The column is written by Dr. Chandrakant Lahariya (MBBS, MD), a Physician-Epidemiologist and a leading expert on COVID-19 disease and vaccines. In this fortnightly column, Dr. Lahariya picks up various topics and gives you tailored solutions, catering to the health needs of your entire family — kids, adolescents, adults, and senior citizens, and all the other members.
In today’s column, Dr Lahariya discusses how our lifestyle choices like drinking, smoking and sleeping patterns, in fact, our COVID-19 recovery.
How have people’s sleeping patterns been affected due to long COVID?
A few reports and studies have indicated that the sleeping pattern of people affected with COVID-19 has changed. If we look at the evidence, we notice a whole range of sleep-related issues. Some people are sleeping more than earlier, and specialists in sleep disorders have termed this as ‘COVID-somnia’, and there are others who face difficulty in sleeping (insomnia) or altered sleep cycles.
Those suffering from the post or long COVID symptoms have also reported insomnia, night sweats, and other problems. From insomnia to hyper-somnia (excessive sleep), night terrors, to the misuse of sleep medications, the phenomenon is being reported and treated not only in people recovering from COVID-19 but also among others during this pandemic.
People who are facing such issue could be those who may never have got COVID-19. This is because in pandemic period, it has affected individual’s mental health and that’s why people have sleep and related challenges. We also need to remember that every disease condition or ill health has not merely physical but also mental health effects. This is a reminder for everyone to pay attention to physical as well as mental health aspects.
Has the pandemic resulted in increased addiction to medical pills?
From India, fortunately, there are not such reports. However, in some countries, epidemiologists and researchers have observed increases in substance use and drug overdoses since the COVID-19. However, it is also the time when government start paying closer attention to these aspects.
How does alcohol affect people recovering from COVID?
Alcohol misuse can affect our bodies in multiple ways. It can up-regulate or extra-activate the immune system, cause inflammation, interfere and reduce the body’s immune response the down-regulation it. Both of which are not good. We know so many harmful effects of alcohol consumptio on heart and lungs and nearly all organs of our body. The excessive alcohol use can damage epithelial cells that line the lung surface and is associated with acute respiratory distress syndrome. Ultimately, impaired immune system function and increased susceptibility to respiratory illness could contribute to more severe COVID-19 and a greater risk of mortality. In addition to the physical effect of alcohol misuse, we need to remember that COVID-19 recovery requires good mental health and ending up with any harmful use of alcohol is not the way to cope. Everyone need to pay attention and control the drinking habits.
Does a sedentary lifestyle play a part in delaying COVID recovery?
Even without the COVID-19 pandemic, the sedentary lifestyle is the risk factors for many health conditions. Now, sedentary lifestyle results in comorbiidties which results in poor outcomes of SARS CoV2 infection. As a risk factor for COVID-19 severe disease, physical inactivity was surpassed only by advanced age and a history of organ transplant. We all have to adopt four healthy behaviours: regular psychical activity, a healthy diet, stop smoking and avoid harmful alcohol use. We can assume these four risk factors for cardiovascular diseases; we reduce our risk of heart attack and other related illnesses. COVID-19 pandemic is our opportunity to recommit to a healthier lifestyle. Regular physical activity is zero cost health intervention. Every age group can start on this in variable time of the day or week. What is more important to get started on regular physical activity. Do today, more than yesterday and tomorrow more than today, that has to be approach.
Is excess screen time harmful during the COVID recovery process?
Increased screen time among young adults during the COVID-19 pandemic correlates with a rise in pandemic-related distress. In addition, increased digital screen time and limited outdoor activities are associated with the onset and progression of poor eyesight. Thus, they could potentially be aggravated during and beyond the COVID-19 pandemic outbreak period.
The WHO highlighted that increased screen time replaces healthy behaviours and habits like physical activity and sleep routine and leads to potentially harmful effects such as reduced sleep or day-night reversal, headaches, neck pain, myopia, digital eye syndrome and cardiovascular risk factors such as obesity, high blood pressure, and insulin resistance due to increase in sedentary time among adults. In addition, increased evening screen time during the COVID-19 pandemic negatively affects the sleep quality of people.
On screen time, we need to pay specific attention about children. Very young children should not have any screen time. The children in pre-school and primary schools are allowed very limited screen time. However, the online classes have increased the exposure. The parents need to pay attention to their screen time and in order to reduce their screen time, may have to manage screen time of adults in the family.
Should someone quit smoking during their COVID recovery?
COVID-19 or not, smoking is harmful, and everyone should quit smoking. There is plenty of scientific evidence that has pointed the mechanisms by which smoking causes harm. People who smoke have twice as many complications after surgery as those who do not. People who smoke also have far worse problems with wound healing, infection, blood clots, fractures joining and chronic pain. Smoking compromises the immune system, which is associated with an increased risk for pulmonary diseases. Finally, smoking causes harm to the lungs, leaving lung tissue inflamed, fragile, and more susceptible to infection.
Then, in the context of COVID-19 outcomes, the studies from China show smokers admitted to hospital with COVID-19 were three times more likely to be admitted to intensive care or to die than non-smokers. From the US, smokers admitted to hospitals were twice as likely to die. In addition, a recent study published by the New England Journal of Medicine found that people who smoke were 2.4 times more likely to have severe symptoms from COVID-19 than those who did not smoke.
Can excess drinking caffeine affect recovery?
Drinking large amounts of coffee, tea, and even caffeinated soft drinks and energy drinks has known harmful effects. These may lead to dehydration and can negatively impact sleeping patterns. Too much caffeine (which is present in tea as well and not just in coffee) have Short-term effects such as Anxiety, Tremors, Palpitations, Diarrhoea, Headaches, Indigestion, Sleep issues, as well as Long-term effects in the form of Insomnia, Acid reflux, migraine triggers, Anxiety, Irritable bowel syndrome (IBS) and Hypertension. This is not the complete list. A good approach can be that any should avoid to have tea or coffee after 6 pm, and that could be a good rule of thumb, if not a hard rule.
How does sugar or sugary drinks affect people’s body during recovery?
Sugary drinks such as soda, packaged fruit juices, fruit juice concentrates and syrups, flavoured milk and yoghurt drinks are harmful to the body as these are not a balanced diet. Studies have noted that most Indian snacks, be it sweet or salty, are in range of being very unhealthy. The excessive consumption of free sugars and carbohydrates is very harmful. The excess sugar in our blood affects immune cells and weaken the immune system. It is a fertile ground for the growth of bacteria and viruses, which also love such high sugar levels in our blood. Having an excessive amount of sugar, especially refined sugars like high-fructose corn syrup, can damage the body in the form of insulin resistance. This condition sticks the immune system in a vicious circle as the body has to produce more and more insulin to help it reach the cells. Therefore, it is important not to consume nutritionally obsolete sugary items. Drinking water instead of sugar-sweetened beverages is a simple way to limit the intake of sugar and excess calories; however, that is easier said than done. Therefore, a determined effort and commitment to slowly reduce sugar consumption is required, and it is doable. Take a pledge today and you will make a good beginning.