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Inverse relation between sleep and PMR symptoms

Posted by eakin @eakin, Sep 28, 2025

I am tapering prednisone, currently at 10 or 11 mg. I observe that when I sleep poorly (up for part of the night, or rising at 4:30) my PMR pain and stiffness is reduced in the morning. If I only get up once or twice for the bathroom but sleep OK, it will be a bad morning: more discomfort, more fatigue. (The sleep issues existed before the PMR and prednisone.) Is this common? Symptoms increase with more overnight inactivity?

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Mike | @dadcue | Sep 26 4:14pm
In reply to @rhonna "The more I research PMR and learn about all the other medical stuff surrounding it, my..." + (show)
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The more I research PMR and learn about all the other medical stuff surrounding it, my TN etc. The more I marvel at the human body. My MRI's to determine a suspected neuological problem revealed alot of otherbidduescwith my spine that I was totally unaware of as I have a high pain tolerance. Thank-you for sharing the details of you TN treatment. Are you in the States by chance? I am in Ontario Canada and our process for diagnosis and treatment is different sometimes. Thanks again, happy weekend!

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@rhonna

I'm in Iowa so just to the south of you. From personal experience, my TN got progressively worse. I don't know if your TN responds to prednisone or not. If it does respond to prednisone... don't think prednisone is a good treatment for TN. The neurologist who told me TN wasn't treated with prednisone was right all along.

On the other hand ... the neurosurgeon who did the MVD surgery reviewed my medication list prior to surgery. He stopped the review and asked me what I took for pain. He said most TN patients had a list of pain medications a mile long. He seemed skeptical about whether or not I had severe TN symptoms because he didn't see any pain medications. I had to tell the surgeon that prednisone was my only pain medication. After surgery ... the surgeon agreed with the emergency room doctor who said it was the worst case of TN he ever saw.

While corticosteroids aren't a standard first-line maintenance treatment for TN, steroids are used to reduce nerve inflammation during an acute pain crisis.

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gud2gro | @gud2gro | Sep 27 2:20pm

We are all so unique. I sleep better if I take prednisone at night. I don't do this on a regular basis - it happens if I have a flare-up and haven't heard dosage from my doctor until later in the day. It affects affects nasal issues caused by a deviated septum and sleeping on that same side.
I've also found that if symptoms are coming on and I'm ignoring them or I'm stressed, I sometimes sleep stiffened. If I wake up during the night and feel that way I use progressive muscle relaxation.

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