The magic came last night 80% — Hurrah! However didn’t last til morning.

[Smokygirl]

So relieved to say that I had a much much better night last — my third night on Pred.

Went to sleep at 12 midnight. I didn’t wake up as usual at 2:00am and slept through until 4:0 am. and there was no pain and little stiffness, which was amazing—-just a bit of discomfort in my right arm. Went back to sleep til 8:00

However when I woke up at 8:00 am. The pain and stiffness had returned in my upper arms.

I am going to take PMR pro’s advice and try splitting the dose tonight.

Wish me luck my wonderful PMR friends! Xxxxxxxx

[DorsetLady PMRGCAuk volunteer]

Good to see an improvement.

If you’d taken your tablets at 4am, then they would have been working during your next sleep, and you would have been okay at 8am.

Coincidentally 4am is when the cytokines are shed daily - and that’s

when the inflammation/pain begins - so if you stop it before it’s starts -good.

Could try splitting dose - or if you wake up regularly during the night before 4am might be worth taking then. Just take with a spoonful of yogurt or a slice of bread or biscuit.

It’s a matter of trying and see what’s best for you.

[Smokygirl in reply to DorsetLady]

Thanks DL. Before pred my most painful times were 2:00am and 4:00 am.

Last night was the first time I slept through the 2:0 am barrier and that was wonderful. Thank you also for your advice re the yoghurt before taking the pred. I do that after breakfast and pre pred in the morning too , as I am not on omzaprazole

First I thought I’d try PMRpro’s suggestion of 10 mg pred after breakfast and 5 mg before sleep. That will be around 11:30 pm and see how that goes. I understand that I am going to have to experiment!

Could you tell me how long it takes for a dose of pred to be at its maximum strength in the body? For me I would need that at 4:00 am. Which is interesting with regard to your info about 4:am cytokines. What are they please?

Thank you so much once again for your invaluable advice

Hugs xxxxx

[DorsetLady PMRGCAuk volunteer in reply to Smokygirl]

Pred (uncoated plain white tablets) should get into your system within a couple of hours, for some it can be a little longer.

As for cytokines- simple answer they are proteins released every day (by everybody) and whilst they are needed, we don’t need too many. The immune system usually controls them so they don’t cause a problem, but because our immune system is compromised they are not controlled sufficiently.

This gives a bit more info - hopefully not too complicated -

verywellhealth.com/what-are...

[PMRpro Ambassador in reply to Smokygirl]

From what you say, although taking the pred when you wake early would avoid the pain at 8am, you would probably find the pain returning that much earlier. 20 hours good effects is 20 hours - whatever time it starts!

[dillydally1]

glad you got some relief, hope splitting the dose works well for you x

[Rugger]

I noticed quite soon that pred doesn't last the full 24 hours for me, so I've split my dose for much of the 3 years. Hoping to be able to wake up relatively pain-free, I asked my GP if he would prescribe gastro-coated pred that I could take at bed time. This way, the pred is released during the night and in my system for the morning. I take it with some yoghurt. This has worked well for me, but it's trial and error for us all!

Best wishes.

Me: PMR since May 2016. A few flares along the way, now on 6mg.