Extreme tiredness (fatigue) after coronavirus

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 and energy levels again. There are different things that you can do to manage fatigue and reduce how it affects your daily life.

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

This idea helps you to save energy. You can learn how to pace, plan 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.

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 (a 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.

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 energy

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

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.

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.

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.

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. 

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.

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.

 

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 practise good sleep hygiene. This means doing things that help you to sleep well every night. 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 and change to improve your sleep.

Do

  • have a regular sleep routine. 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 outdoor 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 1 hour to 1 hour 30 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

Don't

  • 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) in the evening
  • do not drink alcohol in the evening or use alcohol to sleep (alcohol might make you feel sleepy, but it does not help you sleep and you might wake to go to the toilet)
  • 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. Otherwise, you might not be tired when you go to bed. Keep yourself awake by doing something that makes you feel alert
  • do not 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

Tips to save energy

  • Do not hold your breath during any task.
  • Try to avoid pulling, lifting, bending, reaching and twisting.
  • Push or slide items as much as possible, instead of lifting them.
  • Bend with your knees rather than from your waist.
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Contact our Patient Advice and Liaison Service (PALS)

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