June 4, 2023

Today on the Transplant Helper
I’ll be answering a fellow organ transplant recipient’s question “Can I adjust my medications for better sleep?” Prednisone and Sleep

Okay here’s an excellent question by a fellow transplant recipient concerning sleep cycle and medications here’s what he says he said i’m looking for experience and feedback on sleep cycle when do you take your meds to have a minimal impact on staying awake at night he adds to that i was thinking to try to take my meds at 6 am and 6 pm what are your thoughts well

First of all this is an excellent question it’s certainly one i have asked myself in the past as well as i try to give the best answers i can even like i’m doing now and let me suggest to you that you do not change your meds to something as drastic as 6 am and 6 pm and that’ll be for a few reasons but for me personally the main reason to be if i had a bad night’s

Sleep i don’t want to have to get up at 6 a.m every day of my life to take medication so i probably wouldn’t adjust my meds back that far now i’m a guy who for the past nine years post heart transplant i’m typically taking my meds at nine and nine with a few exceptions when i’ve made adjustments like you’re thinking about making but typically speaking i would

Remain with the plan to take the majority of my meds at that nine and nine marker and that means that you’re going to keep things very very consistent now that might be eight and eight it might be seven and seven ten and ten who knows but sticking with a nine and nine example it is so important that things like program aka tacrolimus and or microfinic acid or

Myfordic it’s extremely important that those medications mainly those two be kept at a very very strict regimen that’s why they have suggested to you probably that you do take a cycle like an 8 8 9 9 10 10 cycle keeping them exactly 12 hours apart because those levels are that which fluctuates the most easily and you really what happens when you take them there’s

A little bit of a spike in the beginning there’s a level off point and then there’s kind of a drastic drop off at the end that’s how those two medications act within your body and it’s pretty important that you keep them at a very consistent time not only 12 hours apart but in addition to that let me suggest that you leave them about wherever they are now not go

Back so early because say for example you’re going in on monday you’re going for 8 a.m blood work if you’ve taken drugs like pro-graf tacrolimus back at 6 00 p.m the night before your levels are going to be low by 8 pm the next morning and they’re going to register low and if they register low when there’s kind of a mistake there because of the timing they may up

Your doses unnecessarily and then you’re going to pay the price for that so i would suggest if you’re doing a nine and nine leave those things alone but i would think that would be perfectly fine for you to adjust your prednisone levels to maybe something like a nine and six and you say well jim that’s not 12 hours apart that’s right but prednisone is not nearly as

Sensitive to those time fluctuations as the medications i suggested earlier it’s one of those medications that as long as you’ve got the right level in your system overall because it doesn’t spike as quickly you’re going to do pretty well and this tremendously can impact you in the night time by backing it up to six as you’ve already suggested and assume because if

You can get those in by six then maybe you’ll have a chance in this world of getting a sleep by say nine or ten o’clock because from my experience at least prednisone has the biggest impact as far as tremors as far as you know just uneasiness and the lack of being able to settle or relax for about the first two to three hours so if you take it at six pm yeah you

Might be good to go by nine or ten that is right but it is not so important that i would change all of my medications to that regimen i would probably leave whatever else i’m taking as is and then just change the prednisone taking that 9am or 8am or whatever and then that 6pm in the evening will work well it won’t make your medication levels fluctuate much with

The prednisone as a matter of fact they don’t really even check that but things like prograph that they do monitor you don’t want to have those spikes in there particularly on clinic day when they might detect that and try to make some adjustments that’s just not necessary so go ahead and sit down with your team talk with your coordinator be sure to run this by

Them but i would think the best option is whatever time you’re taking now if it ain’t broke don’t fix it leave things as they are and just simply adjust that evening dose of prednisone back it shouldn’t affect your levels very much and you should get maximum benefit in that and good blood work every time at least that’s our hope thank you so much for this wonderful

Question i think you’re not only helping yourself you’re reminding me of these important facts and perhaps helping others so i would encourage you all please even you stay stronger my friend

Transcribed from video
How can I adjust my medications for better sleep? (Prednisone and Sleep) By Transplant Helper