Does you doctor recommend splitting?

I made the suggestion of a split dose to my doctor after reading how successful it had been in reducing morning pain for a lot of people here at Mayo. My doctor agreed with the split dose, provided that:
1. The early evening dose was a small proportion of the morning dose, in my case 1-2mg.
2. The later prednisone dose was taken at least 2 hours before my small evening dose of melatonin (which I take to compensate for loss of melatonin caused by a beta blocker).

So although my doctor did not "recommend" a split dose, she was willing to go along with it to reduce morning pain. It has worked well for me. No morning pain and I sleep well.

No, she said the prednisone was interfering with my sleep, take all (60mg) in the morning.
I have so much pain, especially in my shoulders, neck, it’s difficult to get comfortable to sleep and stay asleep.
Often up reading, working puzzles, for an hour or two then going back to bed and trying to sleep.
Definitely wearing down my general health, I’m 88.

You didn't mention in your original post that you were taking 60mg which is a very high dose, or how long you have been taking it. Are you being treated for giant cell arteritis rather than PMR which is usually treated with one third or one quarter of that dose?

From what you say, it's the pain that's waking you up possibly as much as the prednisone may be. Does your doctor know you have pain that's causing you sleeplessness? Split dosing is fairly common to control night and morning pain with PMR but I haven't heard of it being needed with GCA at those very high doses.

I’m just a patient relying on the doctors expertise.
The original diagnosis was the GCA, and it was rather serious with all the side affects, high ESR.
Started prednisone at 60 mg, with a slow decrease over 9 months.
Before the diagnosis I ended up in the hospital with loss of half of my blood, extremely anemic, very low diastolic BP…no solution as to this issue despite every test known to man!
Then the GCA diagnosis a month later, the 9 months of prednisone.
6 months later, a total disabling flare of PMR, hospitalization, 140 ESR and other markers, back on 60 mg meds, decrease, then increase again because of pain but just finished after a full year of meds.
She doesn’t seem to be concerned or even I think , understand how I can have this pain even though I’m on a minimal dose, working down to 1mg.
So I’m unsure, I don’t think I fit her “cookie cutter “ image of GCA although from what I read, there is no consistent evidence of every patient having the exact same issues. Mine ran the whole gamut driving my doctor crazy, calling specialists, finally a hematologist asked him if he had considered GCA. Voila!
Sorry, long story and I’m not doing well, losing ground I feel .
I have labs tomorrow for Phamacotherapy that coordinates labs, drs, meds.
Dr. appt in two weeks…

You've really had a rotten time of it, haven't you. And at 88yo the body doesn't bounce back so well from these complications. A reduction from 60mg to zero prednisone in only 9 months is a fast taper. It won't be so much your doctor's "expertise" you're relying on, but their guesses as to what might be happening, and they won't get it right all the time. So you're right to ask questions and keep yourself as informed as you can on what is happening. All the best to you and finding answers and solutions to your ailments.

I think I mentioned that those of us with GCA have a 50% or more, chance of ending up with PMR.

Yes, it's closely related. And those of us who get PMR first have over 20% chance of getting GCA.

My rheumatologist has no problem with me splitting. Morning much easier since I began splitting. On prednisone
5 -5 plus Kevzara. No problem sleeping and much better when wake up than when getting 10 mg in AM. 🤓

I don't split mine. I take it right before I go to bed. 10-11pm. I sleep fine taking it then, not so well if I take it in the morning.

I began tracking how I felt and found my best hours were hour 6-hour 20. And true to form, my best hours are 5am - 7pm. I'd rather have the best hours during the day.

My doctor suggested splitting a 12mg dose to 6 and 6, 12 hours apart, when I had pain come back at 10mg. And then slowly reducing from there. (I do not seem to have more sleep problems on prednisone than before I started it.) The hope was to have less morning pain since it was 12 hours, not 24, since a dose was taken. I'm now at 6 and 5 with morning soreness that only occasionally requires Tylenol.