For many of us with ME/CFS (myalgic encephalomyelitis or chronic fatigue syndrome) or other chronic illnesses, a daily nap (or at least an occasional nap) is a fact of life. We can't create enough energy in our cells overnight to keep us going all day and need to recharge partway through the day. As I was settling down to nap yesterday, with all my various routines in place, I realized that my many years of experience as a champion napper might help others better learn how to get that mid-day rest they need.
NOTE: Sleeping at night is a different story, due to the sleep dysfunction of ME/CFS, which is caused by endocrine (hormone) dysfunction. This can be treated (without sedatives); my son and I have both had solid, natural, refreshing sleep 8-10 hours a night for over 15 years now. For details on how to correct sleep dysfunction, see my blog post and my article for ProHealth (especially good for sharing with doctors). That said, all of the tips below will help with nighttime sleep, too; they just won't be enough on their own to restore the deep stages of sleep you are missing.
I began taking a daily nap--every day, no exceptions--shortly after my diagnosis, a little over a year after first becoming ill in 2002. I read a memoir/nonfiction book, Chronic Fatigue Syndrome: A Comprehensive Guide to Symptoms, Treatments, and Solving the Practical Problems of CFS by Gregg Charles Fisher (with contributions from several doctors). I had spent a year looking for answers and finally had a name for the disease that had stopped me in my tracks. This book brought me to tears, finally recognizing my experiences in someone else's words. Fisher does a great job of describing his own (and his wife's) personal experiences, but he also talks about the science and medicine behind the disease (what was known at the time) and practical tips for living with it. Just learning about exertion intolerance/post-exertional malaise (PEM) changed my life.
One of the concepts Fisher talks about in the book that was eye-opening to me was the idea of proactive rest, of resting before you crashed. He describes how learning to rest before he completely runs out of energy greatly improved his quality of life. Since my first year of ME/CFS had been marked by huge ups and downs and the pattern of feeling better, getting active, then crashing badly again, I realized this could really help me. That's when I began napping every day.
So, with 18 years of daily napping under my belt, here are my hard-earned tips for a good, restful nap:
I found out early on that lying on the couch, reading, or watching TV did not help my body to recover for the rest of the day. I had to truly rest, in bed, with my eyes closed. In fact, as you'll see below, the preparation for a nap will eventually become a habit that will help to tell your body that it's time to shut down for a bit.
Make the Room Dark, Cool, and Comfortable
Experts and doctors have proven that 60-67 degrees F is the ideal temperature for solid, refreshing sleep, so make sure your room is dark and cool at naptime. How do you do that at mid-day? I nap in my bedroom and close our room-darkening blinds (room-darkening, insulated curtains work well in my son's room). In the summer, it is hard to cool the 2nd floor, where our bedroom is, enough for a daytime nap, so I turn the air-conditioning down temporarily and turn on a fan. Our son (the fan expert!) likes these little turbo fans and really loved this taller multi-fan unit for maximum air circulation when he was in college. When it's really hot out, and our bedroom is just too warm, I nap in our finished basement, which is always cool (and dark). The cool temperatures really help.
Like anyone, when it's not too hot, I like my bed with plenty of soft pillows and comfy blankets. Like many with ME/CFS, I have trouble regulating my temperature and tend to be too hot a lot of the time, so layered blankets that can be adjusted are important.
Help Your Body Relax
Every afternoon before my nap, I take two valerian/lemon balm tablets and two magnesium capsules. Valerian is an herb with mild sedative properties, like chamomile; it just relaxes you and makes you a bit sleepy. In fact, chamomile is another great alternative, especially a warm cup of chamomile tea before your nap. We like Celestial Seasonings Sleepytime Tea. But, since I already have trouble with having to pee every 30 minutes (part of Orthostatic Intolerance, our bodies can't hold onto fluids), I just take the valerian tablets. Warning: valerian is very stinky! That's why I avoid the regular capsules and like these coated tablets, which also contain lemon balm, another calming herb.
As for magnesium, people with ME/CFS need a lot of it anyway; it helps with neurological symptoms, pain, headaches, and cognitive function. It also helps with sleep. However, you have to choose the right types. The kinds usually sold at the drugstore--magnesium oxide and magnesium citrate--are poorly absorbed and cause diarrhea. In fact, magnesium citrate is often used for colonoscopy prep! So, yeah, skip those or you'll spend naptime in the bathroom. Instead, opt for types that are well-absorbed, like magnesium malate, magnesium glycinate, and magnesium l-threonate. That last one is the only type of magnesium that crosses the blood-brain barrier (i.e. gets into the brain), so it is especially good for cognitive function and neurological issues--it even helps with dementia.
These gentle herbs and magnesium just help me to relax and get sleepy. For me, they wear off pretty quickly (I usually read for 20-30 minutes and nap for 45-60 min), but you can experiment to see how they work for you. They can help make you sleepy before bed at night, too.
Wear Warm Socks
OK, this one sounds weird, but hear me out. I read a study (it's science!) that keeping the feet warm helps you to fall asleep faster and sleep more soundly. I tried it and it works! Now, every afternoon before I get into bed (except on the hottest days), I put on soft, warm, fuzzy socks (they make them for men, too); I just pull them on over my regular socks. I usually read at the start of my nap, and within 15 minutes, I start to get really sleepy. It works!
Another way to make things dark is to wear an eye mask of some sort. My husband got me a nice eye mask/ear plug set for travel for Christmas, and it's super-comfy (I was using a very old freebie I got on an overseas trip about 15 years ago that had no elastic left in it!). However, when I'm at home and in bed, I prefer not to have that strap around my head, so I just use a men's size soft, dark sock. I just "borrowed" one from my husband, but this is the kind I use. Since I sleep on my side, I just lay that over my eyes, with the leg part over my head; it's soft, comfortable, and not at all restrictive. My mom likes this kind of eye pillow, filled with lavender (another calming herb).
I struggled for years with traditional foam earplugs. I know they work well for some people, but I have small ears, and I can never get them situated just right. Then, I read about silicone earplugs: life-changing! They are little blobs of silicone that come in a case (usually a dozen). You take one out, roll in around in your fingers and mold it into your ear so that it fits perfectly. Plus, the silicone is much better at reducing noise than the old foam-style. Whether you are blocking out lawn mowers and garbage trucks at home, ambient noise while traveling, or a snoring partner, silicone ear plugs work really well.
With all that prep in place, now it's time to help your body relax and settle down to get ready to rest. For me, that means reading, but you might listen to calming music or an audiobook (probably best to avoid Stephen King at naptime). I darken the room and turn off the lights first and use a headlamp to read: another signal to my body that it's naptime.
This would also be a great time to meditate, in whatever way works for you. I do this after I put my book down and lie down with my eye sock on and my earplug in. You can repeat a calming mantra to yourself; focus on tensing and releasing each muscle in turn, from your toes to your head; or even just focus on slow, deep breathing. Most experts recommend a slow 4-count inhale through the nose, hold for 3-4 seconds, and then a slow exhale. This kind of breathing is often all it takes to send me off to dreamland. I find it also helps to tune in to my senses. Of course, I have covered my eyes and plugged my ears, but sometimes I can still hear rain outside or the fan, and focusing on what I feel (soft pillow, warm feet, comfy bed) helps. There are also some great guided meditations available (choose a short one pre-nap) and loads of apps now, like Calm.
Can't Sleep? That's OK.
Although this routine usually puts me to sleep for about 45-60 minutes (90 minutes if I'm having a bad day), some days, I just can't fall asleep, even though I know I need it. I might have something on my mind or am just feeling restless.
On those days, I remind myself that if I can't sleep, then simple rest will still do me some good. I continue my "settle down" routines: deep breathing while I count the slow inhale/exhale, meditation, tuning in to what I feel, tensing and releasing muscles. I might end up falling asleep ... or I might not, but at least I had some time in bed, totally relaxed, in the dark and quiet, to allow my body to recharge a bit for the rest of the day.
A routine can help when your nap is over, too. I usually wake up because I have to pee (again), so that gets me out of bed. After I use the bathroom, I splash cold water on my face and eyes for a few minutes, which helps to revive me. I put my contacts back in and head downstairs for my "after nap meds." With help from our dietician, I arranged my daily supplements so that some of the more-stimulating ones (things that help improve energy) are in the after-nap box. I usually also have a cup of herbal tea with a wakeful flavor/scent, like Celestial Seasonings Lemon Zinger. In the summer, I might have a glass of decaf iced tea with lemon in it.
Finally, it is very important to get some daylight, if possible, to help your body recognize that it is wakeful time again. I don't have the energy for a full walk in the late afternoon (my beta blocker is starting to wear off by then), but I usually walk out to the mailbox or slowly walk around our cul-de-sac, just a little outdoor time to help my body shift out of nap mode. When the weather is nice, I like to sit out on our deck in a reclining chair. Nature and the outdoors are very important to my well-being: just watching the clouds or listening to the birds rejuvenates me. I might bring my laptap out there with me or, on a bad day, my book.
That's how I nap every day! My nap is an essential part of my daily routine. It not only helps to prevent me from overdoing and crashing later, but it recharges me so that I have the energy to write a blog post, make dinner, and enjoy the evening with my family. Without it, I'm a puddle by 3 pm.
And now it's time to make dinner--thank goodness for my nap today!