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What is Long COVID?                                           

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There are currently no recognized causal therapies for Long COVID. The available therapies are based on experience with other diseases and are symptom oriented. The focus is on alleviating the symptoms. Discuss the treatment options with your family doctor and work out an individual treatment plan together. Furthermore, you should check whether your health insurance company also offers a counselling service or accompaniment for Long COVID sufferers: While you as a CSS-insured person benefit from personal support by the&nbsp;<a href="https://www.css.ch/en/private-customers/my-health/advice/health-coach.html" rel="noopener">health coaches</a>,&nbsp;<a href="https://www.sanitas.com/en/magazine/living-together-today/long-covid-symptoms-and-treatment.html" rel="noopener">Sanitas</a>&nbsp;and&nbsp;<a href="https://www.helsana.ch/en/blog/body/illnesses/long-covid.html" rel="noopener">Helsana</a>&nbsp;offer informative articles on the topic of Long COVID.
The Directory contains both&nbsp;<a href="https://altea-network.com/en/blog/complementary-medicine" rel="noopener">conventional and complementary medical offers</a>. In general: Altea does not guarantee the quality and success of the treatments and therapies.
Providers must meet the following requirements to be included in the Directory:
<ul>
<li>In the case of medical services, there must be a specific offer for Long COVID within the framework of compulsory health insurance (KVG).</li>
<li>In the case of complementary medical therapies,&nbsp;<a href="https://www.emr.ch/fr/label_de_qualite" rel="noopener">EMR recognition</a>&nbsp;or&nbsp;<a href="https://www.asca.ch/?lang=fr" rel="noopener" data-anchor="?lang=fr">ASCA recognition</a>&nbsp;of the therapist and the therapy offered is mandatory.</li>
</ul>
The offers can be filtered by Canton, location and symptom and searched for keywords.

Register your offer!

Now available: Altea Care

The Directory provides an overview of treatments and therapies. However, the first point of contact is always the family doctor's office.

Long COVID: clinics, therapies, rehabilitation

<div class="text">
Fatigue&nbsp;
&ldquo;Fatigue&rdquo; is a form of pathological exhaustion that is physical, mental, or psychological in nature. Fatigue is one of the most common of the many symptoms of Long COVID.
Pacing means doing less than your strength currently allows. Pacing is a gentle way of using your resources.
Pacing helps when it has become difficult to calculate your day-to-day energy levels and when you are exhausted and feel completely worn out or very tired. Pacing can also reduce setbacks in your healing process.&nbsp;
The art of pacing involves finding your own optimal balance between conserving energy and practicing any activity, as well as continually increasing your activity. The goal: to get out of the ups and downs between good and bad days and returning to a stable energy level and everyday routine.
&nbsp;
More information and application tips on Pacing:
<ul>
<li>Detailed information and application tips in our Vademecum <a title="Altea VM Fatigue - Pacing part 1 v2.0" href="https://adm.altea-network.com/assets/f102b619-198e-444a-93ec-9de7fb0f83cd?download" target="_blank" rel="noopener">Pacing part 1: recognizing the limits</a> and <a title="Altea VM Fatigue - Pacing part 2 v2.0" href="https://adm.altea-network.com/assets/d0d94f3e-5fb2-4fcb-801b-d2eafa3df600?download" target="_blank" rel="noopener">Pacing part 2: The 4P&rsquo;s rule</a>.</li>
<li>Long Covid Physio. <a href="https://youtu.be/KS-FiXWLs9U">Navigating Pacing. (Podcast)</a></li>
<li>#MEAction. <a href="http://www.meaction.net/stoprestpace/"> Rest. Pace. (Video)</a></li>
</ul>
</div>

<div class="col-12 col-md-6">
<div class="text">
Procedure:&nbsp;
<ol>
<li>Identify your current limits in the four activity areas: physical, mental/cognitive, social, and emotional.</li>
<li>Identify your individual warning sign in each of the four activity areas.</li>
<li>Accept your current limits.</li>
<li>Communicate your current limits and get help.</li>
</ol>
Adjust your daily activities and tasks using the 4P's rule:&nbsp;
<ol>
<li>Prioritize</li>
<li>Plan</li>
<li>Pause regularly</li>
<li>Stay positive</li>
</ol>
&nbsp;
&nbsp;
&nbsp;
&nbsp;
<ul>
<li>Medinger, Gez. <a href="https://youtu.be/gUPvNwvkOlA">The Why, When and How of Pacing | Long Covid&rsquo;s Most Important Lesson. (Video discussion with experts)</a></li>
<li>Royal College of Occupational Therapists. <a href="http://www.rcot.co.uk/conserving-energy">How to conserve your energy.</a></li>
</ul>
Note: for more videos and links see the same page in other languages.
</div>
</div>

Pacing

<div class="text">
Heart rate monitoring is suitable for people with Fatigue to avoid <a href="https://altea-network.com/en/vademecum/fatigue/#pem-post-exertional-malaise" target="_blank" rel="noopener">crashes/PEM</a>. It refers to the constant measurement of the heart rate with a heart rate monitor and is used for <a href="https://altea-network.com/en/vademecum/fatigue/" target="_blank" rel="noopener">Pacing</a>. 
It is often difficult to develop a feeling for the limit of resilience and not end up in a crash/PEM. For many people, subjective perception is not tangible enough. With a defined upper limit (maximum heart rate), pacing becomes tangible and easier to implement. 
Crashes/PEM are often triggered by an activity for which the body has to provide the energy mainly without oxygen. The threshold from aerobic (with oxygen) to anaerobic (without oxygen) energy supply is called the anaerobic threshold. Heart rate is an adequate parameter to monitor anaerobic threshold. 
<ul>
<li>The threshold is very individual and depends on many factors. It can be determined relatively accurately with a cardio-pulmonary stress test. </li>
<li>It is also possible to calculate a guide value. You can find two ways to do this in our &ldquo;Heart Rate Monitoring&rdquo; guide. </li>
</ul>
Please read the detailed information on heart rate monitoring in our <a href="https://adm.altea-network.com/assets/012bdf93-63e0-4ca3-82ec-5c12a9f05d6d?download" target="_blank" rel="noopener">Vademecum</a>&nbsp;(in German, translation will follow).
</div>

Heart rate monitoring 

<div class="text">
Post-Exertion Malaise (PEM) refers to the worsening of symptoms after physical, mental or emotional exertion, it is also referred to as "crash". PEM is a different symptom than a healthy person's "normal" fatigue after activity, excitement, or exertion. For many clinics, researchers, and affected people, PEM is considered the primary symptom of chronic fatigue syndrome (ME/CFS). Many people affected by Long COVID report similar "crashes" even after the smallest physical, cognitive, or emotional exertion.
Early detection of PEM is important and can reduce "crashes" and provide more safety during efforts in everyday life. Early detection also improves physical and mental well-being.
</div>

<div class="col-12 col-md-6">
<div class="text">
How to recognize and reduce PEM:
<ul>
<li>Recognize PEM as a consequence or side effect of overexertion.</li>
<li>Keep diary to identify patterns of overexertion.</li>
<li>Search discussion with a doctor or an expert.</li>
<li>The following methods may help: Pacing / Return to sport / Specific rehabilitation</li>
</ul>
Here you will find a <a title="Altea Ratgeber Pem Pdf V1" href="https://adm.altea-network.com/assets/bf205e20-0d63-4d2b-9576-4b2dd74f5057?download" target="_blank" rel="noopener">PDF with detailed information about PEM</a>&nbsp;(in German, translation will follow). Here you will find two short <a href="https://www.dialogues-mecfs.co.uk/films/post-exertional-malaise/" target="_blank" rel="noopener">videos about PEM</a>. Here you will find a <a href="https://www.youtube.com/watch?v=TGIo1v7KVJQ" target="_blank" rel="noopener" data-anchor="?v=TGIo1v7KVJQ">short introduction to PEM</a>.
</div>
</div>

Post Excertional Malaise (PEM), recognize and prevent "crashes"

"Fatigue" describes a great amount of exhaustion that does not go away even with a lot of sleep. Such an all-encompassing fatigue is also known from other viral diseases. It is important to avoid, if possible, that the exhaustion becomes chronic.

Fatigue

"Fatigue" describes a great amount of exhaustion that does not go away even with a lot of sleep. Such an all-encompassing fatigue is also known from other viral diseases besides Long COVID. It is important to avoid, if possible, that the exhaustion becomes chronic.

Pacing Against Exhaustion and Chronic Fatigue Syndrome in Long COVID | Altea

Fatigue and exhaustion: these tips are important

Attention disorder, concentration difficulties, word-finding impairment and memory loss issues / &ldquo;Brain Fog&rdquo;
Many people report decreased concentration, impaired memory, or word-finding problems after COVID-19 infection. In that case, these complaints are part of Long COVID.
In Long COVID, it is common that the above difficulties occur at the same time as <a title="Fatigue" href="https://altea-network.com/en/vademecum/fatigue/" target="_self">Fatigue</a>, a common phenomenon of Long COVID. In detail, this means that cognitive complaints are particularly severe during periods of pronounced fatigue. Patients often describe Fatigue as a &ldquo;Brain Fog&rdquo; - a rapid and premature mental exhaustion.

<div class="col-12 col-md-6">
<div class="text">
The good news is that in most cases the symptoms improve significantly or even disappear completely over time.
What helps against disorders of thinking and perception?
<ul>
<li>Energy management</li>
<li>Neuropsychological/ergotherapeutic brain power training</li>
<li>Regular sleep and healthy daily structure</li>
<li>Mental health</li>
</ul>
Here you will find a PDF with <a title="Altea VM Thinking and perception- Energy management v2.0" href="https://adm.altea-network.com/assets/8ae5ae05-1650-4bd7-b19d-b4d2a7b133b1?download" target="_blank" rel="noopener">detailed information about the energy management / brain power training</a>.
</div>
</div>

Energy management, brain performance training

Difficulty concentrating and being unusually forgetful are possible cognitive symptoms of Long COVID. This also includes slowness in thinking or difficulty in expressing yourself. Impairment of the eyes has also been described.

Thinking and perception

Treatment of Long COVID symptoms: Thinking and perception | Altea

Thinking and perceptions disorders are also part of Long COVID

Shortness of breath, dry cough, irritable cough
The active breathing cycle helps with&nbsp;dry cough and irritable cough. This exercise is also used for&nbsp;breath awareness&nbsp;and&nbsp;breath training. The active breathing cycle improves your lung ventilation and gently loosens the produced secretion so that you can cough it up. In addition, this exercise can reduce energy-sapping coughing attacks.
Repeat the three-step active breathing cycle&nbsp;several times a day for about 10 minutes. Suitable positions for this exercise are sitting and the side or prone position. The supine position is&nbsp;not&nbsp;suitable, as the lower lung areas are poorly ventilated in this position.
The active breathing cycle takes place in three phases:
<ul>
<li>Phase&nbsp;1: breathing control, perceive breathing</li>
<li>Phase 2: deep breathing</li>
<li>Phase 3: Huffing (or forced expiratory technique)</li>
</ul>
Please read the&nbsp;detailed information about the active breathing cycle&nbsp;(in German, EN version follows shortly).
You can find more information in a&nbsp;<a href="https://www.youtube.com/watch?v=qpzJmjtir08" target="_blank" rel="noopener" data-anchor="?v=qpzJmjtir08">video</a>&nbsp;that shows the active breathing cycle and in a&nbsp;<a href="https://www.youtube.com/watch?v=0Mer-1UeCOA" target="_blank" rel="noopener" data-anchor="?v=0Mer-1UeCOA">video</a>&nbsp;explaining "huffing" (in Dutch).
In a short video, the physio team of the B&uuml;rgerspital Solothurn shows and explains the&nbsp;<a href="https://www.youtube.com/watch?v=NVNhNvT-Bio" target="_blank" rel="noopener" data-anchor="?v=NVNhNvT-Bio">breathing exercise for breath awareness and breath deepening</a>. For more languages (incl. Spanish, Turkish, Serbian, Arabic, etc. click on&nbsp;<a href="https://www.solothurnerspitaeler.ch/uebungen-physiotherapie/" target="_blank" rel="noopener">"Atemtherapie (inkl. bei Covid-19)" and then scroll down until&nbsp; "Teil 3: Aktiver Zyklus Atemtechnik (ACBT)")</a>.

Active breathing cycle

Air hunger, fast breathing, exhaustion
Body positions that facilitate breathing help when you&nbsp;breathe faster than usual&nbsp;or if you&nbsp;feel hungry for air, but also if you find it&nbsp;difficult to breathe in deeply&nbsp;or if you&nbsp;feel exhausted.
In all postures that make breathing easier,&nbsp;leaning on the arms&nbsp;calms and lightens&nbsp;the breath. This happens for two reasons: first, the support reduces the weight of the shoulder girdle and, second, the auxiliary respiratory muscles can better help with inhalation.
The simultaneous implementation of the <a href="/en/vademecum/breathing/#pursed-lip-breathing" target="_self" data-anchor="#pursed-lip-breathing">pursed lip breathing</a> technique also supports the calming of the breath.
The following applies to all body positions that facilitate breathing:&nbsp;inhale slowly and deeply through your nose and slowly exhale using the pursed lips. Remain in the posture that relieves breathing until your breathing calms down.

The exercises can be done while sitting or standing.&nbsp;
Sitting:&nbsp;
<ul>
<li data-leveltext="" data-font="Symbol" data-listid="26" aria-setsize="-1" data-aria-posinset="1" data-aria-level="1">Coach seat&nbsp;</li>
<li data-leveltext="" data-font="Symbol" data-listid="26" aria-setsize="-1" data-aria-posinset="2" data-aria-level="1">Sitting at the table&nbsp;</li>
</ul>
Standing:&nbsp;&nbsp;
<ul>
<li data-leveltext="" data-font="Symbol" data-listid="27" aria-setsize="-1" data-aria-posinset="1" data-aria-level="1">Goalkeeper position&nbsp;</li>
<li data-leveltext="" data-font="Symbol" data-listid="27" aria-setsize="-1" data-aria-posinset="2" data-aria-level="1">Support against the wall&nbsp;</li>
<li data-leveltext="" data-font="Symbol" data-listid="27" aria-setsize="-1" data-aria-posinset="3" data-aria-level="1">Support on a railing or piece of furniture&nbsp;</li>
</ul>
&nbsp;
In the PDF you will find <a href="https://adm.altea-network.com/assets/2ea9476d-f697-4262-822f-52ec4d11a116?download" target="_blank" rel="noopener">illustrated instructions for the individual exercices</a>. (in German, the EN translation follows shortly) 
In a&nbsp;<a title="Positions to ease breathing video" href="https://www.youtube.com/watch?v=CGJYKzd7fUI" target="_blank" rel="noopener" data-anchor="?v=CGJYKzd7fUI">short video</a>,&nbsp;the&nbsp;physiotherapy team at the Solothurn Citizens Hospital&nbsp;<a class="Hyperlink SCXW174738013 BCX0" href="https://www.solothurnerspitaeler.ch/uebungen-physiotherapie/" target="_blank" rel="noopener">shows and explains the various exercises</a>&nbsp;to make breathing easier&nbsp;(page in German, videos in various languages).&nbsp;

Body positions to ease breathing

Shortness of breath, inner restlessness, stress
Targeted breathing exercises can help with&nbsp;inner restlessness&nbsp;or in&nbsp;stressful situations. They ensure better ventilation of the lungs and give you inner peace and well-being.
For breathing training, choose a&nbsp;well-ventilated room&nbsp;or, even better, go&nbsp;outside. Whenever possible, inhale slowly <a href="/en/vademecum/breathing/#exercise-to-unclog-the-nose" target="_self" data-anchor="#exercise-to-unclog-the-nose">through your nose</a> and let the breath flow out through your nose in a relaxed and automatic manner (or via <a href="/en/vademecum/breathing/#pursed-lip-breathing" target="_self">pursed lip breathing)</a>.
Please&nbsp;do not practice on a full stomach.
Initially, perform the exercises at rest&nbsp;for two weeks at least once a day. After this first training phase, you can integrate the breathing exercises into everyday life and use them at any time in stressful situations.
The 3 breathing exercises at a glance:
<ul>
<li>The&nbsp;three-stage breathing&nbsp;- creates a reservoir of fresh life energy in the body.</li>
<li>Opening the chest&nbsp;- gives you rest and relaxation.</li>
<li>The&nbsp;change of breath&nbsp;- is good for the lungs and circulation, and is also suitable for inflammation of the airways, coughing, accumulation of mucus and oppression in the chest area.</li>
</ul>
Here you can find a PDF with <a title="Altea VM Breathing Breatingexercise V2.0" href="https://adm.altea-network.com/assets/8fd834e5-df77-4124-b454-2c1761d874e8?download" target="_blank" rel="noopener">instructions and illustrations for the breathing training</a>.

Breathing training

Shortness of breath, air hunger, fast breathing
Pursed lip breathing helps when it is&nbsp;difficult to&nbsp;breathe&nbsp;in&nbsp;deeply, as well as in case of&nbsp;shortness of breath, air hunger,&nbsp;or when&nbsp;breathing is faster than usual.
Pursed lip breathing brings relief in many ways: it calms the breathing and keeps the bronchi open longer, which improves exhalation.&nbsp;Breathing becomes slower, calm, and relaxed&nbsp;and deeply breathing in becomes easier. Air hunger is satisfied, and anxiety can be brought under control.
Performed regularly, the pursed&nbsp;lip breathing&nbsp;technique can have a preventive effect and reduce shortness of breath episodes.
&nbsp;
This is how it works:
<ul>
<li>Breathe in calmly, if possible, through your&nbsp;nose.</li>
<li>Pucker up your lips as if you were carefully blowing out a candle.</li>
<li>Let the air flow out evenly through the small gap between the loosely stacked lips. Make sure you&nbsp;breathe out at least two times longer than you breathe in.</li>
<li>Do not force&nbsp;your lungs to empty completely.</li>
<li>Repeat the technique as often as it feels good for you.</li>
</ul>
<span data-ccp-charstyle="jlqj4b" data-ccp-charstyle-defn="{&quot;ObjectId&quot;:&quot;bb3bba04-9fce-4676-b159-12b532d20b15|168&quot;,&quot;ClassId&quot;:1073872969,&quot;Properties&quot;:[134233614,&quot;true&quot;,201340122,&quot;1&quot;,469775450,&quot;jlqj4b&quot;,469778129,&quot;jlqj4b&quot;,469778324,&quot;Default Paragraph Font&quot;]}">Here you will find a <a title="Altea VM Breathing Pursed lip breathing v2.1" href="https://adm.altea-network.com/assets/de6bd75a-b483-480a-9fc7-3d61a3ad2696?download" target="_blank" rel="noopener">PDF on pursed lip breathing</a> with instructions and illustrations.&nbsp;
Here are some videos about pursed lip breathing :&nbsp;&nbsp;
<ul>
<li><a href="https://www.youtube.com/watch?v=CGJYKzd7fUI" target="_blank" rel="noopener" data-anchor="?v=CGJYKzd7fUI">SoH - Positions to Ease Breathing and the Pursed Lip Technique</a></li>
<li><a href="https://www.youtube.com/watch?v=A_54zno2fMU&amp;list=PLPbj_BS6skC9SmmtD_YRCDz4uo204-bDT&amp;index=6">Ligue Pulmonaire Suisse : Souffler avec les l&egrave;vres, &ccedil;a soulage. Sais-tu comment faire?</a>&nbsp;(in French)</li>
</ul>

Pursed Lip Breathing

Restlessness, palpitations, anxiety, panic, fast breathing
In case of&nbsp;restlessness, palpitations, anxiety or panic, slow diaphragmatic breathing calms the nervous system by activating the parasympathetic nervous system. This nerve of the autonomic nervous system is responsible for calmness and serenity.
In addition,&nbsp;diaphragmatic breathing supports the heart&nbsp;in its activity and relieves it by slowing down the pulse.
In a&nbsp;state of excitement and&nbsp;stress, we usually breath too much. Doing so, we lose too much of the important gas carbon dioxide. All the muscles tense up and we get stressed and breathless. If we practice moving the diaphragm slowly and evenly, we get an optimal oxygen supply.
Please read the PDF with <a title="Altea VM Breathing Diaphragmatic Breathing V2" href="https://adm.altea-network.com/assets/3b454a3c-ad24-43ce-8c27-d7fdd762e364?download" target="_blank" rel="noopener">detailed information and</a><a title="Altea VM Breathing Diaphragmatic breathing V2" href="https://www.altea-network.com/media/zf3bdjyo/altea_vm_breathing_diaphragmatic-breathing_v2.pdf" target="_blank" rel="noopener">&nbsp;excercices for the diaphragmatic breathing</a><a title="Altea VM Breathing Diaphragmatic breathing V2" href="https://www.altea-network.com/en/long-covid/vademecum/breathing/">.</a><a title="Altea VM Breathing Diaphragmatic breathing V2" href="https://www.altea-network.com/en/long-covid/vademecum/breathing/">&nbsp;</a>

Slow diaphragmatic breathing

Shortness of breath, mouth breathing
Do not&nbsp;do&nbsp;the exercise&nbsp;if you&nbsp;have an infectious disease&nbsp;(e.g., flu, fever, cold)! Please consult your doctor if there are any other side effects.
Nasal breathing is the only correct way of breathing according to&nbsp;<a href="https://buteykoclinic.com/" target="_blank" rel="noopener">Dr. Buteyko's theory</a>. By breathing through the nose, the air is humidified and warmed. This decongests and protects the lung tissue. The nose cleans and disinfects the air, and the airflow reaches more parts of the lungs.

To breathe through your nose, the nose should be free - that's why this exercise is helpful.
Always&nbsp;breathe&nbsp;through your nose&nbsp;during this exercise! Repeat each step&nbsp;six times.&nbsp;
<ol>
<li>Slowly move your head backward and forward.</li>
<li>Inhale while moving backward, exhale while moving forward.&nbsp;</li>
<li>After a normal breath: pinch your nose, swing your head back and forward 3 times. Then breathe in and out slowly through your nose.</li>
<li>After a normal breath: pinch your nose and blow gently into it, but do not let the air escape. Then breathe in and out slowly through your nose.</li>
</ol>
Please read the detailed information and exercise instructions. (To come shortly)
Here you can find two videos explaining the Buteyko Breathing Method:&nbsp;<a href="https://www.youtube.com/watch?v=tgmKIwUqhkg" target="_blank" rel="noopener" data-anchor="?v=tgmKIwUqhkg">video 1 (by Buteyko Clinic International)</a>&nbsp;&nbsp;and&nbsp;<a href="https://www.youtube.com/watch?v=gY9JhCjvAeI" target="_blank" rel="noopener" data-anchor="?v=gY9JhCjvAeI">video 2 (by Dr. Mandell)</a>. &nbsp;

Exercise to unclog the nose

<div class="text">
The Wim Hof breathing training helps with lack of energy and shortness of breath. It strengthens the immune system and helps to deal more efficiently with the inhaled oxygen.
In addition, the alternation between activation and relaxation stimulates the entire nervous system - especially and sustainably the parasympathetic nervous system, that part of the vegetative nervous system that is responsible for rest and digestion. This in turn has a positive impact on our emotional state while supporting our immune system in maintaining or regaining a healthy balance.
As the name suggests, breathing training according to Wim Hof is training and therefore only shows an effect if it is used regularly.
</div>

<div class="col-12 col-md-4 offset-md-1">
<div class="text">
Please read Wim Hof's detailed exercise instructions and tips on breathing training in our <a href="https://adm.altea-network.com/assets/3b01e454-fe97-48f5-aa88-1479789ffee7?download" target="_blank" rel="noopener">Guidebook</a>.
Youtube breathing sessions led by Wim Hof:
<ul>
<li>In English for beginners: <a href="https://youtu.be/0BNejY1e9ik" target="_blank" rel="noopener">https://youtu.be/0BNejY1e9ik</a></li>
<li>In German for beginners:&nbsp;<a href="https://youtu.be/BckqffhrF1M" target="_blank" rel="noopener">https://youtu.be/BckqffhrF1M</a></li>
<li>Also popular: <a href="https://youtu.be/0q8SU_QyoIM" target="_blank" rel="noopener">https://youtu.be/0q8SU_QyoIM</a></li>
</ul>
</div>
</div>

Breath training according to Wim Hof

Since COVID-19 attacks the airways, shortness of breath and dyspnoea can occur during the acute infection, but also afterwards. Fear and feelings of suffocation or the limitation of physical performance can seriously affect everyday life.

Breathing

Since COVID-19 attacks the airways, shortness of breath and dyspnoea can occur during the acute infection, but also afterwards for people who are affected by Long COVID. Fear and feelings of suffocation or the limitation of physical performance can seriously affect everyday life.

Treatment of Long COVID symptoms: Breathing exercises | Altea

These exercises can help in case of Shortness of breath

<div class="text">
Law
Imagine the following scenario: you registered with the IV/AI office over a year ago but have not received anything yet. You have since lost your job, and your sick pay will be running out soon.
What can you do?
To move forward, the following action is advisable:
<ul>
<li>Request, in writing, all of the invalidity insurance files relating to your case, including any files that are "in progress" according to the IV/AI office.</li>
<li>Study the files to check what has been done and where the case stands.</li>
<li>If the rate of progress does not seem reasonable given the nature of the case, send a registered letter to the IV/AI office with the following content:
<ul>
<li>Set a deadline of 30 days.</li>
<li>Insist that a written decision is issued by a specified date (e.g. regarding occupational measures, daily benefits, medical clarification, or pension).</li>
<li>Explain that you will lodge a complaint of legal delay if the deadline is not met.</li>
</ul>
</li>
</ul>
This usually works. If the specified deadline is not met, no plausible timescale is provided for the next steps and a prompt decision is not expected, then you should consider a complaint of legal delay.
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Detailed information and application tips in our Vademecum <a title="Altea VM Law - Invalidity Insurance v1.0" href="https://adm.altea-network.com/assets/7a62b244-cda5-4a28-a4b3-7afff23c7577?download" target="_self">Management of the invalidity insurance (IV/AI)</a>.
&nbsp;
Altea blog 
<a title="69. IV-Verz&ouml;gerung" href="https://altea-network.com/en/blog/69-recht-iv-verzoegerung" target="_self">Speeding up the AI/IV process: How to insist on quick processing</a>
<a title="15. Krankentaggeld" href="https://altea-network.com/en/blog/15-krankentaggeld" target="_self">Who&rsquo;ll cover my loss of earnings if my insurer says I&rsquo;m healthy?</a>
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Other links
<a href="http://www.ahv-iv.ch/en/Home" target="_blank" rel="noopener">Information Centre OASI/DI&nbsp;</a>
<a href="http://www.covid-langzeitfolgen.ch/" target="_blank" rel="noopener">Verband Covid Langzeitfolgen</a> (Covid Long-Term Consequences Association, German Website)
</div>
</div>

Management of the invalidity insurance (IV/AI) 

Legal aspects are of primary importance when it comes to Long COVID: how to deal with insurance companies? How to receive daily sickness allowances? Are certificates of incapacity for work available? What role does a diagnosis play in these legal aspects?

Law | Altea Long COVID Network

Health insurance, IV/AI and other legal issues: here you find some answers!

Sleeping troubles
Sleep hygiene refers to all&nbsp;habits and circumstances&nbsp;that are conducive to healthy sleep. Consistently following a few simple rules often results in a significant&nbsp;improvement in sleep quality.
Sleep hygiene helps with&nbsp;problems falling asleep, i.e. if you need more than 30 minutes to fall asleep after going to bed, or with&nbsp;problems sleeping through the night, i.e. if you wake up regularly at night and then lie awake for a long time.
Healthy sleep&nbsp;strengthens the immune system and general well-being. The rules of sleep hygiene will help you to have a restful sleep and thus reduce your daytime tiredness and increase your mental and physical performance during the day.

Pay attention to the following four things:
<ol>
<li>Do not eat&nbsp;large meals&nbsp;3 hours before bedtime.</li>
<li>Stop drinking&nbsp;coffee or other beverages containing caffeine and tea&nbsp;4 to 8 hours before bedtime.</li>
<li>Stop drinking&nbsp;alcohol&nbsp;3 hours before bedtime.</li>
<li>Don't&nbsp;smoke&nbsp;after 7pm (or better yet, quit smoking altogether).</li>
</ol>
Please read the detailed information and application tips &nbsp;in our guide to Sleep Hygiene &ndash; Behavioral Factors.

Sleep Hygiene – Behavioral Factors

Sleeping troubles
The following tips may help if you have&nbsp;trouble falling asleep&nbsp;or&nbsp;staying asleep through the night:
<ul>
<li>Try to have&nbsp;regular times&nbsp;for&nbsp;getting up and going to bed.</li>
<li>Avoid excessive physical exertion&nbsp;after 6 p.m.</li>
<li>Create a&nbsp;transition period&nbsp;between daily life and bedtime (reference value: 2 hours).</li>
<li>Establish a&nbsp;bedtime ritual, that is, a series of regular actions performed in the same order.</li>
<li>Make your&nbsp;environment comfortable and conducive to sleep&nbsp;(temperature, light, noise).</li>
<li>Don't look at your watch&nbsp;at night,&nbsp;turn off your cell phone.</li>
<li>Do not spend more time in bed than you slept on average per night (reference value: 7-8 hours).</li>
<li>If you wake up at night,&nbsp;do not expose yourself to strong light.</li>
<li>Don't pressure yourself with the idea that you'll only be rested if you've slept through the night.</li>
<li>Keep a&nbsp;sleep diary.</li>
</ul>
Detailed information, application tips and a list of useful Websites, videos and other sources (e.g. sleep diaries) can be found in our Vademecum on <a title="Altea VM Sleep Hygiene Environmental Factors v2" href="https://adm.altea-network.com/assets/2cc0a063-0ec1-47e4-9944-e00a6268247d?download" target="_blank" rel="noopener">Sleep Hygiene - Environmental Factors</a> (in German, the English version will follow shortly).

Sleep Hygiene – Environmental Factors

Sleep disorders
Melatonin is a&nbsp;hormone naturally produced in the brain&nbsp;in response to darkness. It signals the body that it is&nbsp;time to sleep&nbsp;and thus regulates the sleep-wake cycles.
Taking melatonin can help&nbsp;regulate the sleep, and thus manage sleep disorders and improve sleep quality. Then the treatment&nbsp;should be gradually discontinued. Melatonin intake should be complemented by the&nbsp;sleep hygiene measures.
Before&nbsp;starting to take melatonin, it is important that a&nbsp;doctor assesses the sleep disorder(s). Indeed, while it is safe for medical use, it is important to understand what are exactly the troubles: falling asleep, sleeping through the night, or maybe there are other causes that provoke insomnia?

Melatonin intake

Due to Long COVID, both issues with falling asleep and staying asleep can occur. Those who lie awake before falling asleep or in the middle of the night are more likely to be physically and mentally tired during the day. This can also unbalance the sleeping / waking rhythm.

Sleep

Problems falling asleep and staying asleep through Long COVID | Altea

Difficulty falling asleep and sleeping through the night? Check these tips!