Extreme tiredness (fatigue) after coronavirus

Coronavirus (COVID-19) recovery

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

It takes time to rebuild energy levels and build up your strength. There are different things you can try to manage fatigue and reduce how it affects your daily life.

You might also have problems sleeping as you recover from coronavirus

Managing your expectations

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

You might find it helpful to write down your activities in a diary. It can help to remind you that you are making progress, even if this feels slow. Remember that your fatigue will probably get better as your recover from coronavirus. 

  • Try to be patient with yourself and give yourself more time to do things.
  • Try to recognise and focus on the things that you are doing, instead of things 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 principle will help you save energy by learning how to pace, plan and prioritise your daily activities.

Pace

Try slowing your pace down until you feel a bit stronger. Pacing yourself helps you have enough energy to complete an activity.

  • Break activities up 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 normally do each day and each week. Make a plan for 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 (wheeled walker) can make food shopping easier. It can also help your balance. If you have an occupational therapist, 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 to wash your face, brush your teeth and dry your hair. Have rests after each task. Pat yourself dry rather than rubbing to save energy.

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

Prioritise. Try to dry shampoo instead of washing your hair. 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 shops’ layout. You may be able to visit fewer shops if you only shop for what you need. Try shopping at quieter times. Do not use large or deep trolleys to avoid bending when you put in and remove items. 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.

Getting back to a healthy sleep pattern after coronavirus can take time. The first step is to practise good sleep hygiene. This can be difficult for lots of reasons, such as doing shift work, being a parent, living in a studio or having noisy neighbours.

Nearly everyone with sleep problems can improve the quality of their sleep by following the rules below. See which of the following 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 weekends
  • 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
  • keep your bedroom dark enough to allow sleep
  • keep your bedroom quiet. Try thicker curtains, sleeping at the back of your house or 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 (such as non-excitable reading or television). Return to bed when you feel sleepy. Do this as many times during the night as you need

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 have alcohol in the evening, or use alcohol to sleep (it might make you feel sleepy, but it does not help sleep and you might wake to go to the toilet)
  • do not smoke before going to bed. Nicotine is a stimulant and keeps you awake
  • do not read or watch television in bed
  • do not go to bed too hungry or too full
  • do not take another person's sleeping pills
  • do not have daytime naps or sleep in front of the TV in the evening. Keep yourself awake by doing something stimulating. Otherwise, you risk resetting your body clock
  • 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 recovery, please speak to a doctor or nurse caring for you. Your discharge letter should have their contact information.

 

Physiotherapy, phone 020 7188 5082 or 020 7188 5089

Occupational therapy department at St Thomas' Hospital, phone 020 7188 4180

Occupational therapy department at Guy's Hospital, phone 020 7188 4185

Nutrition and dietetics department, phone 020 7188 4128

Speech and language therapy department at St Thomas' Hospital, phone 020 7188 6246

Speech and language therapy department at 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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