First split dose last night. No pain ,no stiffnes... - PMRGCAuk

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First split dose last night. No pain ,no stiffness, NO SLEEP! ☹️

Smokygirl profile image
23 Replies

Took my dose of 5mg Pred at 10:30 last night after eating a pot of yoghurt. Lay awake until 1:30 then got sort of mild tummy ache which lasted another two wakeful hours. Dropped off at 3:30. Woke again at 5:30. Slept from 6:30 til 8:am.

I think I’ll go back to 15 mg in the morning for a while, as it is such early days for me. However I am going to have my breakfast / dose later, about 10:00 am and see how that goes.

Does anyone take their Pred in the middle of the day after lunch?

Thanks again lovely people 😘😘😘

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Smokygirl profile image
Smokygirl
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23 Replies
Highlandtiger profile image
Highlandtiger

If I were you I think I’d be rejoicing that the pain and stiffness has gone! Yay!

Lack of sleep is annoying but I’d take getting rid of the pain any day.

I’ve always taken my pred in one dose in the morning with no particular issues.

Smokygirl profile image
Smokygirl in reply to Highlandtiger

Noooo! I really need my sleep! Also the stomach ache wasn’t nice.

This is only my fourth night on Pred and I think I’ll do the morning thing like you for another few days and see how things go. Perhaps I rushed things a bit!

Highlandtiger profile image
Highlandtiger in reply to Smokygirl

Hopefully it will all settle down for you soon but on a positive note just think how far you've come since last week! 😀

Hi Smokeygirl

It’s very early days & maybe you were expecting a bit too much, some people never get 100% relief but the difference from how they were is so much improved!

You really need to take your Pred before 9am, our own natural Cortisol has all been produced by then & the idea is to mimic this as close as possible.

The difference after three days compared to after ten days for me was huge but l also had a frozen shoulder in the mix.

My advice would be, take your Pred 7.30/8am & see how it goes.

Rest a bit more, are you still trying to work?

Re Splitting the Dose - many people who’ve been on Pred a long time experiment by taking their Pred at different times of the day but my advice to you would be take it as Prescribed then you will get a better picture of how you are actually feeling.

Pred will keep you awake at night; Sleep & Rest are Valuable to you while you have PMR

Kind Regards 🌷

MrsN

Smokygirl profile image
Smokygirl in reply to

Thanks dear Mrs N. I’m sure you are right about rushing things. I’m running before I can walk. I’m going to stick to the morning dose for another week until I see my GP next Wednesday.

Thank again for your kindness xxxx

Smokygirl profile image
Smokygirl in reply to Smokygirl

PS. I am 77 yrs young and very very active, Like everyone here I find it so so difficult to slow down! Xxxx

in reply to Smokygirl

I think that’s best, then you have a proper picture to present to your GP

You may also have ‘other pain’ which doesn’t respond to Pred sometimes it’s difficult to separate the two.

Do rest, you have permission 😉

Remember it’s a Marathon not a Sprint but you’ll get there just the same.

Have s good day

MrsN x

Cross-stitcher profile image
Cross-stitcher in reply to

"Pred will keep you awake at night". Well, it may for some but not for me. After some experimentation, I now take my Pred at 2.00 am. This means I have very little Pred left in my system by the time I go to bed at 11.00 pm, and yet I still cannot fall sleep easily, however active I have been during the day.. I often find myself resting and reading until I take the Pred at 2.00 pm, with a large glass of water (no food needed) and a bathroom visit, and then I fall deeply asleep until 8.30 am or thereabouts. I wake with no pain or stiffness, and this lasts me all day. If any stiffness sets back in by the evening, a warm bath or shower is good. So, my conclusion is that neither pain nor Pred is causing my insomnia. It's just one of those things I have to live with. And, at least I am not living with morning "pre-Pred" pain which might be the case if I took it with breakfast.

Smokygirl profile image
Smokygirl in reply to Cross-stitcher

Hi, thanks so much for your input. It is so interesting how everyone is different and has worked out the routine that suits them best.

Actually I now get the same amount of good sleep as you—— 6 hours approx. Until Pred and PMR I have always slept 8 hours.

I take my Pred at 10 :15am after breakfast. It kicks in strongly about three hours later but it’s OK until then.

I have a busy morning and then I seem to flake out at 2:30 pm and have to go to bed for an hours sleep. I am then busy and out at night playing bridge. I go to sleep at11:00 pm. I wake up at 5:30 am . The Pred seems to last me 20 good hours but nevertheless I can manage until breakfast and go for a brisk mile walk first.

I have only been on Pred for one week, and my next worry is keeping my bones strong——- the advice and info from all you wonderful people is invaluable,

Thanks so much once more and very best wishes to you xxx

scats profile image
scats

Give it time it's early days yet. That actually sounds like a not unusual night for me since starting pred. My husband worries if I'm still asleep in bed when he wakes now. I have learned to nap during the day if necessary. A lot of adjustments come with PMR.

I have tried splitting my dose because I used to wake with leg pains, this worked fo a while. I now take my pred with my evening meal. I take mostly coated pred which takes longer to be absorbed and is active by the early hours. I expect I will probably have to change things again as hopefully my dose decreases.

Celebrate the loss of pain, but gently!

Smokygirl profile image
Smokygirl in reply to scats

Oh thank you Scats, that is so interesting. I shall bear this in mind for the future. I need an afternoon nap always but need a decent nights sleep too! Everyone has such a different path.

Thankyou so much for your kindness and all the best to you too xxx

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Splitting your dose may cause sleeplessness, but Pred does for some anyway.

Maybe you were just a hyped up because everything is so new - I think you need to give it a week to see if it’s going to work for you. It does for some, but not all.

Perhaps taking Pred with just a couple of spoons of yogurt rather than the full pot might resolve the tummy ache.

As I said previously you need to find what suits you - but you do need to give different regimes time to work.

If you normally wake during during night - say after 2am for call of nature it might be worth taking Pred then.

The later in the day you take Pred, the later you will feel the benefit- which is why 8am or thereabouts is suggested time.

But to be honest maybe you are trying a tad too hard to get it right immediately- it takes us all time to find “our” way! Just relax - it will come. 💐

Smokygirl profile image
Smokygirl in reply to DorsetLady

Dearest DL —— I know you are right. I’m going to go back to the morning dose for a week. I rarely wake up at 2:00am , usually it’s about 4:00 am for the loo. I know I have been rushing things!

Thank you so much for your continuing kindness and support.

I am so truly grateful xxxxx

jinasc profile image
jinasc in reply to Smokygirl

A cuppa, slice of Bread and swallow tablets............................ 4am ideal time - you go back to sleep, tablets start to work.............than a warm shower when you get up,

Some countries, not the UK use slow release tablets. PMRpro knows the proper name, it escapes me at present.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply to jinasc

Lodotra I think.

SheffieldJane profile image
SheffieldJane

My insomnia was greatly helped by 10 mgs of Amitriptylin taken one hour before bedtime.

Linny3 profile image
Linny3

If I know I have a busier day ahead of me than usual I will save 1/2 mg and take it later in the day. It seems to help me get thru the afternoon easier.

PMRpro profile image
PMRproAmbassador

You could try splitting but taking the second part much earlier in the day and that should extend the effect but not affect your sleep so much. OTOH, taking it all early (6am if you wake that early) and settling down for another hour or two allow the pred to work is a common approach.

Smokygirl profile image
Smokygirl in reply to PMRpro

Thanks again PMR pro! Taking the second part much earlier in the day sounds like a really good idea. Perhaps after lunch? I think I’ll try that next week. I would prob be asleep at 6 :00am and anyway would not want to eat food at that time and as I have a dodgy stomach, I won’t take any meds’ without eating something solid first. xx

nickm001 profile image
nickm001

You want to take your pred as close as possible to 4AM. What is the best way for you is hard to say, you would have to experiment.

-If you decide to take all in one go, then the best time to take it is as early as possible, as soon as you wake up (5-8AM) , 9 AM the latest. As some have mentioned, cytokines are released at about 4AM and will start causing inflammation as soon as they are released. The sooner you take pred, less damage they will be able to do. Taking pred after lunch does NOT make much sense.

-If you decide to split the dose, then the most effective way is to take some pred (usually 1/3 - 1/2 of the dose) as late as possible in the day, just before you are going to sleep. The purpose of taking pred late is to have it ready and at high level of concentration before 4AM . Since it take s about 2 hours for pred to be absorbed, ideal time is 1-2AM. If you take it after lunch or at dinner time, it is mostly wasted, because it is too early for 4AM event.

Having said that, at the beginning it is best not to jump around too much. Standard recommendation is to take it in AM as early as possible. Maybe after several months, when things settle down, then you may experiment if you feel that split dose will help and fits better your lifestyle.

Smokygirl profile image
Smokygirl in reply to nickm001

Thank you so much Nick for your advice. It is very interesting and as you say, later on I shall start to experiment.

As you know it is very early days for me, and at the moment, as I have only had a week on Pred, I am finding that taking all my 15 mg at 10 :15am after breakfast seems to cover my needs.

Taken any earlier and I wake up in discomfort at 4:00 am.

When I split the dose I couldn’t get to sleep!

With the Pred taken at 10:15 am, I am busy and out in the morning , get in from bridge at about 10:30 pm and I am able to sleep through at night until 6:00am which gives me six and a half hours as I go to sleep at around 11:30pm.

I also flake out in the afternoon and go to bed for an hour.

I go for a brisk mile walk before breakfast and I shall certainly try to keep this up. For the moment this is my regime!

Thank you again and every good wish x

Smokygirl profile image
Smokygirl in reply to Smokygirl

Also sticking to a low carb diet which we have done for 40 years as our son has been diabetic since childhood. Hope it stops the weight gain —- did it stop you gaining weight?

nickm001 profile image
nickm001 in reply to Smokygirl

I never gained weight on pred, but that is another story... It helps most of the people, as you can read in the forums. I have an active life enough that it does not matter what I consume. My diet is balanced and includes carbs.

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