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Gaining Control with Planned Rest

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By Bruce Campbell 

The first step in learning how to pace is to find your limits or Energy Envelope. You got an overall understanding of your Envelope by placing yourself on our Rating Scale and you may have extended that understanding by defining your limits in specific areas, using the techniques outlined in the last article.
The second challenge is to adapt your life to them, step 2 in pacing. This process, which can occur as you are refining your understanding of limits, is a gradual process, usually taking a period of years and involving the use of multiple strategies.

You’ll find a dozen pacing strategies described in this and the next two articles, beginning with planned rest, a strategy many people try first and most find helpful.
“Simple But Not Easy”
As you proceed, you might keep in mind something one person said about self-management: “What this program teaches is very simple, but not easy.” Simple indeed: find your limits, adjust to them, then work to expand them.

But very challenging: living well with ME/CFS and FM requires that we change our thinking and how we live our lives. You can think of it as replacing one set of habits with a new set. This change is gradual and requires hard work, patience and courage.

Scheduled Rests
Rest is often used as a way to recover from a crash, but it can also be used to prevent problems. Taking planned rests on a regular basis can help you reduce your symptoms and gain stability. We call this practice pre-emptive rest.
Setting aside time every day for rest may seem counter-intuitive. You may ask, "Why should I rest even if I feel OK? Isn't that giving in to my illness?" I know those were my thoughts when I first heard of scheduled rests. But I was intrigued by the idea that I might gain control over my illness and bring predictability to my life by having consistent levels of activity and rest each day.
Before I discovered scheduled rest, I often experienced the cycle of push and crash. I would be more active than my body could tolerate, experience intense symptoms and then use rest to recover. (We call resting in response to a crash recuperative rest.)
Planned rest helped me escape this cycle and gave me a sense of control. Resting everyday according to a fixed schedule was part of a shift from living in response to symptoms to living a planned life.
I started with a 15-minute rest in the afternoon and was surprised at how much it seemed to help, reducing my symptoms, increasing my stamina and making my life more stable. After a while I added a morning rest as well. I came to believe that these two short periods of recharging my batteries, taken no matter how good I felt, were the single most helpful tool in my recovery.
You might wonder whether scheduled rest adds to your total rest time. It didn't for me and it doesn’t for most people. In fact, planned rests usually reduce the time people spend resting because they help people avoid overdoing and the need for long periods of recovery.
The strategy of taking daily planned rests is one of the most popular strategies used by people in our program and something many people try as their first pacing strategy. Here are the thoughts of three people who experimented with it while taking our introductory class.
[Right after starting the class,] I decided to incorporate two scheduled rests into my day and the results have been incredible. My symptoms and pain have decreased and I feel more "in control." My sleep has been more refreshing and even my mood has improved.
Since I've been forcing myself to rest every day, I have found I have more stamina. And I've noticed the graph of my days doesn't dip and rise so steeply.
I have been resting in between activities, sometimes only for five minutes. For the first time in the four and a half years that I have been ill, I feel that it is possible to manage my symptoms and have some predictability in my life.
To repeat, scheduled or pre-emptive rests are different from the rests associated with push and crash or recuperative rests. Recuperative rest is done to recover from overdoing. Scheduled rest is a preventive measure, a strategy for reducing symptoms, gaining stability and reducing total rest time.

In contrast to rest taken as a way to recover from intense symptoms, scheduled or pre-emptive rest is a strategy for avoiding flare-ups and escaping the cycle of push and crash.
Defining Rest: Lying Down, Eyes Closed
In our program, we use the term rest in a special way. For us, rest means lying down with your eyes closed in a quiet place. We do not consider such things as watching TV or reading to be rest. We view them as activities. They may require less energy than housework, errands, or paid work, but they are activities nonetheless.
Here's what one person said about rest after taking our course:

"Watching TV, talking on the phone, or talking with my family...I learned that these things could actually be quite tiring, even if I was lying down. Resting with eyes closed is completely different and, I found, very helpful. Before the course, I only thought I was resting; now I know that rest means lying down with my eyes closed (without television or the telephone)."
Resting by lying down with eyes closed is straightforward and brings immediate benefits to most who try it: greater stability, reduced symptoms and greater stamina. If lying down with eyes closed in a quiet place doesn’t work for you, you might experiment with other ways of resting, such as listening to quiet music or a meditation app.

The important thing is to take a break from normal activity and to create a quiet place to recharge your batteries. If you fall asleep while resting, it may be a sign that your body requires more rest. You can determine your body's need for rest by keeping a sleep log.
Finding Your Optimal Rest Schedule
The length of the rest period, the number of rests and the way rest is done vary from person to person. Many people take a couple of rests of 15 minutes to half an hour each. People with severe ME/CFS or FM may benefit from taking many brief rests a day, for example a 10 to 15 minute rest every hour or two.
One person who tried multiple short rests was a woman who became tired with almost any exertion. By using frequent rests, she was able to cut her total rest time in half. Prior to trying pre-emptive rests, she spent six hours a day resting, two naps of three hours each.

Then she experimented with pre-emptive rest by breaking up her day into one- and two-hour blocks and taking a 10 to 15 minute rest during each block. After six months, she had cut her rest time down to three hours a day. By resting in small blocks, she added three hours of activity time to her day without increasing her symptoms.
A New Habit
The idea behind pre-emptive rest is that you establish a habit and make scheduled rest a part of your daily routine regardless of how you feel. It can be tempting to skip the rest when you are feeling good. At such times, it may be helpful to remind yourself that, by taking scheduled rests, you are avoiding symptoms, and the need for more rest in the future.
Resting the Mind
When you begin using pre-emptive rests, you may find you are distracted by your thoughts. If that occurs, try using a relaxation technique or listening to a CD or some of way to focus your attention on something other than your thoughts. Directing your attention elsewhere gives a way to relax your mind, making it easier to rest.

For step-by-step instructions, see the article Stress Reduction: Five Practical Techniques
Using Planned Rest for Travel and Exercise
You can apply the idea of planned rests in many parts of your life. For example, I used it for several years to expand my envelope for travel.

I found that if I stopped during driving trips for a ten to 15 minute rest every two hours, I arrived fresher at my destination and had a lower symptom level throughout my trip. I reduced my symptoms further while traveling by doubling my usual daily rest times.
Rest is commonly recommended for exercise routines: exercise-rest-exercise-rest. While I was recovering from ME/CFS, I used rests to expand the length of my walks. I found that if I walked for a while and then sat down for an equal amount of time, I could walk farther without increasing my symptoms.
For some people, the rest periods may be longer than the time spent exercising, but the principle is the same: controlling symptoms by alternating periods of exercise with times of rest.