Some useful hints

• keep a diary of what and when you eat every day
• try to take advantage of the times when your appetite is best
• drink plenty of liquids
• if your taste changes, try different foods, or eat the foods that taste best to you
• ask your doctor or nurse for any leaflets that are available which give dietary advice
• you can also ask your doctor to refer you to a dietitian, who can give you helpful ideas.

It is important to try to exercise a little if you can, even when you are unwell. Research has found that exercise may actually help relieve the symptoms of fatigue. The problem is that while too much exercise might make you tired, as can too little, so it’s important to find your own level. A good balance between being active and getting plenty of rest is best. The physiotherapist at the hospital may be able to advise you about what would suit you.

General suggestions for exercise

• Regular, light exercise such as walking has been shown to reduce fatigue as well as nausea and vomiting, and can help some people to sleep better.
• Plan some activity or light exercise into your day.
• If exercise is impossible, try to stay active in your daily routine.
• Pay attention to how your body reacts to exercise: how did you sleep? How did you feel the next day?
• Drink plenty of fluids before, during and after exercise.
• Perhaps keep a record of your activities to share with your doctor or nurse, so they can help monitor your progress.
• It is important to find a balance between activity and rest, and to exercise in a way that allows the muscles to recover after activity.

It’s very important to try to keep a normal sleeping routine when you are ill, even though your fatigue may make you feel like sleeping all the time. There are many ways to overcome fatigue which your nurse or doctor will be happy to discuss with you. In the meantime, the following might be a useful guide to make the most of your rest periods:

A ten point plan for better rest

Sleep quality is very important and may help to fight fatigue as well as reduce your need to sleep during the day. The following are some pointers to ensure better night-time rest.

1. Sleep just long enough
Sleep for as long as you need to feel refreshed during the following day, but not more than necessary. Limiting time in bed seems to produce better-quality sleep. Too much time in bed can lead to disturbed and shallow sleep.

2. Wake up at the same time every day
A regular wake-up time in the morning seems to strengthen most people’s sleep routine and eventually leads to regular times of going to sleep.

3. Exercise regularly if you can
A regular daily amount of exercise may help to deepen sleep over the long term.

4. Reduce noise
Occasional loud noises (such as aircraft flying overhead) disturb sleep, even if you don’t remember the disturbance in the morning. If your bedroom is noisy, you could mask some of the noise using a small electric fan, or you could use ear-plugs.

5. Keep a steady temperature in your bedroom
If your room is either very warm or very cold, your sleep may be affected. Room temperature should be comfortably warm.

6. Have a bedtime snack
Hunger may disturb sleep. A light bedtime snack, warm milk, or a hot drink seems to help some people to sleep better.

7. Avoid stimulants
Many people who have problems sleeping are very sensitive to stimulants. It is best to avoid drinks that contain caffeine and chocolate for a few hours before bedtime.

8. Know how naps affect you
Some people find that daytime naps help them sleep better at night, while others sleep less well after them. Find out what suits you best.

9. Limit your intake of alcohol
Alcohol can help tense people to fall asleep more quickly, but the sleep tends to be broken. It is advisable, therefore, to avoid large amounts of alcohol near bedtime.

10. Know when to say 'enough'
Rather than lying in bed tossing and turning, you could get up and watch television or read a book. Wait until you feel tired again and then go back to bed. Audiotapes with stories may help you to sleep, and are stocked in most bookshops and libraries.

Mental exercises can also help you to sleep. These usually take about 10 minutes and include:

• trying to remember the lines of a song or poem
• making alphabetical lists of girls’ or boys’ names, countries, trees or flowers
• reliving a favourite experience in every detail
• writing mental letters
• relaxation exercises.

Your body will still get some benefit from lying quietly in bed resting, even if you are not actually asleep. Although you may feel as if you have been awake all night, you may well have managed to have several hours of good quality sleep.

You can get information on sleeping well from the Royal College of Psychiatrists.