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Managing Triggers

Some relapses may be due to the waxing and waning of your illness, but other setbacks are triggered by actions you take and situations you can learn to manage or avoid. You can begin to gain control over relapses by identifying the causes that apply to you.

To get you started, here are seven triggers often mentioned by people in the self-help program. The first four are the causes mentioning most frequently. (Some people remember the top three using the acronym SOS: Sleep problems, Overactivity, and Stress.)


Living outside one’s limits is the the most common cause of intensified symptoms. The antidote: pacing. Keeping to a daily routine in which you live consistently within your limits reduces the frequency and severity of relapses.
Poor Sleep

Non-restorative sleep, the second mostly frequently mentioned relapse trigger, can intensify symptoms and precipitate a vicious cycle in which symptoms and poor sleep reinforce one another. The solution: address sleep problems by improving sleep habits, using medications and treating sleep disorders. (For details, see the page on Sleep.)

CFS and fibromyalgia make people very stress-sensitive, so minimizing stress can prevent relapses. Stressors may include ongoing symptoms; isolation; emotionally-charged events, such as financial problems, a disability review or a move; physical illness; or long-term situations, such as family conflict. (For ideas on reducing stress, see the Managing Stress section of the site.)
Sensory Overload

If you are sensitive to light, noise or crowds, you may experience intensified symptoms in situations of sensory overload. One common solution is avoidance. For example, get together with one or a few people rather than a large group. Visit stores and restaurants when they are not busy. Wear sunglasses and ear plugs in places that use fluorescent light or are noisy. For more, see the article Sensory Overload: Sources and Strategies on the self-help program website.
Travel and Other Special Events

Special events, like a vacation, family visits or the holidays, can trigger a relapse. The solution: reduced activity level and planning ahead using the strategies outlined on the Travel & Special Events page.
Other Illnesses

Coming down with an acute illness, such as a cold or flu, or having multiple chronic illnesses can reduce energy and worsen CFS and FM symptoms. By treating other conditions and acknowledging that they intensify symptoms, you can reduce CFS and FM flares.
Stressful Relationships (Particular People)

Interactions with people who are negative, demanding or hyperactive may be a source of stress. Responses include talking with the person to redefine the relationship, limiting contact, getting professional help and ending the relation.


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