waking Early 4am

[Naibor]

Hi all.

Recently diagnosed with PMR in October last year. Started on 15 mg Pred. Having difficulty reducing. However my main problem is waking up in pain early morning around 4am. Can this be alleviated by adjusting the time meds are taken?. Was advised by GP to take at breakfast.

Any advice would be truly appreciated.

Best wishes

Naibor

[SheffieldJane]

Yes, it worked for me. It was well worth waking up at 2 am and taking Pred with a little yoghurt. This is the optimum time because at around 4 am the cytokines ( inflammatory substance) are released into the blood stream and this causes the pain. You effectively cut this off at source.

[Naibor in reply to SheffieldJane]

Thanks for the reply

So just to understand what your saying. It could be beneficial to take the pred when I’m woken early from the pain returning.

[SheffieldJane in reply to Naibor]

It would be better to wake up a couple of hours before you wake up in pain and take your Pred dose then. With any luck you won’t then wake up in pain at 4 am. If that makes sense?

[Naibor in reply to SheffieldJane]

Ok I understand. I will give it a try, Thanks for the advice.

Best wishes

[DorsetLady PMRGCAuk volunteer]

Couple of things... having looked at your bio - think you are trying to reduce too quickly - although you are probably doing as told by doctor.. and following the "official" tapering, but doesn't suit everyone - as we know from comments on here.

If your dose isn't lasting full 24 hours, it may not be quite enough... and the problem is once you've flared, it always seems more difficult to get same result on initial dose that you did first time around. Did you have a good result at 15mg first time around?

When you attempt to reduce again, suggest you try 1mg a time, so ask GP to prescribe....

Maybe have a look at this intro/info post -

healthunlocked.com/pmrgcauk...

.. and yes if you wake around 4am or just before then take your Pred then - with a spoonful of yogurt, small piece of cheese, or something similar.. you may be able to get another hour's or so sleep ..

Another option is to split dose - approx 1/3rd in evening & 2/3rd with breakfast.. so the evening one helps with the 4am cytokine discharge - which is probably what is waking you...(fuller explanation in link).

[Bcol]

Agree totally with DL. I like SJ and others take mine around 02:00ish with some yogurt and a banana, assuming I've got one, and that has given me few if any problems in the morning or during the day. I do think it is really important though, to get on top of the inflammation early on, with enough Pred, and then taper at a slow speed which allows you to keep it under total control, however I also realise that is not always possible with some doctors.

[PMRpro Ambassador]

That is the time at which the inflammatory substances are shed in the body and a lot of people wake then with various feelings or pain. If you are able to take pred at about 2am it will be working by then which might help. Or it may be that the pred effect isn't lasting the full 24 hours until the next dose is due - so then it doesn't make a lot of difference when you take a single dose, there will be some pain before the next, and splitting the dose may work better - plus you can choose the times you take it rather than wking in the middle of the night.

[AyJayBass]

I take my Pred as a spit dose, between 30 and 50% (percentage depending on total daily dose) at bedtime using coated tablets so that the pred becomes effective by 4am. I take the remainder with breakfast.