We started circadian dosing in the spring of 2003. Jack was not quite 5 yrs old. 

OOPS - I am windy tonight. I typed this long response (see below) then re-read your question and realized the answer was simple. I hated to delete my windy response as there may be something of interest in it for you - if so, read below - if not skip. Long day!

I think this dosing is most effective once the child is old enough to have a pretty set sleep rythmn with most (if not all?) of the sleep at night. As I understand the reasoning, circadian dosing is trying to mimic the body’s normal production of cortisol, which is very low to none in the evening/night hours. Having no dose at night also works well because the largest amount of growth hormone is produced late evening/night. By letting the steroid fade away in the evening/night you are allowing for the growth hormone to do it’s work without interference of cortisol. You can also typically lower the Cortef dose since they don’t need it in their bodies at night anyway. The catch is that you have to give the Cortef early enough to suppress the 3:00/4:00 am hormone surge.

In all honesty, it is kind of a pain to get up at night. I think it is great if you need to do it and you can view it as a short term solution for long term gain. But if all is going well on a traditional schedule I wouldn’t change.