Thirteen Questions about Pacing

Pacing is one of the most important ways to manage fatigue. It involves balancing activity and rest so that you don't get into "energy-debt" or over-tired. Good pacing and fatigue management means that you can make the most of the energy that you have.

If you manage to pace well, it is likely that you will feel better and have more choice and control over what you do. Pacing means that you can positively decide how you want to spend your energy.

Fatigue is extreme tiredness. Often a "good night's sleep" is not enough to relieve fatigue, but careful management and pacing can make a real difference.

People experience fatigue in different ways. Some people experience significant physical tiredness, such that they need to lie down, others experience mental tiredness, like difficulties in concentrating and remembering. Some people experience fatigue as pain or soreness in muscles and joints. Fatigue is individual - the way that it is best managed does vary from person to person, but the principles of pacing apply generally.

Fatigue is common in many different illnesses, and managing fatigue is an important component of learning to live with a chronic illness.

Activity can be:

• physical, such as moving parts of our bodies, walking etc.,
• cognitive or mental, such as thinking, concentrating, attending to something, or
• activity can be emotional.

All of the different types of activity require energy. Some people think of their energy as being like a battery. Doing an activity (whether it is physical, cognitive, emotional or a mixture of these) drains some of the battery. If the battery is re-charged soon, it means that it can be used again. If the battery is totally drained, it takes a long time to charge. Activity drains the battery and rest charges it again.

Pacing and energy conservation is about balancing different activities with rest.

When pacing, rest is essential. Rest does not always mean sleep, but it does mean a break from physical, cognitive, or emotional activity. Some people try to do different types of activity, such as taking a walk as a break from studying. While this may be helpful to reduce mental fatigue, it is still using energy, so "real" rest is needed too.

How a person rests will depend on their needs. Resting means being quiet in body and mind. Some rest tips include:

• Get comfortable. Make sure that your body is fully supported, and you are in a comfortable position. Some people find that low lighting helps.
• Make sure that there are no distractions. Rest time is important, and should not be disturbed - by anything!
• A good way to rest may be to sit or lie down as comfortably as you can, relax all the muscles in your body one-by-one, and take deep breaths.
• Some people find short meditation helpful.
• Clear your mind - thinking, worrying, or feeling angry require emotional energy. Some people find clearing their minds the hardest part of resting, and use strategies like breathing deeply and listening to their own breathing helpful.
• If you plan to rest with music in the background, the music should be relaxing, with no lyrics - listening to the words of a song requires energy.
• Watching television is not usually restful, it is stimulating and requires some concentration. If you want to watch television, then you will also need to include rest.
• Reading is often not restful, because it requires concentration.
• If you need to sleep during the day, take very short naps (for about 15 minutes). That way you won't disturb night sleeping.

Short, regular rest periods are probably the best way to recharge the batteries.

Pacing is about balancing activity with rest. This means:

• planning activity and rest breaks into every day,
• prioritising the things that need to be done, and
• reducing the energy needed to do activities.

To pace, you need to plan what you can comfortably do in a day, and plan rest to enable you to do those activities. The key strategy is to make sure that you are not going into "energy debt", so that you are recharged after each rest and able to go on.

If you feel very tired at the end of the day or week, then maybe you need to re-organise your pacing. It is better to rest before you tire, rather than try and do a lot of activity and then rest for a day or more.

According to a number of pieces of research, the most effective strategy is to rest for ten minutes every hour, but this is often too difficult to manage in college. Even so, it is important to include rest during the day.

The first thing to do is to know what you want to do, and that usually means prioritising because it's not possible for anyone to do everything.

The next step is to work out how much rest you need to recover from what you want to do. For example, if it is important to go to lectures, then you need to make sure that you have enough time to rest after, and ideally between each lecture.

Once you know what you want to do, and how much rest you will need, then you can plan to spread the activities over the day. Don't try to do everything together, because it will be more tiring and you will either need more rest than if you split the activities up, or you will go into "energy debt".

Avoid rushing, and give yourself plenty of time. Rushing takes up a lot of energy and increases stress. Stress is tiring.

Setting up a timetable for each day is often helpful. The key here is to be realistic. Set the timetable so that you can manage it on a moderate to bad day. This way you won't overestimate what you will be able to do.

Plan to do less than you may want to do - in the long run you will probably get more done through pacing, because doing too much means it takes longer to recover. In your timetable, include the essential things that need to be done - rest is one of the essential things.

It's also important to pace each activity - doing a task (especially a physical task) at a moderate pace requires less energy. If you leave a bit more time to do the essential physical activities (such as getting up and dressed) then you may conserve energy.

Be kind to yourself. Negative thoughts, perfectionism, and self-criticism are all tiring. Pacing is a strategy to enable you to do the things that you need and want to do, and rest is an essential part of that. Sometimes people feel guilty or lazy resting, they feel like they should just keep doing, and should always finish things - these feelings are not helpful, because if people don't pace and take rests, less tends to get done in the long run. It is important to listen to your body, and leave things half done if you need to rest. You are more important than anything that needs to be done.

Only you can decide what activities are most important to you. The key thing about prioritising is that you decide to do, or not to do something. Sometimes people find themselves just doing things without realising it - this makes pacing very difficult.

Things can be prioritised by deciding if they are essential, can be delegated to someone else, deferred or eliminated.

Essential activities are important to you. Usually you enjoy doing them, or they are part of who you are. For example, going to some classes may be essential because you may learn something, and they may be essential to enable you to sit or pass exams. Alternatively, it may be important to you to be a student, and going to lectures is part of that role. (Think also of the secondary benefits of doing some activities, such as meeting classmates in lectures.)

Some activities can be delegated to other people. These are important things that need to be done, but that you don't actually need to do. Common examples of activities that can be delegated include household tasks. When delegating, it's important to let the person do the task, even if it is not the "perfect" way to do it. You need to spend your energy on the most important things.

Some activities can be deferred to another time. Be careful about deferring too many things, because they can pile up. It may be possible to include some time for a deferred activity each week.

Some activities can be eliminated altogether. This involves saying "no" to other people's demands. It also means that you remember that pacing is important, and that your rest is an essential part of your day. Eliminating activities means that you are more likely to be able to pace the important activities with rest.

Think about what to eliminate - the activities that are stressful and that you don't enjoy or get anything out of are usually the first to go.

When you have prioritised your activities, check that the essential ones are not all physical, cognitive, or emotional. Having a balance of activities that require different types of energy is important.

Task simplification is the name given to breaking things down so that less energy is needed.

Examples of ways to save energy may include:

• Have a place for your study materials, close to where you usually study so that you don't need to carry things around.
• Try to only carry essential items in your bag, to reduce the weight. Carrying around weight is tiring.
• Plan your activities so that you don't need to walk distances, this may be as simple as doing all the "upstairs" things before going "downstairs" in a morning, or eating lunch close to your next lecture.
• Get help when you need it. Sharing the workload saves energy. If someone is photocopying materials, ask them to do a copy for you, and if you are photocopying, do a copy for that person.
• When you are doing things, make sure your body is in a comfortable position and is as supported as possible. Sitting is less tiring than standing.
• Avoid queues.

Pacing can be hard when you want and need to study, and it seems like other people have more time and don't need to rest. Sometimes people try to do several hours work all at once and are exhausted after it - this does not work as well as pacing.

As with any other activity, studying for shorter sessions followed by rest is the best way to go. It is also important to try and do some form of physical activity during study periods as well - this can be anything from gentle stretching to vigorous exercise and will depend on what suits you best.

Pacing is a more effective study technique than trying to do hours of solid work for anyone, even if they don't experience fatigue. It's even more important if you do experience fatigue because studying is tiring. The key to effective studying is to "study smart, not study long".

Pacing study involves prioritising what you need to study, and what you want to get out of the study in the end. The type of study needed to prepare for an exam is different from writing an essay or assignment. Knowing what you want to get out of studying helps you to focus - it's like setting goals (e.g. "I want to be able to answer an exam question on this topic", or "I want to have the essay on this topic written"). Be realistic. Plan to do less than you think you can do.

Consider where you study. Sitting in a comfortable position and in a posture that is well-supported is the most energy-efficient way to study. Choose the most comfortable place for you, with furniture that suits you. Some people find that studying in bed is best, but that may mean re-organising notes and putting books back somewhere, all of which takes up energy. Try to keep all of the things that you need, including books, folders, notes etc in the same place, and easily within reach of your study area. Looking for things or reaching for books takes up energy.

It is important to study where there is as little distraction as possible. It takes more energy to concentrate when there are distractions. Distractions include clutter on the desk, other people, and even music in the background.

Rest is absolutely essential when studying, and even if you can concentrate for long periods of time, it is probably best to study for no more than 40 or 50 minutes at a time. Some people find that studying for 20 minutes at a time is the most effective, so you need to work out what is best for you. To make the overall time spent most efficient, it is best not to need to put everything away before resting and then take it all out again when doing another study period.

Pacing deadlines for essays, assignments etc. is essential and is often something you will need to do yourself. Typically, all the deadlines for assignments are close together at the very end of one term or the beginning of the next. It is unrealistic (for anyone) to expect that it is possible to write several essays in a short period of time, so plan ahead. If you don't know, ask the department what assignments will be due in on what dates, and find out whether they have already been set (e.g. if the essay topic is already known). Start early with whatever is known, and plan to do some work on the assignments each week, well ahead of time. If some of the assignments are on coursework that has not yet been covered, it may still be possible to get the relevant articles and references ready ahead of time. If you are in doubt - ask! A lecturer is probably going to be more supportive of someone pacing the workload than of someone who wants extensions.

Managing multiple deadlines through pacing is a positive strategy for anyone, and a skill to bring to a future employer. It may be essential if you experience fatigue, but nevertheless it is a transferable skill that many employers value.

Pacing the study needed for exams is a sensible and effective strategy. Some students rely on "cramming" information and doing "all-nighters" before exams, but this is not appropriate if you are pacing. Cramming generally means that information is learned at a superficial level, which makes doing really well in exams difficult.

To pace exam study, it is important to work out, well ahead of time, what you need to know for the exam. Set a timetable to cover the material over a number of weeks, and as with all pacing timetables, plan more time for each topic than you think you need. It may also mean prioritising topics, so check with past exam papers and other resources to make sure you are comfortable with what you are covering.

When you experience fatigue, a key strategy along with pacing is using the easiest way to do something. This is important for studying. Find out what your particular learning styles and preferences are (for example, by doing a "Learning Styles Questionnaire") and then adapt your technique so that you are using your strengths. For example, many people tend towards being visual learners, but write study notes in paragraphs. Changing the paragraphs into diagrams will work to a visual learner's strengths and make it easier to learn, understand, and remember.

Pacing the exams themselves is particularly tricky, especially if you have a lot of exams in a short period of time. If you have concerns about exams, it may be helpful to speak to your Tutor and disability officer as early in the year as possible, so that, as far as is possible your needs can be accommodated.

It is important that you are not in "energy debt" before an exam, because that will make the exam much harder. The two or three weeks before the exams are probably the most important times to pace and make sure that you are getting enough rest. It will be far more difficult for you to do well in an exam if you are very fatigued because you have crammed - it is likely to be better if you are less tired and so able to write what you know.

Pace the exam itself. Most exams are several hours long. Some disabled students are entitled to extra time in exams, so ask your disability officer and tutor if you are in doubt. Use the extra time wisely - that means taking a break every hour. The break may only be short, but try to move slightly, and rest your body and mind. The five minutes or so each hour may seem like a "waste of time", but is much less of a waste than getting half way through an exam and not being able to finish. Practice "switching off" and resting for five minutes when studying so that it will be easier on the exam day.

After an exam, it is likely that you will be very tired. Take a break and rest. Some people find it helpful to do some form of light exercise to relieve tired muscles. Pacing during an exam period may mean less last-minute studying. Pay special attention to pacing during exams that are close together.

No, not necessarily. Pacing means spreading the workload over a period of time, so that you can balance activity with rest. Pacing over a term can mean that it is possible to get some assignments done ahead of time. It also means studying in small but effective chunks so that by the time an exam happens, the studying is done. At times, getting extensions and deferring exams may be needed, but this is often the last resort, and tends to happen in exceptional circumstances, such as when the essay titles are withheld until very close to the deadlines or when there are just too many exams to do in a short period of time.

Pacing can often mean explaining your situation clearly and asking for the supports that you need. If you seek supports or accommodations early, it is more likely that it will be possible for these to be in place.

Most of the guides on pacing available typically relate to conditions such as multiple sclerosis, rheumatoid arthritis, and ME/CFS.

Also, guides commonly available tend to describe household activities and general pacing, rather than information directly relevant to studying and other activities that form part of being a student.

Below are links to some guides available on the web:

http://www.afme.org.uk

http://www.fatigueanswers.com

http://chronicfatigue.about.com

http://www.mstrust.org.uk