@liz26 The process is slow because the inflammation needs to be controlled. Some people struggle with this process and even relapse while tapering from prednisone. Your rheumatologist helps with the management of this through routine blood tests and monitoring your tapering. You may want to talk to your rheumatologist about adding a steroid sparing drug. Yes, they are expensive but are covered by some insurance programs. While all drugs have side effects, I was eager to wean myself off prednisone asap so introducing the Rinvoq early made sense to me. Sleep management is much worse when you are on high doses of prednisone. Your sleep will improve as you taper to lower doses.