thank you everybody for all your comments.  I think it is very important to start an excercise program.  we actually just bought a treadmill and my 4 y/o loves to run on it.  I hope it lasts.  we are also watching her diet.  However her weight seems to be characteristic of cushingoid features.  I read Charmandari’s research and I think it makes a lot of sense.   If the onset of cortef is 1-2 hrs and the peak 17ohp is between 4am an about 10-11 am and cortef generally lasts 6 hrs then it makes no sense to dose at 10 or 11 pm because it will be gone by the time the peak comes.  Also it is providing steroid at the exact time when it is not needed.  I am going to speak with my doctor next friday at my daughter’s appt about circadian dosing.  It makes sense to me.  If anyone has heard from their physicians reasons not to do circadian dosing the please let me know.  again Thank You for your responses.