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Rest & Relaxation

Adequate, good quality rest and relaxation is absolutely make or break for anyone with ME/CFS. If you have trouble getting off to sleep try a range of relaxation/breathing techniques and be aware of related issues flagged up in the other sections of this guide. Also consider the following:

Sleep Quality Enhancement

• Environment | I find a dark, cool, quiet, odour free/fresh air infused sleeping environment to be optimal. Re: chest tightness see bottom of page
• Biorhythms | Go to bed when you feel tired enough to sleep, not long before, nor long after, and try to keep to regular bed/rise times
• Posture | Use just the right size/number of pillows (so that neck is straight/head not tilted), and aim to sleep on your (left) side if you can
• Support | Place a pillow, or fold of duvet, between your knees, and ideally also between your arms/elbows, when sleeping on your side
• Water retention | Sleep with top end of bed slightly elevated if you experience issues with heartburn and/or bladder filling related disturbance

Sleep Quality Detractors

• Napping | Along with oversleeping, this disrupts biorhythms, depletes blood volume, risks CNS disturbance, and undermines depth of subsequent sleep
• Eating | Large meals should be avoided in the evening - particularly those containing foods that you find difficult to comfortably digest
• Drinking | Take care to strike the right balance between staying well hydrated and mitigating against the risk of waking prematurely with a full bladder
• Thinking | Try to avoid engaging in too much cognitive activity around bed time as this can contribute to the ‘tired but wired' issue that many battle with
• Zapping | Interactive activity, especially computer based, can have the above effect plus it's good to avoid EMFs from electrical devices well before bed
• Back sleeping | Associated with poor sleep-quality and enhanced snoring/sleep apnea. If you must: use a thin pillow + pillows under knees & lumbar
• Front sleeping | Places pressure on the neck/spine, which can lead to neck/lower back pain. If you must: use shallow pillows under head and hips
• Curling | The foetal position can induce neural strain and sensitivity in those with neuromuscular tension, so try to keep your neck/spine fairly straight

Sleep Agents

Many PWME have drug intolerance and are wary of pharmaceuticals. Unfortunately many docs have a fetish for medicating with sedatives/antidepressants like Amitriptyline. Other, more ‘natural', agents that some PWME report as being helpful include the following (all of which can have unpleasant side effects):
5-hydroxytryptophan (5-HTP) | Serotonin, a precursor to the amino acid Tryptophan (below)
• L-Tryptophan | Found in many foods e.g. eggs, dairy products, beans and oily fish, and is a precursor to the sleep hormone Melatonin (below)
• Melatonin | Induces sleepiness
• Valerian | Induces sleepiness
• L-Tyrosine | Supports neurotransmitter/hormonal activity
• L-Theanine | Reduces physical/psychological stress
• GABA | Reduces brain activity/tension

Intro | Location | Detox | Diet | Rest | Activity | Psyche