I had many many helpful replies about my hot flashes and i thank each of you...ii read every one of them...yesterday was a bear...i wanted to bite someones head off...does anyone take thier prendisone at night? Im thinking it might be better for me...ive always taken it early morning and im questioning that....ty all my friends who help and guide me through each day of this crappy disease...sharon
Hi Sharon, there are some people who do take their pred at night. I take mine as soon as I get up. Different strokes for different folks. What strenght of pred are you on? Some people (I think) split their dose. am and pm. Pat
The accepted thinking is that taking it in the morning leads to less adrenal suppression and that that is a good thing. It is also usually said that it will reduce the side effects such as sleep disturbances. However - not everyone has sleep problems and some have sleep problems whenever they take it!
Some people have found that taking their pred at night means the worst of the side effects they are having problems with seem to fade - possibly happening during the night while they are asleep. Some people have had "wobbly legs" or feel excessively sleepy after taking the pred - taking it late evening worked well for them and they still slept well. You can only experiment a bit, we are all different.
If it is any consolation, I was very bad tempered as a result of the PMR, and the temper situation always deteriorated during a flare. And that was nothing to do with pred - I wasn't taking it at all at first! Get one of those signs for putting up warning of the dog and put it on the door - substituting a photo of you. And have a sign round your neck warning you may bite - but it isn't directed personally at the victim ;-) Seriously though - warning your nearest and dearest that you aren't entirely answerable for your actions isn't a bad idea, show them the lists of pred side effects for backup.
Eileen, on a different thread, where someone was having problems with the brain fog and fatigue. You suggested taking the Prednisilone at night. I was in a nightmare with the brain fog at the time, arguing black was white, that I hadn't done something the day before which was proved I had and only then did images come drifting through the fog, over 24 hours!! It took me a few days to shift the dose to after my evening meal but I was transformed! I now rarely need my afternoon sleep and my brain is much clearer. People think I am more like my old self. I know that is not entirely true, but it is a vast improvement. I have more enthusiasm for life. I didn't feel confident it would be for me because I often have difficulty sleeping but I can only assume the fatigue and sleepiness that usually overtakes me in the afternoon comes on in the night. And I can be as dense as I like while I am asleep.... So thank you!
Should I worry about my Adrenals?
Hope my experience helps you tuningup.
Sheila
I also take the prednisone at night to avoid the fuzzy brain fog head and fatigue. When I began taking it in the evenings I was taking 30 mg (down from 40). Since I'm aware of the accepted principle that taking it in the morning is best in terms of waking the adrenals, I will test the waters by switching back to the mornings as I lower the the dose. I gave it a try at 18 mg and it was a mistake. Day fog and funk returned big time. After about 4 days I gradually switched back to evenings again.
I take my predisone at 11pm because I was getting very light headed and dizzy when taking it in the morning. That took care of one problem. Just keep adjusting until you find what is right for you. Good luck. I'm on my way down now....9mg and hoping to drop by 1 every six weeks. MaryKay
Brain fade................I sent my reply to sheilamac instead of to you. Hopefully you will still see it. MaryKay
"Should I worry about my Adrenals?
I just know someone will say yes - but I don't!
If you are taking more than a moderate dose for a couple of weeks or a lower dose for longer there will be suppression of production of cortisol - in much the same way as having the central heating boiler on all year round with a thermostat will mean it does not produce heat in the summer as there are enough thermal units running around the lounge already!
When your pred dose is lowered far enough, that whole feedback set-up has to get itself in gear again and it is out of practice so it struggles a bit. There are diseases where the adrenals shrink and inadequate cortisol is produced as a result but for the vast majority of us it is the whole thing that has to get back into balance, including the hypothalamus, thyroid and pituitary production lines for other hormones and things. It's like those circular swings where a load of children stand or sit on them and it swings happily until someone stands up instead of sitting or even jumps off - then some readjustment is needed.
At the very worst you might end up on a low dose of pred for life - but the side effects are less because they are caused by an EXCESS of corticosteroid. If you aren't producing much and it has to be supplemented - no excess. There have been some suggestions that it might even be a wobbly adrenal set-up that causes the trouble in the first place but there isn't any real evidence of that so far. But a dose of 5mg for life that keeps PMR at bay is a reasonable option in my book!
In terms of "waking up the adrenals" there is no need to worry about that until below 10mg. But I know a few who took pred at night right to the end and had no problems at all. One had been on pred for a second bout of PMR over a period of about 4 or 5 years, had had a hip replacement at a dose of about 5mg I think and was an octogenarian by the time she'd finished. Adrenal function normally falls off a bit with age - her's was obviously fine!
Thanks for this Eileen. It's nice to know there may be no need to worry about "waking up the adrenals" for some time. One of the other reason I tried to switch back to mornings is that taking the prednisone at night makes me have to get up to the loo every hour or two, which means a rather broken sleep. Fortunately I'm able to go right back to sleep, but I'm rarely in bed for more than 6 or 7 hours.
Gosh, ladies, that has all been very helpful! I did wonder if I would be going back to taking it in the morning when the dose got lower and one hopes the side effects wouldn't be so bad. So that is great! I am in the process of getting to 11mg so I'm am ok for a wee while yet, I see. And I won't worry about waking up my adrenals just yet. Have a lovely day everybody. It is sooo beautiful here in Scotland at the moment. 
I've heard others say the same - not a side effect of pred I had to cope with! I did find if I woke up at any point it was better to go to the loo immediately even if I didn't really need to and then I would go straight back to sleep. I couldn't survive on 6 or 7 hours in bed! I'm in bed by 10pm or soon after and it's a struggle to get out at 9am - though that is after 2 hours awake with cups of tea and Sky News. Not my choice I assure you, I'd rather sleep!
I wonder if speaking to your GP and asking for a mild diuretic to use in the afternoon might transfer the frequency to a more manageable time of day and allow a better night's sleep.
Is it you that's in Fife? Here in Italy we've had a beautiful week around the sort of snizzle (the odd tiny ball of snow rather than a pretty snowflake) but the rest of the time it was lovely sun. Today is foul - sunny this morning but now gray but with a howling gale! Surprised there is any loose snow up the mountain! There are still people up there - -13C and was over 50 km/hr wind! Can't even contemplate the wind chill at that...
I could ask about a diuretic; however, I have had a minor problem with low sodium levels pre PMR which have continued. There was some suspiscion that a diuretic tablet I was taking for moderately high BP was the culprit. I was taken off the diuretic and put on losartan (which has been increased 3 times as BP has risen with PMR 
). Sodium is still slightly below normal. So, I don't know if Doc will think trying the diuretic again is a good idea or not. I'm away from home for a month and will ask when I'm back. It would be nice to get 7 or 8 hours of reasonably unbroken sleep as I feel much better on the rare occasions that has happened.
Yes, curently living in Craigrothie near Cupar. I'm a Dundonian and am finally 'home'... And loving it. We haven't had much snow. Used to live in Grantown on Spey and the snow was horrendous, making life very difficult and its all snowed up as usual at the moment, so I am delighted to be in Fife... Crisp, sunny winter days are what I like.
What happens if you take it a bit sooner or later?
We both came to Dundee to uni and kept returning when we tried moving away! We've finally made two consecutive moves away so returning to Dundee is now unlikely - my brother lives by Duntrune and one daughter is in Rosyth but the other daughter is in Whitby. Crisp, sunny winter days? You need to move here! Snow only poses a problem while it is actively falling - as soon as it stops the roads are cleared and we're back to normal. We get very little wind - which is good because that is worse than snow as far as I'm concerned.
PS - you know there is a good PMR support group in Dundee I take it?
I've varied the evening time between 8 pm and 11 pm and it hasn't made any difference in terms of the number of loo trips or hours of sleep. I must admit it's hard to stay awake to take it at the later hours at times. I've thought about trying it right after supper, but am afraid I might wake up at 3 am and not get back to sleep. I say that because it's about 2 hours after taking the prednisone when the fog and fatigue set in, and it lasts about 6 or 7 hours. Coincidentally, that's when I'm able to sleep.
Perhaps I'll try when I get back home in a month or so. Taking it with the evening meal would have the added benefit of not having to eat a snack later in the evening. I sure don't need the extra calories, no matter how few.
Hi Sharon, I thought of you....I woke up this morning with hot flashes, and I think it is because of the higher amount of prednisone my doctor put me on because of the severe flare up I had recently. He wants the inflammation to calm down.
I am taking 25 mg for 5 days right now, and I split up the dosage. I take half after dinner at night and the other half very early in the morning, and I am pain free.