Our 5.5 year old daughter has been on this schedule since she was born and we have never had any problems giving her the 10pm dose. We syringe it into her mouth (dissolved in water) and give her a drink of water to wash it down. She never even wakes. I have on occasion given her the tablet, just popped in her mouth, and she crunches it up in her sleep. The only worry I have with this is that she may not swallow all of the tablet at once and it may sit in her teeth, possibly causing damage to her teeth and also she is then not getting a full dose. If I do it this way, I make sure I prop her up and give her a good drink. She has never woken with an upset stomach or in any discomfort from having her meds on an empty stomach.Jenni