Extreme tiredness (fatigue)

Coronavirus (COVID-19) recovery

Extreme tiredness (fatigue) is common when you recover from coronavirus (COVID-19). Living with this symptom is difficult. It affects things that you would like to do, which can be frustrating.

It takes time to build up your strength, fitness and energy levels again. There are things that you can do to manage fatigue and reduce how it affects your daily life. These include:

Watch our film about recharging your energy levels.

You might also have problems sleeping as you recover from COVID-19

Managing your expectations

Allow yourself to do things in a different way that helps with your energy levels. It can be difficult to change the expectations that you put on yourself. You might feel frustrated if you cannot do the things that you want.

It can be helpful to write your activities in a diary. This reminds you that you are making progress, even if it feels slow. Remember that your fatigue will probably get better as you recover from COVID-19. 

  • Try to be patient with yourself and give yourself more time to do things.
  • Try to recognise and focus on the things that you can do, instead of the things that you cannot do yet.
  • Try not to feel disappointed if your recovery seems to be slow. Everyone has a different recovery time.

Pace, plan and prioritise

Plan

Think about the activities that you usually do each day and each week. Plan how you can spread out these activities.

If some activities make you breathless or tired, plan ahead and do them throughout the day rather than all at once. For example, instead of having a bath or shower in the morning when you are busy, have one in the evening.

  • Do weekly activities, such as gardening, laundry and food shopping, on different days.
  • Collect all the items that you need before you start a task.
  • For some people, special equipment can make tasks easier. For example, using a rollator (walking frame with wheels) can make it easier to do food shopping. It can also help your balance. If you have an occupational therapist (healthcare professional who helps with issues that affect your daily activities), ask them for advice and support.
  • You might get more done when family or friends visit and can help you.

This idea helps you to save energy. You can learn how to plan, pace and prioritise your daily activities.

Pace

Try to slow down your pace (speed of doing activities) until you feel a bit stronger. Pacing yourself helps you have enough energy to complete an activity.

  • Break up activities into smaller tasks, and spread them out during the day.
  • Build periods of rest into your activities.
  • Plan 30 to 40 minutes of rest breaks between activities.

You recover faster if you work on a task until you are tired, rather than exhausted (the 'big push'). Doing something until you are exhausted means that you need longer to recover. 

For example, think about how you climb the stairs. 

The pacing approach is to climb 5 steps, rest for 30 seconds and then repeat. You do not need a long rest at the top and will not feel so tired the next day.

The big push approach is to climb all the stairs at once. You might have to rest at the top, and feel achy and tired the next day.

Prioritise

Some daily activities are necessary, but others are not.

Ask yourself these questions to decide which activities are necessary and which can wait until you have more energy.

  • What do I need to do today?
  • What do I want to do today?
  • What can I do on another day?
  • What can I ask someone to help me with or do for me?

Examples of how to save your energy

Here are some ways that you can plan, pace and prioritise in your everyday life.

Plan. Keep all the things that you need in the same place. Put a mirror at face level when you sit down. Use liquid soap, as this makes a lather more quickly than a bar of soap. Use long-handled equipment, such as a long-handled sponge.

Pace. Sit down to wash your face, brush your teeth and dry your hair. Have a rest after each task. Pat yourself dry rather than rubbing, to save energy.

Prioritise. Use dry shampoo instead of washing your hair. Dry shampoo is a product that cleans your hair, but does not have to be rinsed out with water. Use electrical items, such as an electric toothbrush and razor, to save energy.

Plan. Make a list that follows the layout of the shops. You may be able to visit fewer shops if you only shop for what you need. Try shopping at quieter times. To avoid bending when you put in and remove items, do not use large or deep trolleys. Pack items together that go in the fridge, freezer or same cupboard. This makes your shopping easier to unpack.

Pace. Have a rest when you get to the shops. Take your time to collect your items. Put heavy items in different bags, or use a trolley to push your shopping home instead of carrying a bag. 

Prioritise. Think about if a family member, friend or neighbour can get items from the shops for you. Another option is to do your shopping online.

Tips for moving about

  • Do not hold your breath during any task. Try to breathe naturally as you move.
  • If you have pain, try to avoid too much pulling, lifting, bending, reaching and twisting.
  • Push or slide items as much as possible, instead of lifting them.
  • To look after your back, bend with your knees instead of your waist.

Problems sleeping

Sleep is an important part of feeling well and happy, but almost everyone has problems sleeping at some time in their life. Not being able to get to sleep or stay asleep can be distressing and affect your wellbeing.

It can take time to get back to a healthy sleep pattern after COVID-19. The first step is to have a good bedtime routine. This means doing things every night that help you to sleep well. It can be difficult for lots of reasons. You might do shift work, be a parent, live in a studio flat (where you have 1 room for living and sleeping in) or have noisy neighbours.

Nearly everyone with sleep problems can improve the quality of their sleep by following the rules below. See which of these things you could try to improve your sleep.

Our film about boosting your sleep has hints to help you improve the quality of your sleep.

Do

  • wake up at the same time each day, including at the weekend
  • get regular exercise each day, preferably in the morning (regular exercise improves restful sleep)
  • get regular exposure to daylight or bright lights, especially in the early afternoon
  • keep the temperature in your bedroom comfortable
  • make sure that your bedroom is dark enough for you to sleep
  • keep your bedroom quiet. Try having thicker curtains, sleeping at the back of your house, or using earplugs to avoid being woken by noise
  • only use your bedroom for sleep, sex and getting dressed
  • give yourself 60 to 90 minutes to wind down before going to sleep. For example, have a warm bath
  • if you lie in bed awake for more than 20 to 30 minutes, get up, go to a different room (or different part of the bedroom) and do a quiet activity. For example, you could read something or watch a television programme that is not too exciting. Go back to bed when you feel sleepy. Do this as many times as you need during the night

Do not

  • do not exercise just before going to bed
  • do not do a stimulating activity just before bed, such as playing computer games, watching an exciting movie or TV programme, or having an important discussion with a loved one
  • do not have caffeine (for example, coffee, tea or chocolate) after lunchtime in case it stops you from sleeping
  • do not drink alcohol in the evening or use alcohol to sleep (alcohol might help you go to sleep, but it is not qood quality, and you might wake to pee)
  • do not smoke before going to bed. Nicotine is a stimulant (a substance that makes you feel active and full of energy) and keeps you awake
  • do not read or watch television in bed
  • do not go to bed when you are too hungry or too full
  • do not take another person's sleeping pills
  • do not have daytime naps or sleep in front of the television in the evening. They might stop you from sleeping at night. Keep yourself awake by doing something that makes you feel alert
  • do not try to make yourself go to sleep if you are not feeling sleepy. This only makes your mind and body more alert

Resource number: 5122/VER1
Last reviewed: January 2021
Next review date: December 2023

Contact us

If you have any questions or concerns about your coronavirus (COVID-19) recovery, please speak to a doctor or nurse caring for you. Your discharge letter (the letter that you get when you leave hospital) should have their contact details.

Physiotherapy
Phone: 020 7188 5082 or 020 7188 5089

Occupational therapy department
St Thomas' Hospital, phone: 020 7188 4180
Guy's Hospital, phone: 020 7188 4185

Nutrition and dietetics department
Phone: 020 7188 4128

Speech and language therapy department
St Thomas' Hospital, phone: 020 7188 6246
Guy's Hospital, phone: 020 7188 6233

Do you have any comments or concerns about your care?

Contact our Patient Advice and Liaison Service (PALS)

Is this health information page useful?