The morning stretch before things get moving
Expressions used for the stretch between waking and the first dose taking effect, when the body does not move easily.
In the graph
- Response through the day
- Time a dose was taken
The morning stretch is usually the one you meet at the greatest distance from the previous dose. With no doses overnight, several hours have already passed since the last one by the time you wake.
Two different situations
When someone says the morning was hard, it is in practice one of two things, or both. You look at a different place on the curve for each.
- Before the first dose — from waking until you take it. That day’s medication has not gone in yet.
- Slow to come up even after the first dose — you took it, and it still takes a long time to rise.
Above, the two sit next to each other and feel like one block, but what to look at alongside them differs. If the first part ran long, it is a question of the gap between waking and the dose; if the second part ran long, it is looked at alongside a late rise.
So for this pattern, noting one extra value — the time you woke — changes how much the record is worth.
About the two terms
Both morning akinesia and morning OFF (early morning OFF) are used for this stretch.
How far each term reaches differs between sources. Some use the two almost interchangeably; others use them for different situations. This site does not settle which is right. It asserts neither that they mean the same thing nor that they mean different things.
Which is why separating the two stretches in the record is more dependable than the name. With the time you woke, the time of the first dose, and the time things began to change, you can convey the same content whichever term is used.
When the term comes up in a consultation, it is safer to ask which of the situations is meant.
People often put it like this
- My eyes are open in the morning and my body will not move
- Even getting to the bathroom waits until well after the dose
- Mornings are the hardest part of my day
- Turning over in bed at night is difficult
Things often discussed alongside it
These are factors that come up in conversation about this pattern. This is not a list of confirmed causes, and more than one of them is often in play at once.
- With no doses overnight, several hours have already passed since the last one by the time you wake.
- How long the first dose takes to come up differs greatly between people. The rate at which the stomach empties into the small intestine is described as playing a part.
- The quality of the night, and how much you turned, may be at work alongside it.
- The order of the first dose and breakfast may make a difference.
Worth writing down alongside this pattern
- The time you woke This value is what lets you measure the length of the morning stretch.
- The time of the first dose The gap from waking is the first value to look at for this pattern.
- The time you felt things start to change The gap from the first dose to here is the second value to look at.
- How you were moving in between This records how low the morning stretch ran.
- The order of breakfast and the dose that morning Note whether you ate before or after.
- How the night went A single line about whether you slept well or woke often.
What you could show your care team
A record is material for describing your situation. Decisions about which medication you take, at what dose, and at what time belong with the clinicians who look after you.