Voices and Choices, Chesham Bucks.

Winter Healthcare

(Produced for Voices & Choices, October 2017)

We all know that it’s harder to stay healthy in winter; colds and flu are far more common than at other times of the year and many other health conditions are worsened or exacerbated by cold weather. Winter can also bring practical and psychological challenges which can contribute to ill health at this time of year. In this article we pull together practical information on some of the most common cold weather ailments and give some general advice on ways to keep active and healthy during winter. We cover:

  • Ten of the most common winter illnesses – how to help avoid these and treat them
  • How to avoid tiredness
  • Tips for keeping yourself and your home warm
  • Keeping a well-stocked medicine cabinet
  • Some practical tips for being best prepared for winter

Top 10 Winter Illnesses

1. Flu

Flu can be a major killer of vulnerable people; people aged 65 and over and people with long-term health conditions such as diabetes, kidney disease and chronic obstructive pulmonary disease (COPD) are particularly at risk of developing serious complications of flu such as pneumonia.

The best way to prevent getting flu is to have the flu jab which gives good protection against flu and lasts for one year. The injected flu vaccine is offered free on the NHS annually to people aged 65 or over and other high risk groups. Additionally, these groups are also eligible for the pneumococcal vaccine, which provides protection against pneumonia.

Flu symptoms are similar to cold symptoms but one key difference is the speed of onset of symptoms which, with flu, come on very quickly. Symptoms are also likely to be more severe and can include a sudden fever (a temperature of 38C or above), aching body, feeling tired or exhausted, difficulty sleeping, loss of appetite, diarrhoea or tummy pain, nausea and vomiting in addition to typical cold symptoms such as sore throat, cough and headache.

If you suspect you have flu, NHS advice is to see your GP if you are aged over 65 or in a high risk group. Like colds, there is no cure for the flu virus but to help you get better more quickly:

  • rest and sleep
  • keep warm
  • take paracetamol or ibuprofen to lower your temperature and treat aches and pains
  • drink plenty of water to avoid dehydration (your pee should be light yellow or clear)

Antibiotics won’t treat the flu virus itself, although they may be prescribed if you are diagnosed with a secondary infection such as an upper respiratory tract infection or pneumonia.

2. Colds

Nearly everybody catches cold sometimes but you can significantly reduce the risk by washing your hands regularly and trying to avoid touching your nose and eyes. When an infected person coughs or sneezes, they release droplets of mucus into the air, or into their hand if they use their hand to cover their mouth. If you get these droplets on your hand (for example, by shaking hands or touching contaminated objects such as doorknobs and light switches), you can pass them into your eyes or nose when you touch them. Most of us touch our eyes and nose more often than we realise. Cold viruses travel easily from the eye to the nose and throat, where they can cause infection. Thorough and frequent hand washing destroys bugs that you may have picked up from touching surfaces used by other people.

Read this guide from NHS Choices on how to wash your hands properly.

It’s also important to keep the house and any household items such as cups, glasses and towels clean, especially if someone in your house is ill. 

Top tip: If you get a cold, use disposable tissues instead of fabric handkerchiefs to avoid constantly reinfecting your own hands.

Colds are caused by viruses and cannot be cured by antibiotics. In fact, there’s no cure for a cold, but you can look after yourself at home by:

  • resting, drinking plenty of fluids and eating healthily
  • taking over-the-counter painkillers, such as paracetamol or ibuprofen, to reduce any fever or discomfort
  • using decongestant sprays or tablets to relieve a blocked nose
  • trying remedies such as gargling salt water and sucking on menthol sweets

Many painkillers and decongestants are available from pharmacies without a prescription. They’re generally safe but might not be suitable for people with certain underlying health conditions, and those taking certain other medications. Speak to a pharmacist if you’re unsure.

You only really need to contact your GP for a cold if:

  • your symptoms persist for more than three weeks
  • your symptoms get suddenly worse
  • you have breathing difficulties
  • you develop complications of a cold, such as chest pain or coughing up bloodstained mucus

3. Sore Throat

A sore throat is most often one of the symptoms of a general cold or flu virus and therefore prevention of winter sore throats is more likely if you follow the good hygiene advice described above for colds. There are also several other common conditions resulting in a sore throat which arise mainly in winter and are caused by other types of viral or bacterial infections:

  • laryngitis (inflammation of the voice box) – you may also have a hoarse voice, a dry cough and a constant need to clear your throat
  • tonsillitis (inflammation of the tonsils) – you may also have red or spotty tonsils, discomfort when swallowing and a fever
  • strep throat (a bacterial throat infection) – you may also have swollen glands in your neck, discomfort when swallowing and tonsillitis

Sore throats can be caused by factors other than infection eg:

  • Irritation – during cold weather, the dry heat indoors can cause a sore throat, especially in the morning. Also, being around smoke, drinking alcoholic beverages and eating spicy foods can cause a sore throat. Straining or misusing your voice (as in yelling at a ball game) can also cause a sore throat.
  • Allergies – just as pollen, dust and pet dander can irritate the nasal passages, they can also irritate the throat of someone who is allergic to such things.
  • Reflux – people who suffer from reflux, either on an occasional or chronic basis, will awaken some mornings with a sore throat due to the regurgitation of stomach acids into the back of the throat overnight.

Like colds and flu, sore throats will rarely be treated with antibiotics – these will only be given in cases of severe bacterial infection. Treatment and advice for most sore throats is to:

  • take ibuprofen or paracetamol
  • drink plenty of cool or warm fluids, and avoid very hot drinks
  • eat cool, soft foods
  • avoid smoking and smoky places
  • try gargling with a homemade mouthwash of warm, salty water
  • suck lozenges, hard sweets, ice cubes or ice lollies

There are also products such as medicated lozenges and sprays sold in pharmacies that you may want to try. There isn’t much scientific evidence to suggest they help, although some people find them worth using.

Top tip: One quick and easy remedy for a sore throat is to gargle with warm salty water. Dissolve one teaspoon of salt in a glass of part-cooled boiled water. It won’t heal the infection, but it has anti-inflammatory properties and can have a soothing effect.

You don’t usually need to get medical advice if you have a sore throat but it’s a good idea to contact your GP or NHS 111 if:

  • your symptoms are severe
  • you have persistent symptoms that haven’t started to improve after a week
  • you experience severe sore throats frequently
  • you have a weak immune system – for example, you have HIV, are having chemotherapy, or are taking medication that suppresses your immune system

Very rarely, a sore throat can be a sign of a serious problem. Visit your nearest accident and emergency (A&E) department or call 999 for an ambulance immediately if:

  • your symptoms are severe or getting worse quickly
  • you have difficulty breathing
  • you’re making a high-pitched sound as you breathe (called stridor)
  • you have difficulty swallowing
  • you start drooling

4. Asthma

People with asthma have airways that are very sensitive and should be especially careful in winter. Cold or damp air can enter the airways and trigger them to go into spasm, causing asthma symptoms, such as coughing, wheezing, shortness of breath and tightness in the chest; and winter can be a difficult time for people with asthma for other reasons too. It’s near-impossible to avoid the cold and flu viruses that many people say make their asthma symptoms worse.

During cold, damp weather there are also more mould spores in the air, which can trigger asthma symptoms.

How can you reduce winter’s effect on your asthma?

Asthma UK advises that the best way to avoid a change in weather triggering asthma symptoms is to manage your asthma well:

  • Take your medication exactly as prescribed and discussed with your GP or asthma nurse.
  • Check with your GP or asthma nurse that you’re using your inhaler(s) correctly.
  • Use a written asthma action plan and keep it where you can see it (on the fridge, for example). You can also take a photo of it on your phone so you can refer to it whenever you need it.
  • Go for regular asthma reviews.
  • Keep an eye on the weather forecast!

You can also try these practical tips:

  • Carry your reliever inhaler with you at all times and keep taking your regular preventer inhaler as prescribed by your doctor.
  • If you need to use your inhaler more often than usual, or use more puffs, speak to your doctor about reviewing your medication.
  • Keep warm and dry – wear gloves, a scarf and a hat, and carry an umbrella.
  • If sudden changes in temperature – like stepping from a warm house onto a cold street – trigger your symptoms, try wrapping a scarf loosely over your nose and mouth before you go out. This will help to warm up the air before you breathe it in.
  • Try breathing in through your nose instead of your mouth, as your nose is designed to warm the air as you breathe it in.

5. Norovirus

Norovirus, which causes diarrhoea and vomiting, is one of the most common stomach bugs in the UK. It’s also called the “winter vomiting bug” because it’s more common in winter, although you can catch it at any time of the year. Norovirus can be very unpleasant but it usually clears up by itself in a few days and you can normally look after yourself at home. Try to avoid going to your GP, as norovirus can spread to others very easily. Call your GP or NHS 111 if you’re concerned or need any advice.

Symptoms of norovirus:

  • Suddenly feeling sick
  • Projectile vomiting
  • Watery diarrhoea

Some people also have a slight fever, headaches, painful stomach cramps and aching limbs. The symptoms appear one to two days after you become infected and typically last for up to two or three days.

What to do if you have norovirus

If you experience sudden diarrhoea and vomiting, the best thing to do is to stay at home until you’re feeling better. There’s no cure for norovirus, so you have to let it run its course. Antibiotics will not help as this is not a bacterial infection. You don’t usually need to get medical advice unless there’s a risk of a more serious problem. However, do seek medical advice if:

  • you have symptoms of severe dehydration, such as persistent dizziness, only passing small amounts of urine or no urine at all, or reduced consciousness – elderly people have a greater risk of becoming dehydrated
  • you have bloody diarrhoea
  • your symptoms haven’t started to improve after a few days
  • you have a serious underlying condition, such as kidney disease, and have diarrhoea and vomiting

To help ease your symptoms:

  • Drink plenty of fluids to avoid dehydration. You need to drink more than usual to replace the fluids lost from vomiting and diarrhoea – as well as water, you could also try fruit juice and soup.
  • Take paracetamol for any fever or aches and pains.
  • Get plenty of rest.
  • If you feel like eating, eat plain foods, such as soup, rice, pasta and bread.
  • Use special rehydration drinks made from sachets bought from pharmacies if you have signs of dehydration, such as a dry mouth or dark urine.
  • You can take anti-diarrhoeal and/or anti-emetic (anti-vomiting) medication – these are not suitable for everyone though, so you should check the medicine leaflet or ask or your pharmacist or GP for advice before trying them.

How is norovirus spread?

Norovirus spreads very easily in public places such as hospitals, nursing homes and schools. You can catch it if small particles of vomit or poo from an infected person get into your mouth, such as through:

  • close contact with someone with norovirus – they may breathe out small particles containing the virus that you could inhale
  • touching contaminated surfaces or objects– the virus can survive outside the body for several days
  • eating contaminated food – this can happen if an infected person doesn’t wash their hands before handling food

A person with norovirus is most infectious from when their symptoms start until 48 hours after all their symptoms have passed, although they may also be infectious for a short time before and after this. You can get norovirus more than once because the virus is always changing, so your body is unable to build up long-term resistance to it.

Preventing norovirus

It’s not always possible to avoid getting norovirus, but following the advice below can help stop the virus spreading.

  • Stay at home if possible until at least 48 hours after the symptoms have passedYou should avoid visiting anyone in hospital during this time.
  • Wash your hands frequently and thoroughly with soap and water, particularly after using the toilet and before preparing food. Don’t rely on alcohol hand gels, as they do not kill the virus.
  • Disinfect any surfaces or objects that could be contaminated. It’s best to use a bleach-based household cleaner.
  • Wash any items of clothing or bedding that could have become contaminated separately on a hot wash to ensure the virus is killed.
  • Don’t share towels and flannels.
  • Flush away any infected poo or vomit in the toilet and clean the surrounding area.
  • Avoid eating raw, unwashed produce and only eat oysters from a reliable source, as oysters can carry norovirus.

6. Painful Joints

There’s no evidence that changes in the weather cause joint damage but if you suffer from arthritis you may find that your joints become more painful and stiff in winter. It is not entirely clear why this is the case because the scientific evidence is conflicting: some studies find a strong relationship between short, cold, damp days and arthritis flare-ups whilst other studies have found little or no link between weather and joint pain. Increasing joint pain in cold weather could be due to changes in joint fluid thickness or could simply be the result of the ‘winter blues’ – many people get a little depressed during the winter months, and this can make them perceive pain more acutely. Everything feels worse, including medical conditions.

Whether the joint pain/weather connection is scientifically true or not, you can still use these arthritis pain-relief tips when your aching joints act up in winter:

  • Dress Warmly – if it’s cold outside, keep aching hands warm with gloves, and add extra layers over knees and legs.
  • Hydrate – staying hydrated helps you stay active. Even mild dehydration might make you more sensitive to pain, according to study results published in the September 2015 issue of Experimental Physiology.
  • Exercise – a 2013 article in The Journal of the American Medical Association (JAMA) highlighted the significant improvement people with knee arthritis can get from weight loss, from diet and from exercise. While it’s understandable to want to avoid winter chill, people with joint pain should still stay active. The less sedentary you are, the better your physical function, according to a study of people with knee arthritis published in Arthritis Care & Research (ACR) in March 2015. Consider an indoor exercise plan if outdoor exercise is not feasible.
  • Warm waterswimming in a heated pool is both great exercise and soothing to joints. You can also get relief from warm baths, according to the Arthritis Foundation. Just don’t go straight out into the cold after your soak. Let your body temperature normalize a bit first.
  • Vitamin D supplements – low levels of vitamin D might play a role in how sensitive you are to arthritis pain, according to research in the September 2015 issue of Pain Management. Being deficient in vitamin D also raises the risk for osteoporosis. You’re less likely to get enough vitamin D from its natural source, sunlight, in the winter, so talk to your doctor about your need for supplements or vitamin D-fortified foods.
  • Guard against falls – walking on icy surfaces significantly increases the risk of a fall; people with arthritis need to protect their joints from further damage. If you’re going outside, pick solid, supportive shoes with good treads and try to walk on a surface that doesn’t look slick.
  • Try fish oil – Omega-3 fatty acids seem to reduce the level of inflammation. The Arthritis Foundation recommends up to 2.6 grams of fish oil capsules twice a day. Make sure to let your doctor know if you try omega-3s, as they can increase the risk of bruising or bleeding.
  • Consider over-the-counter pain medications – you may want to take an over-the-counter pain reliever when your joint pain seems to worsen with the weather. The ACR guidelines include a recommendation to use these over-the-counter pain relievers for osteoarthritis. Always check with your doctor first to make sure it is safe for you to take.
  • Get a massage  although pain is emanating from the joint, some of the pain is also emanating from the muscles around the joint. Getting an hour-long massage once a week for at least eight weeks was shown to reduce pain, according to research in the June 2015 issue of The Journal of Alternative and Complementary Medicine.
  • Acupuncture  this is another option for those willing to consider non-traditional treatments. It does seem patients derive some benefit with regard to pain. You also might find the process relaxing and feel generally healthier, according to research in the August 2015 issue of The Journal of Alternative and Complementary Medicine.

7. Cold Sores

Cold sores are small blisters that develop on the lips or around the mouth and are caused by the herpes simplex (HSV-1) virus. Winter is the primary season for cold sores as this is when the HSV-1 virus responsible for the sores tends to be re-activated. This is the case for several reasons:

  • Exposure to cold temperatures as well as drastic temperature shifts, like moving from the cold outdoors into a warm house, can be traumatic enough to trigger a cold sore outbreak.
  • Harsh, winter winds can dry out the lips and make them more hospitable to the virus
  • Dry, warm air in heated homes can encourage the virus to spread and break out more often.
  • Less vitamin D in the body and an immune system weakened by winter can increase a person’s risk of developing a cold sore.
  • llnesses, such as colds, flu and bacterial infections, that seem to pop up when the weather is cold can also trigger cold sores. When the body is busy fighting one invader, it is more vulnerable from attacks by other bacteria and viruses.
  • Inflammation in the body, like that which accompanies chronic arthritis, may overproduce the stress hormone cortisol. Cortisol can suppress the immune system and trigger a cold sore attack.

Cold sores usually clear up without treatment within 7 to 10 days. However, antiviral creams are available over the counter from pharmacies without a prescription. If used correctly, these can help ease your symptoms and speed up the healing time. To be effective, these treatments should be applied as soon as the first signs of a cold sore appear – when you feel a tingling, itching or burning sensation around your mouth. Using an antiviral cream after this initial period is unlikely to have much of an effect. Cold sore patches are also available that contain hydrocolloid gel, which is an effective treatment for skin wounds. The patch is placed over the cold sore while it heals.

Once the HSV-1 virus has become active in the body, in most people it tends to recur periodically. While there is no cure, there are ways to minimize cold sore outbreaks. Here are some top winter tips to help avoid painful and embarrassing cold sores:

  • Avoid Stress – particularly in the run-up to Christmas. This can be a time of high stress and you are more likely to have a flare-up if you are stressing over Christmas shopping, cooking, wrapping gifts, visiting relatives etc. If you’ve had a cold sore before, try to take it easy. Try to simplify your Christmas preparations eg by shopping online and make sure you get plenty of sleep; the reduced stress could help you stave off a breakout.
  • Keep Your Lips Moisturised – winter is tough on the lips. The winter season requires a jacket, hat and gloves. If you’re going to protect the rest of your body from the cold, make sure you protect your lips from getting chapped, too! Protect your face and mouth with lip balm, moisturiser and a scarf.
  • Wash Your Hands – in the same way that frequent and rigorous hand washing can help prevent cold and flu viruses, this is also the case with the cold sore virus. In addition to regular hand washing when you are at home, you should wash your hands as often as possible when you travel, as aeroplanes, airports and other forms of public transportation are breeding grounds for germs. If you develop a cold or the flu, you’re more likely to develop a cold sore, so wash your hands often!
  • Take Action Immediately – if you’ve had a cold sore before, you know the symptoms that you feel before one appears on your face. If you’ve never had one before, look out for a tingling or burning sensation around your lips or on your gums. As soon as you feel these symptoms, use an anti-viral cold sore cream which can be purchased easily without prescription from any pharmacy.

8. Heart Attacks

A heart attack (myocardial infarction or MI) is a serious medical emergency in which the supply of blood to the heart is suddenly blocked, usually by a blood clot. Heart attacks are more common in winter. This may be because cold weather increases blood pressure and puts more strain on the heart. Your heart also has to work harder to maintain body heat when it’s cold. Therefore, it is important to stay warm in your home. Heat the main rooms you use to at least 18C and use a hot water bottle or electric blanket to keep warm in bed. Wrap up warm when you go out and wear a hat, scarf and gloves.

Symptoms of a heart attack can include:

  • chest pain –the chest can feel like it’s being pressed or squeezed by a heavy object, and pain can radiate from the chest to the jaw, neck, arms and back
  • shortness of breath
  • feeling weak and/or lightheaded
  • overwhelming feeling of anxiety

It’s important to stress that not everyone experiences severe chest pain; the pain can often be mild and mistaken for indigestion. It’s the combination of symptoms that’s important in determining whether a person is having a heart attack, and not the severity of chest pain.

Dial 999 and ask for an ambulance if you suspect a heart attack.

While waiting for an ambulance, it may help to chew and then swallow a tablet of aspirin (ideally 300mg) – as long as the person having a heart attack isn’t allergic to aspirin.

9. Cold Hands and Feet

   Raynaud’s phenomenon is a common condition that makes your fingers and toes change colour and become very painful in cold weather. Fingers can go white, then blue, then red, and throb and tingle. The small blood vessels of the hands and feet go into spasm, temporarily reducing blood flow to your hands and feet. You may also experience numbness, pain, and pins and needles. Reynaud’s syndrome is usually triggered in winter as symptoms are induced by cold temperatures although sometimes stress can also trigger symptoms.

Symptoms of Raynaud’s can last from a few minutes to several hours. It’s not a serious threat to your health, but can be annoying to live with, because it can be difficult to use your fingers.  Other parts of the body that can be affected by Raynaud’s include the ears, nose, nipples and lips. In severe cases, a medication called nifedipine can help, but most people manage to live with their symptoms.

In many cases, it may be possible to control the symptoms of Raynaud’s yourself by avoiding the cold, wearing warm gloves and socks when going out in cold weather and using relaxation techniques when feeling stressed. Stopping smoking can also improve symptoms, as smoking can affect your circulation.

10. Dry Skin

Dry skin is a common condition and is often worse during the winter, when environmental humidity is low. When the air outside is cold and dry, the water in your skin evaporates more quickly; this makes your skin feel dry and tight, and makes it look flaky. Also, if you suffer from eczema (also known as atopic dermatitis) symptoms typically get worse during the cold months and can lead to itchy, dry skin.

To reduce chapping, redness, itching, and keep skin more healthy and comfortable this season, try these tips:

  • Wash in lukewarm water – hot showers and baths always feel good in the winter, but when you can, particularly when just washing your face or hands, choose lukewarm water to avoid stripping so many oils away from the skin.
  • Moisturise immediately afterwards – your skin not only needs more moisture, but moisture right after you wash. Applying moisturiser to damp skin helps seal that dampness into the skin. Keep a bottle near the bath, shower cubicle, and at every sink and use liberally every time you wash.
  • Choose moisturiser carefully – some over-the-counter moisturisers have petroleum-based ingredients that can actually further dry your skin in the winter months. Be sure to choose a smart formula that has natural, nourishing ingredients. Go for an oil-based rather than a water-based solution, as it’s more likely to help your skin retain moisture in the winter.
  • Protect – get used to wearing gloves and scarves to protect skin from cold winds, rain and snow. Also, winter sun can be just as damaging as summer sun, so apply a sun screen to your face when you go out.
  • Humidify – heating systems dry out the air, so consider installing a humidifier in your home, particularly in your bedroom, to put moisture back into the air and help prevent your skin from drying out.
  • Drink – we tend to drink less water in the winter because we turn to hot drinks like cocoa and tea, but don’t forget that your skin needs hydration from the inside, out. A little warm water with lemon can be very refreshing and hydrating at the same time.
  • Overnight moisturise – dryer areas like hands, feet, elbows, and knees have thin skin and tend to lose moisture faster than other areas on the body. Consider slathering on a deep moisturising balm at night, then wear cotton gloves and socks to seal in the moisture until morning.
  • Exfoliate – we often forget to help the skin slough off dead cells in the winter, particularly on our hands. Yet moisture can’t get in if the dead cells are too plentiful. Find an exfoliating mask and use it on your face and your hands, as well as gently on your lips, then follow immediately with moisturiser to truly see a smoother difference. Exfoliating body washes are also helpful in the winter months.
  • Avoid toxins, specifically allergens and irritants – particularly if you have eczema, dermatitis, or psoriasis, you have to avoid allergens and irritants that may trigger a flare up. Winter skin is more fragile, so avoid irritating fabrics (like wool) and chemical-laden detergents, and use mild cleansers and moisturisers designed for sensitive skin.
  • Hydrate from the inside out – eating foods high in water content can help hydrate your skin from the inside out. Try watermelon, cantaloupe, apples, oranges, kiwi, and watery veggies like celery, tomatoes, cucumbers, courgettes and carrots. Make sure you’re getting enough vitamin C and zinc to support the healthy production of collagen and elastin. Also consider an omega-3 supplement, or consume more fatty fish and flaxseed to give your skin the building blocks it needs to appear supple and smooth.
  • Change your cleanser – cleansers can be extremely drying to the skin. If you’re used to using options that contain glycolic or salicylic acid, rotate with a more hydrating version that contains moisturising ingredients. After cleansing, don’t leave the skin naked for more than 30 seconds, as this can dehydrate it, leading to increased dryness. Apply a hydrating toner and moisturiser to seal in moisture.
  • Use DIY masks – homemade hydrating masks can provide needed moisture in the winter months. Use natural moisturising ingredients like honey, avocado, yogurt, olive and jojoba oils, almond oil, bananas and aloe. Mix what you like together to create a cream or paste, and leave on the skin for 10-30 minutes for lasting hydration.

General Tips for keeping well in winter

1.   Banish winter tiredness

Many people feel tired and sluggish during winter. This is due to the lack of sunlight, which disrupts our sleep and waking cycles.

Here are five energy-giving solutions that may help – and some conditions that can sometimes be the cause:

  • Let in some sunlight – as the days become shorter, the lack of sunlight means your brain produces more of a hormone called melatonin, which makes you sleepy. Open your blinds or curtains as soon as you get up to let more sunlight into your home, and get outdoors in natural daylight as much as possible. Try to take even just a brief daily walk, and make sure your work and home environments are as light and airy as possible.
  • Get a good night’s sleep – getting enough undisturbed sleep is vital for fighting off winter tiredness. It’s tempting to go into hibernation mode when winter hits, but that sleepy feeling you get doesn’t mean you should snooze for longer. In fact, if you sleep too much, chances are you’ll feel even more sluggish during the day. We don’t actually require any more sleep in winter than we do in summer – aim for about eight hours of shut-eye a night, and try to go to bed and get up at the same time every day. Make sure your bedroom helps you feel relaxed and sleepy: clear the clutter, have comfortable and warm bedding and turn off the TV.
  • Get regular exercise – exercise may be the last thing you want to do when you’re feeling tired on dark winter evenings. But you might be surprised by how energetic you feel after getting involved in some kind of physical activity every day.  Exercise in the late afternoon may help to reduce early-evening fatigue and also improve your sleep. Try to reach the recommended goal of 150 minutes of exercise a week. Winter is a great time to experiment with new and different kinds of activity. If you find it hard to get motivated to exercise in the colder, darker months, focus on the positives – you not only will feel more energetic but might also stave off winter weight gain.
  • Learn to relax – are you feeling pressured to get everything done during the shorter daylight hours? If so, it may be contributing to your tiredness – stress has been shown to make you feel fatigued. There’s no quick-fire cure for stress, but there are some simple things you can do to help to reduce it. Many people find adding meditation, yoga, breathing exercises or mindfulness techniques into their day helps them to calm down and feel more relaxed.
  • Eat the right food – being overweight or underweight can affect your energy levels and leave you feeling sleepy, so it’s important to make sure you eat a healthy, balanced diet. Once the summer ends, there’s a temptation to ditch the salads and fill up on starchy foods such as pasta, potatoes and bread. However, you’ll have more energy if you include plenty of fruit and vegetables in your meals. Winter vegetables – such as carrots, parsnips, swede and turnips – can be roasted, mashed or made into soup to provide a warming winter meal; and classic stews and casseroles are great options if they’re made with lean meat or pulses, and plenty of veg. You may find your sweet tooth going into overdrive in the winter months, but try to avoid foods containing lots of sugar. They may give you a rush of energy, but it’s one that wears off quickly.

While it’s normal for all of us to slow down over winter, there are some medical conditions that could be causing your tiredness. Sometimes a lack of energy and enthusiasm (lethargy) can be a sign of winter depression. Known medically as seasonal affective disorder (SAD), it affects around 1 in 15 people, but it can be treated. Your tiredness might also be linked to a condition like anaemia, or a long-term infection that your body is trying to clear. If your tiredness is stopping you from going about your normal life, or goes on for a long time, you should talk to your GP.

2.   Keep Warm

  • Wear several layers of clothes rather than one chunky layer – clothes made from cotton, wool or fleecy fibres help to maintain body heat.
  • Use a hot water bottle or electric blanket to keep warm in bed – but don’t use both at the same time.
  • Have at least one hot meal a day – eating regularly helps keep you warm; and make sure you have hot drinks regularly.
  • Try not to sit still for more than an hour or so indoors – get up and stretch your legs.
  • Stay active – even moderate exercise can help keep you warm.
  • Wrap a scarf loosely around your mouth when outdoors – add a hat and wear shoes with a good grip too. If you have a heart or respiratory problem, stay indoors during very cold weather.
  • Keep your home warm:
    • If you’re not very mobile, are 65 or over, or have a health condition, such as heart or lung disease, heat your home to at least 18C (65F).  Keep your bedroom at 18C all night if you can – and keep the bedroom window closed during the day. You may prefer your living room to be slightly warmer than 18C.
    • Draw curtains at dusk and keep doors closed to block out draughts.
    • Get your heating system checked regularly by a qualified professional.
    • Make sure you claim all the financial support you can to help with heating bills. Grants available include the Winter Fuel Payment and the Cold Weather Payment.

3.   Keep a well-stocked medicine cabinet

Stock up on medicines and stay a step ahead of the winter bugs. Key medicines to stock up on over the winter period include:

  • Painkillers – paracetamol, ibuprofen and aspirin – used for colds and reducing aches, pains and high temperatures.
  • Decongestants – these can help ease the symptoms of a blocked or stuffy nose (nasal congestion) and are available as nasal sprays, tablets, liquids or flavoured powders to dissolve in water.
  • Oral rehydration salts – fever, diarrhoea and vomiting make us lose water and essential minerals which can lead to dehydration. Oral rehydration salts can help restore your body’s natural balance of minerals and fluid, and relieve discomfort and fatigue. Note: they don’t fight the underlying cause of your illness, such as a virus or bacteria
  • Anti-diarrhoea tablets – diarrhoea can be caused by a range of things and can happen without warning, so it’s a good idea to keep anti-diarrhoea medicine at home. The most common is loperamide.

Always follow the directions on medicine packets and NEVER take more than the stated dose.

4.    Be Prepared

  • If water pipes freeze they can burst. Make sure you know where the main stopcock is and check that it’s easy to turn so you can turn off the water if you need to.
  • Have your electric blanket serviced at least every three years.
  • Keep a mixture of salt and sand handy to put on steps or paths in icy weather.
  • Order repeat prescriptions in plenty of time, particularly if bad weather is forecast.
  • Ask your local pharmacy if they offer a prescription pick-up and delivery service.
  • Keep basic food items in the cupboard or freezer in case it’s too cold to go shopping. You could also do your food shopping online and get it delivered to your door.
  • Eat healthily and keep as active as possible.
  • Keep a torch handy in case you lose power and keep your radio, mobile phone, laptop or tablet fully charged, so you can use the battery power if there’s no electricity. If there is a power cut you can call 105 for free. You’ll be put through to your local network operator who can give you help and advice.
  • Keep a list of emergency numbers, such as your utility companies, by your phone.

Useful Links

You may find the following links useful. Please bear in mind we cannot be responsible for the content on these sites. Websites are constantly trimmed and edited, so any content on a third party site may disappear.

Asthma UK fund world-class research, provide expert advice and support and campaign for change on the issues that affect people with asthma: Asthma UK 

Arthritis Research UK invests in breakthrough treatments, the best information and vital support for everyone affected by arthritis: Arthritis Research UK

British Heart Foundation is the nation’s heart charity and the largest independent funder of cardiovascular research: British Heart Foundation

Information on Seasonal Affective Disorder (SAD): NHS

Information on Exercise for older people: NHS 

Information on financial help available to help with winter fuel bills:

Winter Fuel Payment

Cold Weather Payment

Sources of Information

Ten winter illnesses: NHS

Winter illnesses – Colds: NHS 

Winter illnesses – Sore Throat: NHS

Winter illnesses – Asthma: Asthma UK 

Winter illnesses – Norovirus: NHS 

Winter illnesses – Painful Joints: Everyday Health 

Winter illnesses – Cold Sores: Detroit Free Press

Winter illnesses – Heart Attacks: British Heart Foundation 

Winter illnesses – Cold Hands and Feet: NHS 

Winter illnesses – Dry Skin: Healthy Living Made Simple 

Winter illnesses – Flu: NHS 

Banish winter tiredness: NHS 

Keep Warm: NHS 

Keeping a well-stocked medicine cabinet: West London CCG

Practical tips for being prepared for winter: Age UK

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