EDIT: Nobody I know have this problem of not having a choice and falling asleep when extremly tired.
I've have this conversation before so I know this with them at least.
If you have a medical condition, then what the hell are you doing driving whilst tired when you know you don't have a choice staying concious .
I might sound ridiculous, but I don't have any kind words for what you sound like.
Like I said, if you have problems falling asleep whilst in command of a 1000kg + vehicle driving at speeds in excess of a human running, you have to be VERY SPECIAL in the head.
PS. Had to edit this so many times to make any sort of sense.
I used to work with a guy who fell asleep when he was at the wheel of a car. He was 22 and had no medical conditions but had been made to work for 3 days straight with maybe 2 hours off between shifts. On the third night he went back to his hotel to get changed and fell asleep whilst driving down the road, his car flew off the road into a tree and he ended up in a 9 month coma (got some brain damage too).
It gets to a point where you can fall asleep without even realising it because you are that tired (micro sleep I think it is called).