Over the last week I have not been getting my normal amount of sleep. Thanks to a tip from Celeste, I believe I know the reason. It might be the Prednisone that I started taking a week ago. I am finding that it takes longer to fall asleep. Worse yet, I have great trouble falling back asleep if I should be awakened during the day. Normally I could fall back asleep quickly if my sleep was disturbed. I only got 4 hours of sleep today and will probably pay a price for it later tonight at work.

Remembering that I work the graveyard shift, sleeping from 6:00 or 7 a.m. to 3:00 p.m., here is my current MG drug schedule:

1. Mestinon Timespan at 4:00 a.m. and 4:00 p.m.
2. Pyridostigime at noon, 8:00 p.m. and midnight.
3. Prednisone at 4:00 a.m., noon, and 8:00 p.m.

I think the 4:00 a.m. Prednisone may be part of the problem. Also the noon Pyrdostigime might not be helpful, as I am sleeping, rested, and the most symptom free. I had been setting an alarm to take the noon dose, sleeping another 3 hours after taking it.

I wanted to get some advice before I see my neurologist on February the 3rd. I was thinking of concentrating both the Pydostigime and Prednison during my waking hours. That means that the 3 Pydostigime tablets and the 3 Prednison tablets would be taken during my 16 or 17 hour waking period. It also means that I would be taking a Pydostigime 3 hours after taking a Mestinon Timespan tablet.

I believe that I metabolize the Pyridostigime and Mestinon out of my system quickly. Before starting the Mestinon Timespan, when I was only taking the Pyridostigime, I would have the return of symptoms around 3 hours after taking it.

I was thinking of changing my schedule to the following:

1. Mestinon Timespan at 4:00 a.m. and 7:00 p.m.
2. Pyridostigime at 4:00 p.m. 7:00 p.m. and midnight.
3. Prednisone at 4:00 p.m., 7:00 p.m., and midnight.

I have 5 different 7-day pill boxes and set iPhone alarms to make this all manageable.

Any advice?

Thanks,

-Mark-