Medications O’clock

I am lucky enough to have had time shifts 3 times in as many weekends. I found myself traveling to the east coast the weekend before and after daylight savings. While travel is always exciting this much switching up time zones can really throw me for a loop. I am blessed or cursed with a fairly strong circadian rhythm. My sleep/wake cycle syncs up pretty well to sunrise and sunset. The downside to this is that it takes me a few days to get my internal clock on the same page as the “real world” clock at times.

All these time shifts got me wondering what to do about medication timing. I have one medication that I take twice a day (theoretically every 12 hours). The rest of my medications are either morning or evening once a day. In utopia I would take my twice a day medication exactly 12 hours apart. Over here on planet earth I take it before I leave for work on weekdays, when I wake up on weekends, and at some point before bed every night. My best guess is that my doses are between 8 and 16 hours apart. Maybe some day I will be worried enough about my asthma control or have the rest of my life together enough to set medication timing as a goal. At present for me getting taking all the medications is good enough for me. I try to keep to the right timing. I’m just not that concerned if I take it 12 hours apart on the dot.

I am in good company as someone who is less than perfectly compliant. One study found that patients with chronic diseases are more likely to be compliant with once a day dosing than twice a day dosing.1 The researchers also concluded that the stricter the definition of compliance the fewer patients that were considered adherent.1 This makes perfect sense to me. After all patients are humans not robots, many of us will not set a timer or an alarm and grab that preventive inhaler at exactly 12 hours after the last dose. Remembering to take 60 doses a month rather than 30 gives you twice as many chances to forget the dose entirely or be away from your medications when you are due for the next dose.

If I’m being completely honest with myself I generally do a better job of taking medications on time when I’m traveling than when I’m at home. When I leave town I tend to toss my preventative meds in whatever bag I’m taking on my daily adventures. At home my preventative medications live on the nightstand. Unless I know that I will have an extra long day away from home I don’t pack my preventative inhaler when I leave the house. Obviously having my medications with me all the time when I’m traveling will improve my compliance with taking them on schedule. I’m still not a precisely compliant patient and I don’t really think I can blame that on time zone changes. How do you deal with time zone changes and keeping your medications on schedule?

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