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pred short course and pre-existing insomnia


I've been put on a short course of 20mg of pred following an exacerbation due to a virus. I'm on day 3 and feeling really rubbish. I have suffered from insomnia, anxiety and depression on and off for years, all managed without any medication. They have been pretty bad lately as the asthma exacerbation makes me feel anxious and all these conditions are feeding each other. So I've been put on pred, which I more or less knew would make all this worse, but having felt pretty rubbish for about 4 months with a phlegmy cough that won't resolve with high dose of inhaled steroids left me no other option.

I think what bothers me most is the insomnia, because it affects my concentration so badly and I feel a useless wreck. I was wondering if anyone had any tips on how to cope with these side effects while on pred? I've read here that taking it early in the morning is best, so if I'm feeling like I might be able to get to sleep at, say, 4am can I take it then or will it make me wake up after a few hours? Waking up to take it won't work because when I'm like this the slightest disturbance to my sleep means I can't get back to sleep.

6 Replies


You need to take prednisolone around 8am in the morning, preferably with breakfast...... not in the middle of the night or any other time of day. If taken in the evening it can increase insomnia...


Hi Kate

Thanks for your reply. I understand that 8am is the best time to take it, but I'm not awake at that time because I'm not managing to go to bed until somewhere around 4-6am. I usually get woken up by a small noise (either my son or the cat or something) at varying times, but the last thing I want is to be woken by pred, so trying to work out if I should have it before I go to bed, or when I wake up.


How long are you on pred? If it's for a while then you're probably best experimenting! It's tough, I'm a goods sleeper, and can happily get back to sleep after waking up to take it. I can easily get to sleep after taking pred (if I've been up late) but the worry with that method would be that if you'd started to absorb the steroids before you managed to fall asleep (which I assume would be quite likely) then you'd be very very awake! Two possibilities; could you manage on a very tiny amount of sleep for one day in the hope that getting into a decent steroid routine will help you sleep later. If you have a day where you can essentially lie on the sofa and not try to sleep but let yourself properly relax then you might survive and sleep better for it?? Alternatively, take it when you do wake up (ASAP) and with plenty of food and just manage the insomnia as best as possible for the course! Sorry I can't be much help, like I say, I sleep well! If you want we can average out our hours!! I sleep afar too much!!

yaf_user681_53148 in reply to Hidden

If you want we can average out our hours!! I sleep afar too much!! LOL, yes please!

Well, I'm being reviewed on Monday and hopefully I'll be off it and that's that. It's just a short course, so I shouldn't complain (it sounds like you are on it for the long run?) Yeah, I honestly don't know what to do. Today I took it at 12 which is probably much too late and I stayed in bed for a while trying to go back to sleep, which probably wasn't wise, but god, so tired, you know? I think I'll leave the pred by my bed, along with a snack and have it as soon as I'm awake. Sigh.


I keep pred and a banana by my bed! And I'm always on steroids but usually hydrocortisone, I have a source of pred every month or so! For me sleep-wise, being on ored is nice, I don't think my steroids are being managed properly, there are times when I know I don't have enough because I'm sleeping about 18hrs a day, drives me mad!! My mum just comes in and yells ""take some more steroids"" at me if I'm still asleep when she gets home from work!! Sadly not sleeping brilliantly as lungs are rattling a lot!!

Being tired is awful! Do you find you can listen to the radio or something while you're lying in bed? I find it much easier to sleep with sound in the background as I'm not thinking about sleeping, or about whatever is worrying me, but I can focus on the sound (ideally something I know well) and drift off! Doesn't work for everyone but it's great for me!

Good luck!!

Yeah, I was thinking of listening to a guided meditation on the old ipod tonight once I feel a little tireder. I find these quite difficult to use anyway (I'm just too unsettled generally), but it won't hurt to give it a go! I guess I'll just have to rough it out for a few more days and hope that this stupid cough will go away!

Hope you feel better soon too!

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