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Non-pharmacological Treatment It is important that all CFS and FMS patients keep a diary of symptoms, associated conditions, and responses to medications. Some researchers believe that following a structured sleep plan will aid patients in obtaining a regular sleep pattern, which in turn will aid in relieving many of the symptoms of CFS and FMS. They recommend the following rules for 6 to 8 weeks (12): 1. Go to bed about the same time every night, ideally 11:00 - 11:30 PM. 2. Get up at the same time every morning 7:30 - 8:00 AM. DO NOT LIE IN BED EVEN IF TIRED. 3. Increase exposure to natural daylight, especially after waking in the morning. 4. Avoid daytime naps, go into natural daylight for 30 to 45 minutes instead. 5. Avoid caffeine, alcohol, nicotine, and stress behaviors that may interfere with sleep. Relax before bedtime. 6. Start a graded exercise program. Walking is an excellent outdoor activity. 7. Drink hot milk at night 30 minutes before bed. 8. Develop a bedtime routine that encourages natural sleep. If not asleep within 20 to 30 minutes, go to a different room for 20 to 30 minutes, then repeat the routine as often as necessary. Studies show that a comprehensive, supportive program, in addition to pharmacological therapy, is the most successful approach to treating FMS and CFS. Aerobic exercises, such as swimming, biking, and walking, are known to improve muscle condition, and reduce muscle pain and tenderness. Exercise must be kept at a prescribed level, as with gentle stretching, because overexercising will worsen symptoms. As a general rule, stretching should not exceed existing pain limits. Some patients have benefited from physical therapy, chiropractic or osteopathic manipulation, therapeutic massage, and acupuncture. Also, use of heating pads, warm baths or showers, whirlpools, and moist hot packs have given relief to some patients. Relaxation techniques may also aid in relieving muscle tension. (1, 4, 8, 13, 14, 15) Education is an essential component of the FMS and CFS treatment plan. Patients must be taught coping strategies to recognize and manage stress, understand sleep patterns, practice good nutrition and energy conservation, and understand pain management techniques, the role of physical conditioning, and medication use. It is important that FMS and CFS patients limit their intake of caffeine, alcohol, and nicotine because these substances adversely effect restorative sleep patterns and energy levels. (4, 8, 9, 13, 14, 15) |