Homework also may include keeping an energy diary, which can be a key component of CFS cognitive therapy. The diary serves as a general guide for setting limits and planning activities. The patient uses the diary to track any factors, such as a job or a relationship, that may be making the fatigue worse or better. It is also used to track the times of day when energy levels are at their highest and lowest peaks and adjust schedules accordingly. Developing fairly rigid daily routines around probable energy spurts or drops may help establish a more predictable pattern.
Flexibility is important.
Instead of a long nap, for instance, patients may need between five to 10 minutes rest periods every hour or more, during which time relaxation or meditation methods are useful. Cognitive therapy teaches patients how to prioritize their responsibilities, dropping some of the less critical tasks or delegating them to others. Limits should be designed to keep both mental and physical stress within a manageable framework so that patients do not get discouraged by forcing themselves into situations in which they are likely to fail. As part of the therapeutic process, patients learn to adapt even to impaired concentration, a common CFS problem. For example, the patient learns to choose activities that are appealing, that will focus attention, and will help increase alertness.