Not sure about sleep, per se, but reducing physical activity to a minimum when symptoms flare, RESTING, helps most MGers recover their strength, to some extent, or another... Best Wishes, HG007

Thank you,, do you take a night time dose of mestinon or is rest all you need.?

Rarely, if ever, a night time time dose. However, we are all different. Some find it necessary, others do not. Eventually you will learn what you need, and when you need it.

There is the timed/extended mestinon. I first started it at night but take 90 mg q6hrs day and night. I also take 30 or 60 mg regular mestinon in between as needed with 40 mg prednisone in am. also on rituxan every 6 months . Nothing else has done any good. As happy guy said it's trial and error.oh but stuff happens that throws it all out of whack! Have a good w/e

Thank you, can you remember if it ever improved by going to sleep, or just rest?

Jlroberts, sleep improves all of my symptoms except ptosis. Several docs have told me I am atypical on several of my presentations, but I think there is so much no one understands about MG that it is difficult to say what is atypical. This forum and general Internet searches have shown me that others have experienced what I am experiencing. What I am experiencing may not be the experience of the majority of MG patients, but at least a few others have experienced it. I am not imagining it and I am not going to be dismissed simply because my doctors have not encountered this particular of symptoms in an MG patient before. I hope it helps to know you are not alone.

May I inquire, do you have significant general fatigue?

My symptoms are mild most of the time. I do have generalized weakness. Some times I have a bad day and symptoms are significant. I do not go to sleep because I am sleepy, more because I can not keep the eyes open. Or hold my head up, so I take 1/2 extra if it does not work I lay down. It does not always go away but it helps with most things.

Thank you it does help to know I am not the only one.

When I first was having double vision, the first symptom that I recognized, I was OK for an hour or two in the morning before getting worse as the day progressed. That was before diagnosis and before medication. My eyelid also stayed open for a time in the morning too.

The general statement is . "The severity of weakness fluctuates during the day, usually being least severe in the morning and worse as the day progresses, especially after prolonged use of affected muscles." (this one from http://www.myasthenia.org/HealthProfessionals/ClinicalOverviewofMG.aspx )

I tried to stop taking mestinon about 5 pm and then not do anything physical after that and then took my first dose about an hour before I had breakfast to get me going again.. I had bad leg cramps at night and thought they were lessened by stopping mestinon .before I went to bed.

I took as much as 120 mg per dose as often as every 3 hours to be functional during the day, although I did better on 60 mg every 2 hours. My wife was going through stage 4 cancer treatment and needed my help and functionality. to help her through it. (She made it OK). So I told my neuro I had to be functional right now rather than being able to wait until prednisone worked.

Eventually (5 months) prednisone (60mg/day) got rid of the MG symptoms and I quit taking mestinon. My neuro said that as I tapered the prednisone to the lowest effective dose, she thought that I should go down to where I needed some mestinon along with the prednisone so I could drop it lower than prednisone only. Prednisone was worse for me than mestinon.

I was one of the 15% to go into remission which has continued fro 3 years now. But my neuro tells me in most folks it returns again.

Good Luck.