PEM yourself to sleep (simple technique to get to sleep when your brain is too wired)

Hip

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I thought I'd just report this simple "PEM yourself to sleep" technique that I find helps gets me to sleep at times when my brain is "wired" and overstimulated.

I use this technique when I have gone to bed, but then find that 30 to 60 minutes later I am still not asleep, because my brain is still too revved up. So then I get up, and do this "PEM yourself to sleep" technique.

This "PEM yourself to sleep" technique involves doing a very short burst of intense exercise: I use the squats exercise, doing around 60 to 80 squats in rapid succession for about 2 minutes, until I start to get a bit of lactic acid burn and muscular exhaustion in my legs, and start to breathe heavily from the exercise. Then I stop, and go straight back to bed.

When I get back into bed, I find I am breathing heavily from the exercise for some minutes, but nevertheless I invariably find that within 5 minutes, I am fast asleep. It almost never fails to work.

Demonstration of Squats
I do squats at about twice the speed shown
in the video (I do about 50 squats per minute).
I also place my hands on my knees, and use
the strength in my arms to help perform the squat.​

What seems to happen (subjectively) is that the lactic acid burn and muscular exhaustion in my legs kind of quickly drains the overstimulated energy out from my brain, and this allows me to get to sleep fast.

So this short intense burst of exercise seems to rapidly lead to a welcome mental tiredness and mental relaxation. It's as if you are PEMing yourself to sleep (technically this immediate post-exercise tiredness is probably not PEM, as post-exertional malaise typically takes hours or days to appear after exercise; but it's a similar thing).

I find it works well for insomnia caused by being too "wired" and overstimulated. You are perhaps using one of the known symptoms of ME/CFS — the rapid muscular fatiguability — to your advantage here, generating this muscular fatigue in order to become tired in a relaxed way, which allows for sleep.


Obviously, depending on the severity of your ME/CFS, you may need to be careful not to overdo the exercise, and actually cause real PEM the next day.

In my case, my ME/CFS is at the top end moderate, nudging into mild. So I can do 60 to 80 squats without any PEM repercussions the next day. Others with more severe ME/CFS might get adverse PEM effects from 80 squats, and so may need to substantially reduce the number of squats.

Or perhaps this technique may not be advisable at all for more severe ME/CFS. I know that when my own ME/CFS was worse and entering into severe territory (several years ago), I was too weak to do even 5 press-ups in a row. So this technique may only be viable for those with ME/CFS closer to the mild end of the spectrum.


I don't use this technique every night, as fortunately on most nights, I find I am able to get to sleep within 10 to 15 minutes of going to bed (provided I take 5 mg of melatonin an hour before bed). But if I get one of those nights where I am too "wired" to sleep, after lying there in bed trying to sleep for perhaps 60 minutes, I will just get out of bed, do my 60 to 80 squats next to my bed (which takes less than 2 minutes), and I find I am then soundly asleep within 5 minutes.
 
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Gingergrrl

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I read this out of curiosity and have to add a caveat that doing 60-80 squats would not be possible (or safe) for those who have POTS. It could trigger extreme tachycardia, sudden drop in blood pressure, shortness of breath, dizziness, and in some even angina or fainting.
 

Hip

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doing 60-80 squats would not be possible (or safe) for those who have POTS.
I have POTS, but these rapid squats don't cause problems in my case. It's possible though it may affect others with POTS, so it's a good point to mention.

But you don't have to do squats; you could for example do sit-ups or press-ups. The tiredness is created I find by exhausting a major muscle and creating a lactic acid burn in that muscle. But any muscles I think would do.
 
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Gingergrrl

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I have POTS, but these rapid squats don't cause problems in my case. It's possible though it may affect others with POTS, so it's a good point to mention.
Thanks and I felt I had to mention that caveat as someone who had intractable POTS for 3-4 years. My POTS is basically in remission now, as far as doing the normal activities of daily life, BUT I end up accidentally triggering a POTS episode every 3-4 weeks and those squats (even 4-5 of them) would trigger an episode for me.

I can do an hour of (very basic) Pilates but certain motions, I cannot do. I’d be hesitant for anyone with POTS to attempt exercises involving repeated standing and bending motions especially with their arms above their heart, or worse if above their head.
 

Hip

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What I find tends to trigger more fatigue and brain fog than you might expect is any activity that involves crouching down for a while, then standing up, and doing this repetitively. Like for example cleaning the bottom of your cupboards. I think that's because with POTS, my body cannot adjust blood flow properly when standing up after being crouched down for some time.

It's possible I guess that some of the tiredness that comes on after I do the squats is POTS-related (rather than just muscle fatigue-related). But in any case, when I am trying to get to sleep, in those circumstances that tiredness is welcome and useful.
 

roller

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1) i used to do sit-ups in bed, as many as possible. that worked like a charm to fall asleep.

2) also, leaving a light on might help sleeping.

3) no beam of moonlight in the room.

actually, i never had really trouble falling asleep. its more like user @ukxmrv writes on the other forum:
We are all more active at night and think better. Exertion does rob us of this and early starts leave us with no good period during the day.
i also started functioning somewhat only after nightfall. mentally and physically.
it was the time, when i tried to rip all that what i missed to do during the day.
 
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ChrisD

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This exercise sounds way too intense and strenuous, it would send my body into overdrive BUT I have noticed that just spending time in the squat position helps me somehow. I remember hearing that stretching the glute in this way will create a Serotonin release - which may explain this phenomena.

So based on this I don't think it's neccessary to even do so many squats, just use it as a yoga position. I often find stretching my hips out in bed helps me fall asleep.
 

Hip

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1) i used to do sit-ups in bed, as many as possible. that worked like a charm to fall asleep.
Yes, I think any form of muscular exertion will probably work.


One mechanism by which a very short amount of high-intensity exercise might relax the overstimulated brain is the following: it relates to IL-6, which is a cytokine, but also a myokine (a myokine is a factor secreted by muscle cells in response to muscular contractions).

Massive amounts of IL-6 are released from the muscles during muscular exertion. Now IL-6 has two sides to its nature: on the one hand IL-6 is pro-inflammatory; but IL-6 also has an anti-inflammatory mode, and the IL-6 produced from exercise is the anti-inflammatory type.

The classical signaling pathway of IL-6 is anti-inflammatory, and IL-6 from muscles goes via this classical signaling pathway; whereas the trans-signaling pathway of IL-6 is pro-inflammatory (I posted about these two pathways here).

So if we assume (as others have posited) that the overstimulated "wired" state of ME/CFS is due to high levels of glutamate in the brain, and given that glutamate is produced in copious amounts by microglia and astrocytes during brain inflammation, then it may be that the soothing anti-inflammatory effects of IL-6 from the muscles lowers this neuroinflammation, thus decreasing glutamate production, thereby putting the brain into a more relaxed state.
 
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percyval577

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Things like squats i could do before I was uncomfortable ill. Only now I know I was ill before and than it helped excelent!
After my EBV I still was able to move around and to work halftime, but these exercises make my brain much worse now. I would think brain fog and pem hinder sleep.

What also was able to help me were two yoga execises, bhudshangasana and (then) shalabhasana. You almost don´t need to move but your muscles get trained (and hopefully you may get more tired than exhausted).
The same can be achieved btw when you "sit against a wall", like being on a chair but below there is nothing, so you need to press against a wall (in your sleeping room or wherever). I couldn´t do it though after my EBV.


The video is interesting I think because the different variations of the exercise (so still focused) are a kind of pacing, arn´t they?

Yes, I think any form of muscular exertion will probably work.


One mechanism by which a very short amount of high-intensity exercise might relax the overstimulated brain is the following: it relates to IL-6, which is a cytokine, but also a myokine (a myokine is a factor secreted by muscle cells in response to muscular contractions).

Massive amounts of IL-6 are released from the muscles during muscular exertion. Now IL-6 has two sides to its nature: on the one hand IL-6 is pro-inflammatory; but IL-6 also has an anti-inflammatory mode, and the IL-6 produced from exercise is the anti-inflammatory type. What is called the classical signaling pathway of IL-6 is anti-inflammatory, and the IL-6 from muscles goes via the classical signaling pathway; whereas the trans-signaling pathway of IL-6 is pro-inflammatory (I posted about these two pathways here).

So if we assume (as others have posited) that the overstimulated "wired" state of ME/CFS is due to high levels of glutamate in the brain, and given that glutamate is produced in copious amounts by microglia and astrocytes during brain inflammation, then it may be the soothing anti-inflammatory effects of IL-6 from the muscles that lower brain inflammation, thus decreasing glutamate production, thereby putting the brain into a more relaxed state.
I can put two observations, The second one shall not agree with your assumption.

1. Movements will require and lead to action of nerves. I myself feel/interpretate that this alone can cause little sudden crashes (now where I am improving, wheras before it didn´t behave like so). I think it as exaggerated misconnections of nerves resulting from an ill plasticitymechanism.

2. iL-6. When I was worse and couldn´t do yoga, and didn´t like to walk for more than one or two hours otherwise my pain was increasing for the next days - I still was able to ride bike quite intensively for a whole day! On a bike you are fixed, and the movements are slow.
Then having come home in the evening a lot of iL-6 has been released. I think that it was this iL-6 which would have hindered my sleep during the following night. E.g. this study. says iL-6 would lower quality of sleep. I thought back than: If I were an ancient hunter and had hunted for the day and were far from home, it might be requiered to stay awake, and therefore iL-6 might dumpen down quality of sleep.
(I agree of course that movements are healthy and iL-6 reasonibly should be part of it.)
 
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percyval577

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@Hip, Maybe you are right.

Though it makes sense to release a potential proinflammatory cytokine during such an exercise
because you may get wounded. And the longer you do (ie hunting) the more likely it may come about.
And then you have already a lot of this important cytokine in the blood, luckily.

So I would guess that a sudden switch of these two pathways - which both lead to the same molecule -
is intended.
So the question arises, would there be anything which would be desireable to achive in both cases.
And a light sleep I think would be such a thing (at least say for the older/chiefs of a hunt).


Sleep enhances IL-6 trans signaling which is the pro-inflammatory pathway.
(It makes sense because during sleep the organism may want to repair itself.)
So I think this also does not point to a specific pro-sleep property of the other pathway.
 
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roller

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lay flat on the back, lift your feet 2cm, lift your stretched arms 2cm, then lift your back 2cm.
micro-sit-up.

that was all. but really helped hugely.
it would only hurt in the abdomen muscles.
 

Wishful

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Sadly, exercise in the evening (actually after 3PM) now gives me insomnia. Also, I don't have 'the rapid muscular fatiguability' common to ME, so I can't trigger that. If it was real physically-induced PEM, I'd have to do the exercises 24 hrs in advance. Where's a fortune teller when you need one? ;)
 

Sundancer

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Even the slightest exertion worsened my insomnia, since I'm on high dose B12 plus antihistamine it goes lots better. But still won't try exertion when falling asleep takes long, pretty sure I'm making something worse and beginning to suspect that I get high histamine from exertion.

PEM btw kicks in 24 hours after I've overdone it and then keeps up 6 days, to high a price for anything.
 

Gingergrrl

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This exercise sounds way too intense and strenuous
I agree.

lay flat on the back, lift your feet 2cm, lift your stretched arms 2cm, then lift your back 2cm.
When I first read this, I thought you meant to lift all of these things at the same time like you were levitating off the bed LOL :_

pretty sure I'm making something worse and beginning to suspect that I get high histamine from exertion.
That is actually true and in MCAS, exercise or exertion is a trigger of histamine for many people and can trigger an allergic reaction/episode.
 

rosie26

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@Hip Squats are one of my worst triggers for PEM which leads to insomnia. It's too intense an exercise for me. I tried to incorporate it into a 5 minute light exercise routine years ago and was very sick with PEM the next day. I find the same thing with gardening, squatting to weed.
 

Hip

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Squats are one of my worst triggers for PEM which leads to insomnia. It's too intense an exercise for me.
Sit-up might then be a better substitute, though the amount of exercise performed would have to be figured out carefully; you would not want to do so much that you cause PEM the next day.

For some patients it may be that for example just 90 seconds worth of sits-ups as you get into bed may reduce the "wired" state enough to help sleep; but doing more than that may lead to PEM. That's assuming this technique does work for other ME/CFS patients.
 

rosie26

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Sit-up might then be a better substitute, though the amount of exercise performed would have to be figured out carefully; you would not want to do so much that you cause PEM the next day.

For some patients it may be that for example just 90 seconds worth of sits-ups as you get into bed may reduce the "wired" state enough to help sleep; but doing more than that may lead to PEM. That's assuming this technique does work for other ME/CFS patients.
@Hip For exercise I prefer a slow walk down the road and back. This I find more gentle and the body is getting some light exercise. I did this even in my severe years and with the help of someone walking next to me. Also, light housework depending on how sick I am.
 

Hip

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For exercise I prefer a slow walk down the road and back. This I find more gentle and the body is getting some light exercise.
Yes, that's what I do myself for exercise, a stroll down my road.

But the technique detailed here is not really for exercise purposes, but to help get to sleep. And I think this technique will probably only work if you do it just before you get into bed.
 

rosie26

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But the technique detailed here is not really for exercise purposes, but to help get to sleep. And I think this technique will probably only work if you do it just before you get into bed.
I personally wouldn't recommend this considering the consequences I experienced with squats. This sort of exercise induces insomnia and the wired and tired for me.