When a person takes prednisone for long periods, it may disrupt the usual rise and fall in cortisol, causing insomnia. Additionally, corticosteroids such as prednisone decrease serum melatonin levels. Melatonin is another hormone involved in regulating the sleep-wake cycle.
Dr. Roach: Prednisone is a powerful anti-inflammatory and immune-system suppressor that is used for many conditions. It can cause some degree of insomnia in 50 to 70 percent of those who take it, but the higher the dose, the more likely the insomnia.
Prednisone can cause an increase in energy. You may also have insomnia, or difficulty sleeping. Taking the medication in the morning may help prevent this.
I recommend some routine steps for treating insomnia, such as avoiding bright lights, including any electronic screen, for two hours or so before bed; regular exercise, if the condition for which you took prednisone allows it; and a warm bath before bed.
Morning Dosages Are Usually Best For Prednisone
This is when your body stops producing cortisol by itself. If you are on daily prednisone, experts recommend taking the dose in the morning, to reduce this risk. Taking prednisone too late in the evening can cause sleeplessness and insomnia, too.
Prednisone has a tendency to raise the level of glucose, or sugar, in the blood, which can cause increased body fat or diabetes in some people. It is important to avoid "simple" carbohydrates and concentrated sweets, such as cakes, pies, cookies, jams, honey, chips, breads, candy and other highly processed foods.
The fear of using corticosteroids is so common that it has its own name: corticophobia. For topical steroids, this fear stems from well-known and severe adverse effects like Cushing syndrome and permanent skin atrophy.
This medicine may cause changes in mood or behavior for some patients. Tell your doctor right away if you have depression, mood swings, a false or unusual sense of well-being, trouble with sleeping, or personality changes while taking this medicine.
Side effects of steroids
Steroids do not tend to cause significant side effects if they're taken for a short time or at a low dose. But sometimes they can cause unpleasant side effects, such as an increased appetite, mood changes and difficulty sleeping (insomnia). This is most common with steroid tablets.
To avoid withdrawal after long-term use, prednisone should be reduced gradually according to a schedule set by your healthcare provider. Don't try to stop or taper prednisone without your healthcare provider's knowledge or advice.
Steroids increase the number of red blood cells in the body.
Red blood cells carry oxygen to the muscles, producing more energy and better performance.
Prednisone and Mood Swings
These feelings can pinball back and forth in quick succession and seem to come about for no reason and without provocation. In other words, a person receiving prednisone may find themselves feeling incredibly sad or mad and have absolutely no idea why.
Prednisone generally works very quickly — usually within one to four days — if the prescribed dose is adequate to reduce your particular level of inflammation.
The medical literature proposes 3 pathways primarily responsible for neurocognitive AEs of steroids: behavior changes through modification of the hypothalamic-pituitary-adrenal axis, changes in natural sleep-wake cycles, and hyperarousal caused by modification in neuroinhibitory pathways.
A gradual reduction in prednisone dosage gives your adrenal glands time to resume their usual function. The amount of time it takes to taper off prednisone depends on the disease being treated, the dose and duration of use, and other medical considerations. A full recovery can take a week to several months.
“If corticosteroids are to blame, gradually tapering off them can help with weight loss and facial swelling,” Dr. Guo said. “You'll take less and less until your body adjusts, and you might be able to safely stop the steroid. You need to have normal adrenal gland function before you stop long-term steroids.”
Some side effects, such as stomach upset or mood changes, can happen straight away. Others, such as getting a rounder face, happen after weeks or months.
It takes approximately 16.5 to 22 hours for Prednisone to be out of your system.
Take prednisolone with breakfast so it does not upset your stomach. Taking prednisolone in the morning also means it's less likely to affect your sleep. If your prednisolone tablets are labelled as "enteric coated" or "gastro resistant", you can take these with or without food but make sure to swallow them whole.
The most serious prednisone side effects usually include allergic reactions, infections, gastrointestinal issues and elevated blood sugar. These may occur when people take larger doses or take the medication for long-term treatment.
But every now and then, steroid-based drugs like prednisone might cause side effects like brain fog, anxiety, and sleeplessness, says Dr. Blazer.
Compromised immune system
Turns out, prednisone's greatest asset is also its greatest weakness. The very action that makes prednisone so effective — its ability to mute the immune system and relieve symptoms — can also lead to an increased risk of illness and infection, since your body's defenses are low.
Prednisone is a corticosteroid (cortisone-like medicine or steroid). It works on the immune system to help relieve swelling, redness, itching, and allergic reactions.
According to the Centers for Disease Control and Prevention, oral and intravenous corticosteroids reduce the activity of the immune system, and people who take them may be at an increased risk for severe illness from the virus that causes COVID-19.