Trouble being able to sleep more than 3-4 hours before

Have you tried splitting your prednisone dose to take a smaller part of it in the early evening to reduce overnight pain? Sleep is really important for any sort of recovery or healing and a smaller evening dose helps a lot of people with night pain. Most doctors who recommend a split dose (if a single morning dose doesn't control night pain well enough) say to make the evening dose no more than 1/3 of the total daily dose. Often just a couple of mg of the daily dose works well.

Thanks for your suggestion. I hadn't thought of that and my MD hadn’t said anything about splitting the dose. I will discuss that with him tomorrow. Sounds like a good idea.

I struggle to stay asleep, though not to PMR. Do you have an adjustable bed? The ability to adjust my incline is quite helpful to me. I have to stay on my back with arms on pillows.

I find that Ibuprofen helps. I take 200mg in the morning and 200mg after dinner. Slowly exposing your range of motion helps. Arnica cream on the most sore spots helps. Also try moaning and groaning loudly.

I have the same issues with sleep. I sleep 3-4 hours and wake up and sometimes have a hard time getting back to sleep. I have pain medication prescribed every 8 hours as needed. It is not an extended release tablet, so I can break it in half and take a half every 4 hours and this helps me to relieve my pain. I’m a side sleeper and sometimes a neck pillow also helps me, along with a topical pain creme(otc) called Aspercreme.

A restful night's sleep is also a struggle for me. I devised a routine with my counselor:
1. No screens after 8 pm. My bedtime is somewhere between 9:30-10:00.
2. Prepare a cup of chamomile& lavender. Place at bedside.
3. Take 500 mg magnesium.
4. Urinate. Fully empty your bladder.
5. Read paper-based texts - no screens. Choose material carefully. No overly stimulating pageturner. Sip tea while reading.
6. Consider urinating again before totally settling down for the night
7. Listen to music or audiobook. Most apps allow you to set a timer. Again, no overstimulation. You can find playlists for calming music. Audiobooks might include comedians, biographies, inspirational works, etc.
8. I have taken Ativan occasionally in the past to help induce sleep. Since it is an addictive benzo I tried cannabis. My rheumatologist explained that cannabis is not an anti-inflammatory. It simply stops the PAIN message from registering in the brain. Most effective strain for me is 1:1, CBD: THC. One inhalation (gummies need to be taken an hour or more before bedtime) and I'm down for the count.
* I truly hope you find a routine especially suited to your needs. Sleep is an important component for pain management. May you be well.

I also could not sleep horizontally, but found relief sleeping in the recliner half sitting up. After beginning prednisone I could sleep horizontally but the drug woke me up after 3 or 4 hours. I never tried splitting the dose (seems counterintuitive to me) but many swear by it. After getting down below 4mg I am again sleeping through the night and with no pain. This is a tricky condition! And everyone is different.

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) which shouldn't be taken with prednisone because of the higher risk of damage to the lining of the stomach/digestive system and other serious complications. Tylenol (paracetamol/acetaminophen) is okay to take with prednisone.
Loud moaning and groaning can be helpful but may frighten pets and small children.

I’m curious about the 500 mg of magnesium.

My docter prescribed prednisone and ibuprofen . I have stopped taking the Ibuprofen because I had read the warnings about it elsewhere. I think I need a real rheumatologist to help me through this and not just a primary care doctor ..