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Mini-crashes in late afternoon / early evening?

Discussion in 'Post-Exertional malaise and fatigue' started by InitialConditions, Apr 20, 2020.

  1. InitialConditions

    InitialConditions Senior Member (Voting Rights)

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    Anyone else? It's like that afternoon slump that affects many people but much much worse. For me, it occurs around 4 pm and lasts until around 7/8 pm. Everyday. I often go back to bed but very rarely sleep. I've not found anything to help. It's only on the occasional 'better' day that I don't experience this dip in energy and increase in fatigue.
     
    Last edited: Apr 21, 2020
    oldtimer, Ravn, Kitty and 9 others like this.
  2. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

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    Yes. I get this. The only things I can suggest that sometimes help is -

    - Rest earlier. Whatever your routine is if you feel the slump at approx 4 and that's when you rest - try resting at 3 instead. Even if you don't sleep.

    - Take a couple more mini breaks. Sit quietly with your feet up for 15 mins or so & have a glass of water & a piece of fruit if your feeling virtuous. Or a cuppa with a choccie digestive if not (the biscuit gives you some immediate sugar while the fats in the chocolate slows the sugar release so it's slightly more sustained rather than just a spike).

    I'll be interested to hear other people's suggestions.
     
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  3. Wonko

    Wonko Senior Member (Voting Rights)

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    I get it as well - nothing can be done about, just gotta roll with it.
     
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  4. InitialConditions

    InitialConditions Senior Member (Voting Rights)

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    Thanks. Yes, I thought about pre-emptively resting.

    I feel in some sense this is could almost be 'hormonal' - perhaps cortisol-related.
     
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  5. Simbindi

    Simbindi Senior Member (Voting Rights)

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    It's interesting you say that about the fats with sugar. I find a piece of my homemade shortbread or a few pieces of my homemade fudge with a cup of tea work really well to give me a cognitive and physical energy boost. Both have relatively high butter (or butter and milk fat) to carbohydrate ratios and use golden unrefined cane sugar. But shop bought biscuits just leave me wanting to eat half a packet and I don't feel any better for it.
     
    Last edited: Apr 20, 2020
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  6. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

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    We have a few diabetics (insulin dependent) in the family and, in a previous life when I regularly had people coming to stay, I always had choccie digestives or kitkats around for them. The diabetic nurses used to recommend them as good snacks for when they were exercising.

    Coke or a bananas for when the sugar levels started dropping too low as they needed the sugar hit straight away & so the spike wasn't an issue.

    Edit - coke as in the drink! The fully leaded caffeine & sugar variety, but only in a small amount - about 100ml.
     
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  7. Chris

    Chris Senior Member (Voting Rights)

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    I am glad you are raising this @InitialConditions. I sure get those late afternoon crashes. In fact most of my crashes are triggered by bad pacing precisely in the late afternoon time frame (and also late morning).

    Here is a theory I was given:

    Let’s say pwME do suffer from a certain degree of brain hypoxia/ischemia. Poor blood flow to the brain. (in my case a spect scan showed clear hypoperfusion but this is anecdotal).

    At 4 pm your cortisol drops. As a result adrenaline kicks in to compensate for this drop and allow whatever activity you have the bad idea to be engaged in to go on. The rub is, adrenaline increases blood flow first to your legs and arms (to run away from that bear in the woods, or - fight it?), and this diverts further blood away from your brain. Not a problem for healthy people. But for the oxygen and glucose impoverished ME brain, the deficit in these vital elements then reaches a critical point, and your brain shuts parts down to protect itself. And there you crash.

    Like I said, a theory…

    But lord oh lord would I like some day to get once and for all at the bottom of this freak life-robbing phenomena: If i make a short phone call at 1 pm or 8 pm, I’m usually fine; if I make the same phone call at 4 pm, I will crash, for 3 days. Try to explain that to normal healthy people.
     
    Last edited: Apr 20, 2020
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  8. adambeyoncelowe

    adambeyoncelowe Senior Member (Voting Rights)

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    This happens to me too. It's worse if I've taken antihistamines or if I've not eaten properly.
     
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  9. Keela Too

    Keela Too Senior Member (Voting Rights)

    For me it can happen right after dinner. I’m guessing I’m using energy and water to digest the meal, but haven’t yet got the nutrient boost from the meal. Keeping well hydrated can help I think.
     
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  10. Legend

    Legend Established Member (Voting Rights)

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    Interesting. This happens to me every day after dinner, around 3/4pm to 7/8pm. If I don't take this afternoon(or after dinner)-rest serious and must do other things in this period, my fatigue gets stronger the upcoming 1-3 days.

    When I was healthy I didn't need any afternoon-rests. Now it seems to be critical, as I can't function without it.
     
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  11. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

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    please don't give more information than you feel.comfortable with but I wondered if you notice if it matters what and how much you eat?

    I find a meal with refined carbs will definitely do this, unless it's a really tiny portion.

    So I wondered if maybe adding a small amount of fats to the refined carbs might slow & lower the sugar spike and help avoid the drop the follows the insulin spike. I found that made things worse.

    I also find drinking fluid with meals makes it worse.

    Certain foods definitely cause a massive slump after eating.
     
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  12. NelliePledge

    NelliePledge Moderator Staff Member

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    I don’t get up til late morning early afternoon 4pm is a pretty good time for me. However if i don’t let myself have a lie in and get up say around 8 am for workmen or any other no choice type appointment I will often end up dozing in the afternoon. I just assumed it was because I was having 4 hours rather than 8 hours sleep.
     
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  13. Trish

    Trish Moderator Staff Member

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    I tend to fade by mid afternoon, but I put that down to the fact that by then necessary activity has used up my energy for the day. If I try to do more, I suffer the consequences. I can't link it to food.
     
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  14. Keela Too

    Keela Too Senior Member (Voting Rights)

    @Invisible Woman I haven’t really worked it all out. I’m eating low carb (not quite keto as I like milk in hot drinks) so I doubt it’s to do with too much carb in my meals. Also it’s not every evening dinner. Just some. Dunno!
     
  15. alktipping

    alktipping Senior Member (Voting Rights)

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    since my last major crash in 2017 I have zero energy after being up for two hrs . I don't know if that qualifies as a slump or just my new norm .
     
  16. Kitty

    Kitty Senior Member (Voting Rights)

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    Same here – energy starts dropping gradually at about 3pm, and by 4pm I've got nothing. Some days I need to sleep for half an hour, other days it's just rest physically and flatline mentally.

    I come round again at about seven, and have my best energy for the day. When I was working as a part-time freelancer, my ideal work hours were 7pm to 1am.
     
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  17. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

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    Yep. In the evening, especially as it gets to 11pm, I become alert.

    Drives me up the wall because it's the time I am best able to do cognitively challenging tasks but if I do I can forget about sleeping and will feel terrible the next day.

    If only I could feel like this earlier in the flippin' day! :arghh:
     
  18. Ravn

    Ravn Senior Member (Voting Rights)

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    Not sure if my experience is the same 'slump' you others are describing but I do get a daily period of feeling decidedly off.

    Lasts about 2 hours. Builds up gradually over half an hour or so, stays high for the next hour and gradually subsides again until I'm back to "normal".

    It's not related to activity or amount of rest, and also not related to food.

    Seems more body clock related, except that sometimes the body clock is slow. There are periods when it happens the same time every day and other periods when each day it strikes an hour or two later than the day before. It rarely hits in the morning though.

    There's whole-body exhaustion, leaden limbs and brain fog, plus something weird going on with temperature. If I measure in the mouth my temperature is low-normal - so no fever - but if I measure on the forehead the thermometer does register a fever. My skin, especially my facial skin, is definitely very hot as confirmed by several different thermometers and several people putting their hands on my skin. When it happens at night it wakes me up with night sweats. During the day it's a dry heat.

    I get all this with PEM, too, but PEM is more severe and has many more symptoms. So I'm not sure if the daily 'fevering' as I call it is a sort of mini-PEM or something else altogether.

    Have no idea how to avoid it. The only thing to do is to lie down and wait it out. I have a suspicion that I'm more susceptible to setting off actual PEM during this 'fevering' period, which I view as all the more reason for a lie-down.
     
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  19. Wits_End

    Wits_End Senior Member (Voting Rights)

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    My caree normally finds she has to rest mid-afternoon in order to be able to get through the rest of the day - I thought this was quite common in PwME? Certainly she would do everything within her power to avoid having to carry on until 4 pm without a rest.
     
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  20. perchance dreamer

    perchance dreamer Senior Member (Voting Rights)

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    I was getting a really bad slump around 4:00 in the afternoon, and my PA suggested that I eat breakfast earlier than I had been. I had been eating about an hour after I woke up.

    This late-afternoon slump stopped after I started eating breakfast earlier, but I don't remember the reasoning behind it.
     

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