For people who suffer from chronic shortness of breath, the winter months are the most trying. Numerous research studies have shown that respiratory shortness of breath attacks, known as exacerbations, spike during the winter months, often leading to a higher number of emergency room visits and hospitalizations. This trend is most pronounced in northern geographic regions where the combination of colder temperatures and fewer hours of sunlight lead people to pursue an unhealthy mix of lifestyle behaviors.
The vicious cycle swirls like this:
1. Colder temperatures and fewer hours of sunlight lead to people spending more hours of each day indoors during the winter.
2. While indoors, people tend to be less physically active than when participating in outdoor activities. Lack of movement/activity weakens muscles and contributes to de-conditioning of cardiovascular function, especially in people who smoke or already have a respiratory condition.
3. Also, while indoors, people get less vitamin D from exposure to direct sunlight. Vitamin D deficiency is believed to be a leading cause of lung inflammation, along with other antioxidant deficiencies.
4. For those who smoke cigarettes, those exposed to second-hand smoke, and/or those who regularly use wood-burning heating sources, the toxic fumes from the smoke linger in the air longer indoors given that the confined space traps smoke versus dissipating more quickly in outdoor environments, meaning more of the dangerous chemicals are inhaled while indoors.
5. Further, bacteria and viruses most often thrive in warm, moist environments, and during winter months, the most attractive environments for them to survive are found indoors. Therefore, the more time spent indoors, the greater the exposure to bacteria and viruses that cause respiratory infections.
6. Episodes of depression are more pronounced during winter months due to prolonged confinement in indoor environments, lack of activity, and the persistent bleak, inhospitable outdoor environment. Depression can lead people to smoke more, eat more and drink more alcohol.
Now that we find ourselves in the dead of winter, what can you do to improve your chances of better breathing during the next few months?
1. Vitamin D
Increase your consumption of vitamin D through:
- Direct exposure to sunlight (20-30 minutes a day with multiple areas of your skin exposed and without applying sunscreen that blocks UVB rays)
- Foods fortified with vitamin D (cereals, breads and dairy products are good sources)
- Vitamin D dietary supplements
When it comes to dietary supplements, we recommend at least 2,000 IU for smokers and people with respiratory conditions, and look for it in the form of cholecalciferol. Vitamin D as a dietary supplement is inexpensive and widely available in retail stores and from online merchants.
While increasing your vitamin D consumption may sound too simple a solution for good respiratory health during the winter months, it is honestly one of the most valuable steps you can take. It helps protect your immune function and reduces airway inflammation — both valuable benefits for those with respiratory health concerns, especially during winter months.
Studies have shown that 20-30 minutes of cardiovascular exercise and 20-30 minutes of strength training exercise three to five days a week can reduce shortness of breath, improve physical strength/stamina, improve participation in other activities, and improve sense of well being, reduce shortness of breath exacerbations, and reduce hospitalizations related to respiratory health. Not only is exercise beneficial for good respiratory health and physical conditioning, it also has been shown in many studies to reduce feelings of depression.
If you don’t see yourself becoming a gym rat, consider a simple walking program of 30-60 minutes a day, three to five days a week. If you live in an area with snow and ice covered outdoor walkways, try walking at your local indoor mall or on a treadmill. If you live in an area where there isn’t a lot of snow or ice, it is ideal to walk outdoors to gain the additional benefit of exposure to direct sunlight. Whether indoors or outdoors, seek flat surfaces and walking courses/equipment with adequate handrail support if you suffer from poor balance. You might even consider Nordic Walking (walking with ski-pole-like devices).
Alternatively, consider joining a tai chi or yoga class. These mediation-based forms of exercise convey health benefits for people of all levels of physical conditioning, including those who suffer from chronic shortness of breath. If you’re stuck indoors all winter, these classes are also a great way to get out, move around and socialize with others. Many health clubs and community centers offer tai chi and yoga classes specifically designed for people with limited mobility or other health conditions.
If you can’t or don’t want to attend a center-based tai chi or yoga class, consider buying a tai chi or yoga DVD to use at home. These videos offer step-by-step instructions, and many are geared toward people with limited mobility or other health conditions.
3. Delay Your First Cigarette of the Day
While the value of smoking cessation during winter months is particularly high given the increased exposure to smoke in confined indoor spaces, we understand the prospect of quitting may feel like too much of a challenge for some. For those who can’t or won’t stop smoking, consider delaying your first cigarette of the day for 30-60 minutes after you wake. Research studies have shown that smokers who light up their first cigarette within the first five minutes of waking have the highest level of depression among all smokers, while those who delay for at least 30 minutes after waking have the lowest depression among smokers.
4. Consider Electric or Natural Gas Heat
If your primary heating and/or cooking source is a wood-burning stove or fireplace, seriously consider replacing these options with electric or natural gas burning devices. Previous studies have shown that regular exposure to wood smoke can be as detrimental to respiratory health as cigarette smoke, and if you are exposed regularly to both, your chances of serious respiratory health issues are dramatically increased.
In our opinion, you can significantly improve your chances of better breathing during the winter season by following the above steps. The combination of increased vitamin D consumption, regular exercise/physical activity, and reduced exposure to cigarette and wood smoke can make a world of difference for anyone who suffers from chronic shortness of breath.