Question

I’ve always enjoyed a long soak in a hot bath, especially at the end of the day – and still do. But since developing ME/CFS I’ve found that I feel completely wiped out afterwards – as well as feeling more lightheaded and faint than usual. Is this something that could be related to ME/CFS, because it doesn’t appear to be listed as a symptom?

Answer

Firstly, it’s worth noting that having a warm or hot bath obviously raises the body temperature. But once you get out of a hot bath your body temperature falls and this is a powerful trigger for making people feel sleepy. Having a warm bath before you go to bed is something that is sometimes recommended for people who are having problems getting off to sleep.

In ME/CFS, we know that problems with temperature control (disturbed thermoregulation) are a common and important symptom. This can involve increased sensitivity to both hot and cold temperatures and night sweats. The cause probably lies with a small gland in the brain called the hypothalamus – which acts as a thermostat for controlling sleep, appetite and temperature. People with ME/CFS are likely to have an exaggerated response to anything – including having a hot bath.

We would recommend that people with ME/CFS do not have a hot bath (or shower) if you are going to have to do something physical or mental afterwards. The best time to have one is later in the evening when you can relax properly afterwards. And it may then help with getting a good night’s sleep as well! One final point is that having a hot bath will lower your blood pressure and may make you feel faint. As some people with ME/CFS already have low blood pressure, this is another reason for taking care after a hot bath.

Read more: Symptom: Temperature Regulation (1), Symptoms: Hot or Cold Extremities, Symptom: Low Temperature.