bed? Do you watch TV in bed? Do you read before going to sleep? Is it silent? Is there caliming music instead? Temperature? Is it cool? Warm? heating pad? Ice?

Stress- Is this effecting you? Do you have stress coping skills that work for you? When have you changes your coping skills? How do you deal with stress?

Sleep Diary- Tracking the times you awake, your patterns, how long you slept, along with daily activities you did during the day, even times you ate and what you ate...by having a diary of your sleeping patterns you may see a pattern you can correct yourself or if not, your doctor could correct with you.

Relaxation/Meditation treatments before you go to bed...you could think of your favorite place and concentrate on the smells of that place, the sounds of that place, the air of that place, the scenery of that place...etc.

Karen, hopefully there will be something in all that mess I wrote ;) that you could revisit. I am sure there are things in there you have already changed or modified but it also doesn'y hurt to revisit those ideas again. Hopefully there will be other ideas in there too so there are new things to look at to help with your sleeping patterns.

Like I said, I am no doctor but obviously I like to look at all of my possibilities. Again and always, confirm anything with your doctor first! ;)
Hugs always and sleepful nights for you,
Star