Sleep & Fatigue Problems


When we are asleep, the body can concentrate on healing itself. Minimal amounts of energy are needed to maintain body functioning while we sleep. When we don’t get enough sleep, we can experience a variety of other symptoms, such as fatigue and a lack of concentration.

You can apply some practical self-management to the solving of sleep problems and making your night’s sleep as refreshing as possible.


Before Bedtime


  • Avoid eating. Although you may feel sleepy after eating a big meal, this is not a way to help you fall asleep and get a good night’s rest. Digesting food takes energy which is needed during sleep for restoring the body, and that means that your body will not have the energy resources to restore itself. Since going to bed feeling hungry may also keep you awake, try a warm drink - not tea or coffee because of the caffeine - at bedtime.


  • Avoid alcohol. Contrary to the popular belief that it helps you sleep better, alcohol actually disrupts your sleep cycle. It can lead to shallow and fragmented sleep, as well frequent wakings through the night.


  • Avoid caffeine. Caffeine is a stimulant and it can keep you awake. Caffeine is found in coffee, tea, colas and other soft drinks and chocolate.


  • Avoid food with MSG - monosodium glutamate. Many types of food, especially pre-packaged meals may contain this additive which can act as a stimulant. Read ingredient labels and ask In restaurants to be sure you don’t eat MSG late in the day.


  • Avoid smoking. Aside from the fact that smoking itself can cause complications and a worsening of your chronic condition, nicotine in cigarettes is a stimulant. And of course, falling asleep with a lit cigarette is a fire hazard..


  • Avoid diet pills. These contain stimulants which may interfere with falling asleep as well as staying asleep.


  • Avoid sleeping pills. While the name “sleeping pills” sounds like the perfect solution to sleep problems, they tend to become less effective over time. Also, if you take them and then stop, it can become even harder to get to sleep.


  • Avoid diuretics - water pills. You may want to take these medicines in the morning so you are not woken by having to get up in the night. Unless your doctor has recommended otherwise, don’t reduce the overall amount of fluids you drink, as these are important for your health. However, you might want to limit your fluid intake immediately before you go to bed.



Develop a Daily and Nightly Routine By doing the following...


  • Setting up and keeping to a regular rest and sleep pattern. Go to bed at the same time every night and get up at the same time every morning. If you need to, take a nap in the afternoon but not after dinner. Stay awake after your evening meal until you are ready for bed.


  • Getting your sleep pattern back to normal. If you are going to bed at 4am and sleeping until noon, and you want to get back to more usual timing, you can decide to reset your sleep clock. Try going to bed one hour later or earlier each day until you get to the hours you want. This is a way of taking control, and with patience, allowing a new routine to develop.


  • Exercising at regular times each day. Regular exercise can help you sleep well, and it can also help set a regular pattern during your day. It’s better not to exercise immediately before bedtime, as it can stimulate you and might keep you awake.


  • Getting out in the fresh air and daylight, even if there’s no sun, for fifteen to twenty minutes every day.


  • Doing the same things every night before you go to bed. A “time to-get–ready-for-bed” routine such as having a bath and reading a chapter in a book helps your body to wind down and relax.


  • Using your bedroom only for sleeping.  If you get into bed and can’t fall asleep, get up and go into another room until you begin to feel sleepy again. Your routine is supported by the awareness that, in your bed, you fall asleep easily.


  • Using Self-management. If you wake in the night and have trouble going off again. Sometimes people go off to sleep easily but wake up and start thinking. Once their mind is active, they find it difficult to drop off again, and it all seems worse when they worry, in addition, that they are not getting enough sleep. Deliberately setting your mind to a task such as counting backwards in threes from 100, or naming a flower for every letter of the alphabet can distract it.


  • Not worrying about not getting enough sleep. When your body needs sleep, you will sleep. People tend to need less sleep as they get older, and organising your sleep through the dark hours of the night when most other people are sleeping, will help you worry less.


  • Investigate sleeping too much. If you find you are able to get to sleep very easily in bed, in the chair and any other time, but are still tired in the day, it may be because you are not breathing properly at night. People who have the most common sleep disorder, called obstructive sleep apnoea, often do not know it. When they are asked about their sleep, they reply, “I sleep very well.” Sleep specialists believe that obstructive sleep apnoea is very common and often not diagnosed. With sleep apnoea, the soft tissue in the throat or nose relaxes during sleep and blocks the airway, requiring extreme effort to breathe. The person struggles against the blockage for up to a minute, then wakes just long enough to gasp air, and falls back to sleep to start the cycle again. Unaware of waking dozens of times during the night, the person suffers from a lack of deep sleep needed to restore the body’s energy and work on the healing process. This in turn leads to more symptoms such as fatigue and pain. Sleep apnoea is a serious medical problem and can be life-threatening. It has been linked to heart disease and stroke and is believed to be the cause of death for many who die in their sleep from heart attack. Sleep specialists suggest that people who are tired all the time in spite of a full night’s sleep, or who find they need more sleep now than when they were younger, should be investigated for sleep apnoea or other sleep disorders, especially if they or their spouses report snoring.



Fatigue is a real problem and not “all in the mind”. It can stop you doing things you really want to do. Unfortunately, other people sometimes do not understand how fatigue can suddenly hit you. They may think you are not interested or that you want to be alone and are just making an excuse.


To manage your fatigue, it may help you to be aware that there can be many reasons for it. This may include the illness itself, not being active, poor diet, weight problems, emotions, not enough sleep and sometimes medication. A daily record or journal of symptoms may be a valuable self-management tool.


  • The illness itself. To do anything, you need energy. When you have a chronic illness, your body uses up energy to heal itself. This means you may have less energy for everyday activities.


  • Not being active. When you don’t use muscles, they become wasted and don’t work well. The heart is made of muscular tissue and as such, it can also become less efficient. This means the heart will be less good at pumping blood, which carries necessary nutrients and oxygen around the body. When muscles do not get food and oxygen, they cannot work properly. They get tired more easily than muscles that are in good condition


  • Weight problems. Carrying too much weight around can lead to fatigue, because it causes an increase in the amount of energy you need to do anything else. Being underweight can also lead to fatigue. People often say they can’t exercise because they feel fatigued. Believing this creates a vicious circle. People are fatigued because of lack of exercise, and yet they don’t exercise because of the fatigue. Believe it or not, if this is your problem, then motivating yourself to do a little exercise the next time you feel tired (unless its bedtime) might be the answer. You don’t have to run a marathon. The important thing is to get out doors and take a short walk. If this is not possible, then walk around your house.


  • Emotions. Feeling under stress, anxious, fearful or depressed can also use up energy.


  • Not enough sleep. Most people are aware of the connections between being stressed and feeling tired, but fewer are aware that fatigue is also a symptom of depression. If this is the case, rest will probably not help. In fact, it may make you feel worse.


  • Medications. Some medicines can cause fatigue. If you think your fatigue is medication-related, talk to your doctor. Sometimes your medication or the dose can be changed.