Helping you recover: sleep

Problems with sleep are very common in chronic fatigue but trying to stop tiredness by sleeping more usually makes things worse

This fact sheet will give you some useful information and tips on how to manage your sleep as part of your recovery programme.

Good sleep allows your body to rest and relax and helps the healing process. It is important for maintaining brain function, such as thinking, concentration, planning and memory.

Research suggests that it is possible to have too much sleep. Most teenagers need around nine hours – more than this can cause lethargy, headaches and muscle pain, stiffness, reduced concentration and may affect motivation and mood. The more you sleep the less refreshing it becomes.

Sleep difficulties may be caused by:

  • irregular bed and waking times
  • sleeping in the day
  • worry or stress
  • emotional upset (such as an argument, or low mood)
  • pain
  • nausea – feeling sick or tummy pains
  • eating sugary or stimulating foods close to bed time
  • watching screens before bed
  • doing a demanding activity in the evening
  • being too hot or cold
  • bright lights or noise
  • using your bed for lots of activities, or spending waking hours in bed.

There are several ways of improving your sleep pattern and the quality of your sleep.

It may be useful to keep a diary of your sleep – this is a good starting point to understanding what is actually happening and can help you monitor changes.

It is useful to start with practical strategies to help re-establish a regular sleep pattern. Looking at other factors that may be affecting your sleep, such as low mood, worries or pain will also be helpful alongside the practical changes.

  1. Decide on a regular time that you will go to bed and get up. This will help your body and brain get used to switching off at the same time each night. The waking and getting up times are particularly important in setting your sleep pattern, so get up at the same time no matter what time you went to bed/fell asleep.  Don’t change things too much to start with – it’s more important to fix times close to what you do already and make changes gradually.
  2. Allow time to wind down at night, perhaps with a book, audio book, or music on headphones. A warm bath or using a relaxation/meditation technique can be helpful. Do the same things in the same order each night – these will become signals to your brain and body that you are getting ready to sleep.
  3. Avoid food or drinks that contain stimulants such as tea, coffee, chocolate or fizzy drinks before you go to bed.
  4. Switch off screens, including phone, TV and computers at least half an hour before sleep.
  5. Make sure your bedroom is a comfortable temperature and sort out any problems with light, noise or other disturbance if you can.
  6. Use your bed only for sleeping. Don’t watch TV or do other activities such as homework in your bed. Try not to use it during the day – your bed will become a signal only for sleep. Don’t have things on your bed, such as magazines, phones etc which can distract you from sleep, or restrict your movements.

Difficulty sleeping

Worrying about not being able to sleep can make it even harder to relax and fall asleep as it stimulates hormones like adrenaline.

  • reassure yourself that “sleep will come when it’s ready”
  • if you have been in bed for more than 20 minutes and haven’t fallen asleep try getting up and walking around or sit on the edge of the bed to ‘cool off’
  • have a drink, or go to the toilet if you need to, but don’t get involved in any demanding or stimulating activities such as computer or TV.
  • work through your wind down routine again to signal to your brain that you are preparing to go to sleep. Do this as many times as you have to.
  • use a relaxation technique, such as imagining relaxing each part of your body bit by bit, or visualising a restful / happy place. Breathe slowly and gently - see the fact sheets on rest and relaxation for more ideas.

Worrying thoughts

If you can’t sleep because your thoughts are going round and round, and you’re worrying about things it can be helpful to have a ‘worry time’. This can be a time in the day, or before you go to bed when you can think or talk about any worries you have, and what you can do about them. Sometimes it’s useful to write them down – this can help you look at them objectively and work through some problem solving ideas. Alternatively, learning how to ‘let go’ of troubling thoughts is a useful way of finding some calm even when things around you are difficult.

Your mental wellbeing is an important part of your recovery – if you think that low mood and anxiety is a problem for you please tell your therapist. There are lots of ways to help you work through this.

Day time sleeping

Some people get into the habit of falling asleep in the day time because of exhaustion, and often say they can’t do without it.

If your body has got used to sleeping in the day, perhaps when you get home from school for example, it is not helpful to try to change things too quickly.

  • Start by keeping a record of when you sleep in the day and for how long. Work out an average time you sleep for and set a limit, either by using an alarm or by asking someone to wake you at an agreed time.
  • You will need to stick to these times, even if you feel you could sleep for longer on some days.
  • Once you have regulated your daytime sleeps, you can start to reduce their length gradually by say, five or ten minutes a week.

Reducing your daytime sleeping works best when you are also following a nighttime sleep plan and resting for short periods in the day. Once you start pacing your daily activities in this way you will start to notice that you need less and less daytime sleep.

Changing your sleep habits will feel strange for a while and may go against what you think your body needs. Actually, you need no more sleep than your friends.

Sticking to the plan will help your body clock to readjust and your sleep will improve. As you gradually start to do a little more activity, and a broader range of things, your sleep will continue to get better.

Children and Young People's ME/Chronic Fatigue Syndrome (ME/CFS) Service