Sometimes I think she might even have a sleep disorder, but then again everytime I have changed her meds timing, THAT exactly has been the time that her sleep shift has occured.  Every person has a different response to wake stimuli and I guess she is just sensitive. I don’t have a problem giving her meds at 7am when she wakes up, that’s my normal wake up time too ! But somehow I don’t understand how the ACTH peak can be independent of all of this, independent of bed time, of number of wake up cycles, and wake up time.  I know that is what I should believe because research says so but I wish I could understand the why  ?

I called Pharmacia medical advice line and they said that the peak absorption rate is an avg of 1.2 hours , and the half life is about 1-1.5 hours depending on the individual’s metabolism. So I’m thinking if I dose her at 2am, then by about 3.30 she should have mxm concentration and by 4 or even 5am substantial quantitities. I am quite concerned when I should give the next dose though.  If she needs to have mxm concentration upon waking, which is 7am now, then ideally the meds should get into her body by 6am. But if I start doing that then she will start waking up at 6 and it will start a whole new cycle. I don’t want to dose any sooner than 6 hours given that the 2am will be the largest dose. So that’s my confusion. !

If I space the morning dose at 6 hours ,  then I can get by with dosing the evening at4pm which is 8 hours apart and the next one at 2am which is 10 hours but may work because the need is not much at night anyway.  So I can still stay at thrice daily but spacing the doses at 8/6/10 hours respectively.

I’ve got a spreadsheet and some charts showing the concentration of her dose per hour for the night dose , I’m taking it to the next visit . Any other arguments I can use ?

Thanks,

Sueg