Reductions by 25 % and 50 % of a normative 8 hours of sleep will increase inflammatory cytokines even in healthy , asymptomatic individuals
Managing Fatigue while Building Capacity
One of the most important factors in rehabilitation is the management of fatigue . Lessons learnt about the importance of pacing as a strategy in the management of post-exertional fatigue in patients with ME / CFS can be applied in the management of Long COVID . The three key aspects of pacing are : stop , rest , and pace [ 5 ].
STOP – before you reach a point of overexertion as this will interfere with recovery .
REST – often and before you start to get symptoms .
PACE – plan to space out daily physical and cognitive activities to avoid triggering symptoms .
Triggers that can lead to “ crashes ”, such as large meals , caffeine , alcohol , extremes of temperature change and psychological stress , can sometimes be identified through symptom diaries . Behavioural techniques to manage triggers and stress levels help patients to understand how to begin getting some control over their health and energy management .
Extreme caution and an individualised symptom-tiered approach are essential when building up exertional tolerance in Long COVID . Rehabilitation protocols such as the one used at Mt Sinai Hospital ’ s Long COVID clinic start with an initial evaluation by a physician for cardiac and other organ pathologies . Patients are then given behavioural strategies for managing and controlling symptom attacks . This is followed by coaching in breathing techniques . Some patients are also referred for