Nakayama was born on November 23, 1931, on Piserach Island, part of Nomwunweito Atoll in what is now Chuuk State.

In May 1979, statehood was declared for Yap, Chuuk, Pohnpei, and Kosrae as the Federated State of Micronesia, and an elected Congress was seated.

He oversaw the orderly transfer of governmental functions from the United States of America from 1979 to 1986 and served on until 1987, his maximum constitutionally allowable term.

In the summer of 2005, he underwent surgery for a pacemaker in order to stimulate his weak heart.

Three days after that surgery he had an additional stroke that left him paralyzed and unable to speak though he was completely cognizant.