Hi Kathy,
You have to find by yourself what is the best shedule for your Mestinon intake, your neuro is not in your shoes...Vary your intake and observe the results!
I take mine at 9am-1pm-6pm and 11pm, always with some food and beverage, mealtime or not.
Do you know that a special kind of Mestinon does exist, Timespan? It comes in 180 mg tablets which can easily be broken in two, I took half a tablet at 11pm for quite a while, but I do not need it any longer.
Timespan has a slower release rate the the normal Mestinon , it has been designed for passing the night and wake-up periods without too much problem.
Maurice.