My daughter also had no growth issues and was very small, off the charts in both height and weight. Through research we realized that she was oversuppressed. Some doctors try to keep CAH children’s levels at that of non CAH. This cuses oversuppression. 17ohp can be safe between 500-1000 for CAH children. Our daughter’s levels were always <10 or some such. With a new endo, we lowered her doses and spread them out more. First to 3 times a day and now 4 times a day at 3am, 7am, noon, and 5:30 with the biggest doses of Cortef in the 3am and 7am times. (I have no experience with Prednisone) With this schedule she started growing!! In 2 1/2 years since she has been on it she slowly crept back up the charts and is now at 75% height and weight with bone age on track as well as all her levels!! (MY husband and I are both tall and her projected height without CAH issues is 5’10") We are ecstatic with her growth. She is back on target with her potential and doing beautifully. I am a frim believer in the circadium rhythm dosing schedule if your child is showing side effects of the meds which yours seems to be. Do you know what his latests levels are? If he is oversuppressed it could also cause the sleeplessness. Also, if he is oversuppressed and his endo is unconcerned with his growth I would suggest finding a new endo who will listen to your concerns. I have many articles about this type of schedule if you are interested let me know and I will post them. (We had to persuade our endo to try this schedule. I wrote a persuasive letter and sent all the research articles and graphs to back up why we wanted to do this,,, it worked!) Also, you mention growth hormone. I don’t know much about it except that it is secreted mostly when we are sleeping. If a large dose of hydrocortisone is given before bed it can suppress the GH from being released. Doctors prescripe a large dose at night to suppress the 3 am surge of what should be cortisol but in our kids it’s androgens. But if you get up at 3 am and give the meds then, then you don’t need a large bedtime dose because all it’s doing is suppressing the GH. Sorry for the rambling! Good luck, Julia