Timing of taking prednisone

Wow I have been trying to find out if someone else was doing this. Yes it works perfectly for me, maybe for different reasons than you. My problem was if I took it in the morning as prescribed by my doctor by the time I woke up the next morning my muscles and joints were very sore and stiff. They would ease up as the morning progressed and since I would take my prednisone around 9am I was pretty good by early afternoon. I also tried split dosage in am and pm, this worked better than the am only dosage but I still would wake up with manageable degrees of aches and pain. Bottom line was that taking the full dosage at night around 8pm works perfectly for me from a pain management perspective. Hope this helps.

Ditto here….taking prednisone after dinner when I settled in for the day. Don’t notice the dizziness I get like when taking first thing on the morning.

However, the 5 msg is fine, but I take a 8 hr Tylenol to get me thru the day time.

Yup when I first started taking steroids I realized I needed to take them between midnight and 2 am for maximum effectiveness, otherwise I would wake up with terrible myalgias and no additional amount throughout the day would relieve it! It was like my body was busy self-destructing in my sleep and the better I slept, the worse the symptoms were upon waking. Now that I have been taking them for a while my issue seems more to be with combating fatigue perhaps from being on a lower dose and possibly secondary adrenal insufficiency…I ‘run out of gas’ between 10 to 11am and need naps fairly often. I am experimenting with dose splitting but haven’t found the perfect timing yet because my work hours can be very unpredictable…

"It was like my body was busy self-destructing in my sleep and the better I slept, the worse the symptoms were upon waking."

I had this problem too. My pain was the worst at 3 a.m. and I would wake up in extreme pain. I had to take part of my Prednisone dose at 3 a.m. I would save part of my dose for later in the day.

The timing was probably caused by adrenal insufficiency because cortisol levels are at their lowest during the night when we sleep. My cortisol level dropped to extremely low levels when my adrenals were suppressed because of being on Prednisone. It was like my body was telling me to take Prednisone to replace the cortisol that my adrenals weren't producing. It was all part of the circadian rhythm that was repeated every 24 hours. Cortisol is what regulates inflammation so I think my inflammation levels increased during the night when my cortisol level dropped.

"Painsomnia" isn't a medical term but it describes what happens when cortisol levels drop during the night.
https://www.sleepfoundation.org/physical-health/painsomnia

I would like to try that timing . My body is not good in the AM until Pred kicks in but nervous to take it at night due to possible sleep disruption.

I have read that inflammatory chemicals are released in the body at around 4 am. Here is a quote from Google:

"according to research, a significant portion of cytokine release, particularly pro-inflammatory cytokines, tends to peak during the early morning hours, often around 4am, as the body transitions from sleep to wakefulness, aligning with the circadian rhythm and immune system activity during this time.

Key points about cytokine release and the circadian rhythm:
Peak activity during sleep:
While the body releases cytokines throughout the sleep cycle, the highest levels are often observed during the later stages of sleep and the early morning hours.

Morning stiffness:
This phenomenon is partly attributed to the increased release of inflammatory cytokines like TNF-alpha and IL-6 during the early morning, which can contribute to joint stiffness in individuals with conditions like arthritis.

Importance of sleep quality:
Adequate sleep is crucial for proper immune function, as disruptions in sleep patterns can affect the normal circadian rhythm of cytokine release. "

I am an early riser, so I take the prednisone really early, around 4 am. So far I haven't had any problems with it not lasting a full 24 hours.

"I am an early riser, so I take the prednisone really early, around 4 am. So far I haven't had any problems with it not lasting a full 24 hours."
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You're lucky in that regard. Actemra might also be playing a role because Prednisone typically does not last a full 24 hours. It mostly depends on the dose and amount of inflammation that is present. PMR inflammation is said to be "chronic" so it is there all the time.

I'm "light sensitive" so I wake up early or whenever there is any hint of daylight. From what I read, light is the primary determiner of our circadian rhythms.

I'm not disagreeing with the statement about "inflammatory chemicals being released in the body at around 4 am." However, I don't think "released" is the right word and expecially not released at a certain time of day. I know this is repeated frequently but I'm not sure how accurate it is.

My understanding is that cytokines are "triggered and released" primarily by infections and other things at the cellular level. Then cytokines need to be "regulated" primarily by the production and release of cortisol which happens in the adrenals glands. It is all interconnected and the entire process happens throughout the day. How cytokines are regulated is what causes the disruption in how our immune system responds to triggers.

It is extremely complicated so simple explanations to describe what happens are impossible. If anything good happened during COVID it was the research done on cytokine release syndrome.
https://my.clevelandclinic.org/health/diseases/22700-cytokine-release-syndrome
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No wonder there was a surge of cases of PMR post COVID.

I once had a major malfunction post infection and wound up being admitted to intensive care. Multiple doctors basically said they never saw anything like what happened to me. What caused it to happen was unknown but the best explanation I heard was a "cascade of blood related events."

Recently my Dr. changed my 25 mg dosage of prednisone from just in the morning to 15 mg in the morning and 10 mg at night. As a result my arm and shoulder pain at 3 AM decreased by at least 80% and I was finally able to relax at night. I know this sounds weird but at 3 AM when the pain has become bad I get up and have a cup of strong hot coffee. Maybe it's the caffeine I don't know but it sure eases the pain and yes I can actually go back to sleep another 2 hours till I get up at my usual 5 AM. As a result of most of the pain now under control, my blood pressure has been going back to normal again instead of jumping around all over.

I take Prednisone early in the am. My rheumatologist wants me to take it then, but also I find that if I take it after 10 am, I have a lot of trouble going to sleep.

I take 2 Turmeric and 2 Extra Strength Tylenol around 11pm or midnight, to help relieve the morning pain amd stiffness caused by the 4 am- ish cytokine release.

My rheumatoligist said that taking the prednisone in the AM keeps the body on its normal rhythm of cortisol and you want it the rythym to stay stable as you start to taper off the prednisone. I was doing that but my dose did not last until the next mornng. I normaly end up having to use the bathroom between 1 and 2am. I take 5mg of my pred dose at that time and then the rest of my dose around 7am when I rise. I am pretty much pain free for 24 hours. I have just begun this jouney 3 weeks ago and my dose is 20mg. I take 5 mg between 1 and 2 am and then 5mg later in the morning when I get up.