I think most of us can agree that keeping up with COVID-19 has been mentally exhausting and the thought of some finality to it all sounds refreshing and welcome. But what if we are prematurely letting our hair down and hanging our masks up?
“I think we are all drained. It’s been consuming for everyone. Unfortunately, the cases in Palm Beach County are currently on the rise and it’s still very much prevalent. We have to push on and take proper precautions. We cannot misinterpret things re-opening to mean we are in the clear,” says Dr. Ramprasad Gopalan, a local infectious disease doctor who sees patients in seven of the county’s hospitals, including Wellington Regional Medical Center and Palms West Hospital.
Part of pushing forward means adjusting our attire. Multiple times a day Dr. Gopalan dons a knee length gown, an N-95 mask in addition to a full plastic face shield, a head cover that resembles a paper bonnet, shoe covers and gloves to go inside positive rooms in the COVID units. As the community reopens, he asks that we continue to don our cloth face coverings in public settings, as recommended by himself and the CDC. “The mask may not necessarily protect the one wearing it but it may help prevent the spread particularly if the wearer is positive. Keep in mind there are many asymptomatic people who are positive. They themselves may not know they are positive,” says Dr. Gopalan, owner of First Class Medicine. Other precautions include maintaining a safe social distance and proper handwashing.
Not everyone is ready to get back out there and that’s okay too. “There are a gamut of emotions associated with COVID-19. Some are anxious to get back out and others are afraid to rejoin day to day activities. I think the upcoming 3-4 weeks will be very telling in terms of the curve and the trend. If you are too anxious, and are able to continue quarantining or minimize going out, then it’s perfectly fine to watch and wait. However, when we get to the point of time that COVID-19 warnings have been lifted and the community is fully operational and you are still feeling too anxious to rejoin community activities, then you may need to speak to your doctor or seek mental health guidance. We cannot discount that this situation has been traumatic on some,” adds Dr. Gopalan.
While everyone is coping with COVID in their individual way Dr. Gopalan says the patients inside of our local hospitals, and throughout the county, have done considerably well. He credits the nurses and staff. “Wellington Regional Medical Center and Palms West Hospital have handled this efficiently and with compassion. The nurses and staff were very mindful of the apprehensions and panic that COVID patients were experiencing, especially in the early phases when there was a lot of fear of the unknown, and took care not to add to the hysteria. As people became more familiar with COVID, or possibly even knew someone who had it, the general population of positive patients seemed more at ease and confident.” Most positive patients do not require hospitalization and are able to safely care for themselves at home.
It is important to continue to monitor yourself for symptoms such as fever, chills, cough, shortness or breath, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting or diarrhea and to contact your healthcare provider right away should you experience any of these symptoms. Alert your emergency department for acute symptoms such as difficulty breathing, persistent pain or pressure in the chest, new confusion, inability to wake or stay awake, or bluish lips of face.
Those without symptoms, and that are ready to reopen, can take a deep breath (from 6 feet away, of course), pull up your masks, wash your hands and prepare to rejoin the community safely with the aforementioned precautions as it opens to the public.
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Julie Khanna is the owner of Khanna Connections, a marketing, communications and relations firm with a niche in the medical, health and wellness industries.
Two Local Medical Moms Lead the Community in Fitness, Health and Nutrition Throughout the COVID Crisis
Boynton Beach – JUNE, 2020
By Julie Khanna
Two local medical mothers in Boynton Beach are leading the community in health, wellness, and nutrition through the COVID-19 crisis.
“I started the CovidFit Facebook page in March during quarantine to motivate myself and others with at-home workouts, personal achievements, healthy recipes, and other stay-at-home tips,” said Annie Harring, a doctor of pharmacy and assistant professor of pharmacy at Palm Beach Atlantic University.
Annie started the page with a few close friends and family, including her husband and daughters in mind, but it quickly grew in size and recently passed 1,400 members. New posts are added daily with members sharing their own workouts, family fitness routines, healthy recipes, and fitness challenges. Members participate in 30 day plank challenges, burpee challenges, posting a picture of their workout challenges, and more.
Now the fitness challenges are incentivized. CovidFit partnered with Doctor Daxa Patel, owner of soon to be opened Bahia Bowls, and an Ob/Gyn practicing in South Florida for over 20 years. “As a physician, I was looking for a healthy concept that would appeal to everyone. The Bahia Bowls menu offers choices that are nutritious and delicious, gluten and dairy free. The bowls and smoothies provide amazing flavor and loads of energy that promote a healthy lifestyle,” said Daxa.
In the U.S., acai berries are not available as a whole fruit, but as a puree. An acai bowl is thick, like a smoothie, and toppings such as granola, fruits, and honey are added and it’s eaten with a spoon.
CovidFit members and contest participants now have the chance to win free acai bowls from Bahia Bowls. “Açaí bowls are a delicious and nutritious post-workout, or anytime, snack. Adding fresh fruit and other healthy options allows for variety and individual taste preferences,” said Annie.
“Making positive changes such as incorporating fitness, and eating well, is more important now than ever given the COVID-19 pandemic. It boosts healthy immunity and reduces stress-something we could all benefit from amidst these trying times,” said Daxa, a Wellington resident and mother of two.
The page is not just for those experienced with fitness and healthy living. “Hi! I just want you all to know that I’ve exercised almost daily since joining this group. I also learned how impactful it is on my stress level. Thank you,” posted one member.
Providing the community with health, wellness, and acai support during the COVID-19 pandemic isn’t the only accomplishment the group boasts. CovidFit shirts, designed by Annie’s niece, raised enough money from proceeds to donate over $1,000 to the Best Foot Forward Foundation- an organization with a COVID-19 Relief Fund for foster children.
Anyone is allowed to join the group. There are no participation requirements or fees.
Meet Julie Khanna! Her list of contributions to our community is a mile long. She sits on the advisory boards for 2 nonprofits benefiting children and families in Palm Beach County – Community Partners and Camelot Community Care. Not only does she volunteer a significant portion of her time to causes she is passionate about, but she is also a business owner, and mom to 3 bright, independent & entrepreneurial children. Her business, Khanna Connections, LLC, helps professionals and small business industries with brand expansion, strategic marketing, and social media. As a former registered nurse and wife to a Physician, she has a niche in the health and wellness markets but she is not exclusive. She is a brilliant connector of people and generous with her time and her knowledge and seems to know just about everyone. Her talents make her the perfect person to connect small businesses with all of the right people!
Julie has 3 amazing children and believes in fostering the next generation of business owners and, especially, the independence of a female enabling them to stand on their own 2 feet. Her eldest daughter is 17, is a licensed business owner and owns L Khanna Productions, a full videography, and social media agency. She works with several non-profits and private businesses as well. She just graduated from Dreyfoos School of the Arts. Her son is a student at Bok Middle School and is a communications major. He uses his technology and training to do videography for the family businesses and builds their websites. Her youngest child, Devi, owns Devi Masala, a homemade, handcrafted spice blend business. She started the business at age 9 has 3 spices and a line of aprons. She has sold in 4 countries all with online sales and minimal promotions. She earns a nice steady income this way and outsources a lot of the work to her brother and sister. They are both stakeholders in the Devi Masala business and help with videography, promotion, and social media. Mom is hands-off but taught them at an early age if they want to generate an income, they have to work. The saying in the house is “Only work on the days you want to make money.” Before they go out into the world, Mom makes sure they know how to introduce themselves properly, hold a conversation properly, and network themselves properly. The Khanna household is full of motivation, inspiration, and implementation.
As you can probably now see, Julie is a powerhouse! She throws her time, talent, and intellectual resources behind worthy causes. She truly believes in her kids, the grassroots efforts of the organizations she supports, and chose them specifically because she feels her skillset can bring them the most benefit. She is driven by her heart and looks for ways to make the biggest impact in our world.
Thank you, Julie, for taking the time to chat with us and share your inspiration and insights into what makes The Palm Beaches a special place to live.
Q: What inspired you or led you to your current career?
A: “I was actually an Oncology nurse. I have a B.S. in Nursing and oncology is my absolute passion. I think that the general persona of oncology nurses is so strong. They are good innate advocates and I feel that they will weed out the bad ones. So, I feel there are no bad oncology nurses because you have to truly walk in what’s best for your patients. I loved it. But, I did get pregnant. My husband at the time was a Physician and he said, ‘no way you’re working around chemo.” So, I went home, finished my pregnancy, with the intention of going back to work. I got pregnant again and then committed myself to be a stay at home mom for a few years. That’s where my business took shape because I did what I normally do and gave 100% of my support to my family. That included helping to grow my husband’s practice. We were a little bit new in the western communities and the traction just wasn’t there. So I got out there and I started hustling. I found every opportunity for him to grow or to be highlighted or to be recognized. And in the end, here we are now, we have a great relationship because we still believe in each other’s accolades and we pour that into the kids. I am still one of his biggest cheerleaders. Other people recognized what I was doing for him and from that, my company was born. He is an infectious disease physician so he has been very busy lately.”
Q: What is your favorite restaurant in Palm Beaches, and what do you love there?
A: “My favorite is Indus. Well, actually my favorite is my house first. Indus Indian and Herbal Cuisine on Palm Beach Lakes. They have a great buffet there. The owner, Jacob Lawrence, if ever you’re unsure, will come right to your table and will give suggestions based upon what you’re preferences are. They have a tandoori oven there, too.”
Q: How long have you lived or worked in Palm Beaches?
A: “I got here in 1987 at the age of 4 so I have literally grown up here.”
Q: What are your goals?
A: “My family is always first, I need to make sure that they stay on track and maintain momentum and growth. Professionally, I hire stay at home moms to help with the remote work. I think it fosters a network of commerce, we keep it within ourselves and we grow that way. I’d like to grow and expand. I’m always looking for new clients because I have a team to support that.”
Q: Who is the most interesting person you’ve met here in Palm Beaches?
A: “Vanilla Ice. He is incredibly interesting in the sense that he is dichotomic. He has such an interesting, exciting, fast, & fun type of life. I was across the street from 2 sites that he developed while he was filming for his TV show, The Vanilla Ice Project. You never knew what you were going to see next. It could be a crane coming by one day or another celebrity the next. It seems to me like he still stops to smell the roses. He always had a hello to say to my kids. If something super wild was about to happen he would call the kids over to watch. He never drove past one of their lemonade stands without stopping for a glass of lemonade. As a parent, that is a way to communicate to me that you love my kids and that gives me the highest respect for you. He never seems to lose sight of himself.”
Q: If you could travel anywhere in the world right now, where would it be? And why?
A: “I would go to Spain. I’ve never been there and we have a rich family history there. I just love the language and I would love to solidify my learning of Spanish.”
Q: What is your favorite movie OR what is the first movie you remember seeing in a theatre?
A: “My all-time favorite movie is Out of Sight with Jennifer Lopez and George Clooney. Parts of it were actually filmed in Miami and Belle Glade. Is is an old movie but it’s great.”
Q: What advice would you give a crowd of people?
A: “My advice would be that if you’re not helping, you’re hurting. Everybody has something to give. It doesn’t have to be money. It can be your time, your knowledge, your resources, your network, your advice, or your mentorship. But if you’re not helping, you’re hurting. Silence is an answer!”
Q: What is something on your bucket list?
A: “I’d like to conquer my fear of roller coasters because I’m sure I totally like them. If I would actually get on one I would probably like it.”
Q: What is your favorite music/ 3 bands you would like to see (dead or alive)?
A: “I’m very expansive here. Garth Brooks is my all-time favorite. I got to see him once after his retirement but I’d love to see him again. Tupac because I think he is a phenomenal lyricist. He is a true poet. And Sublime, I love their music.”
Q: What current/former local business makes you the most nostalgic about Palm Beaches?
A: “The Palace! It was a roller skating rink in Central Palm Beach County that we grew up in on the weekends. Towards the end of the night, they clear the rink and it would become a total dance party with house music. That was the place to be.”
Q: Choosing anyone alive and a non-relative with whom would you love to have lunch? Why and where would you have lunch?
A: “Dr. Shefali Tsabary. She’s my icon. She’s a motivational speaker & very intuitive. She reminds me of Wayne Dyer. She’s very insightful and amazing. I will take her to Indus because she’s Indian.”
Q: What is your favorite thing or something unique about Palm Beaches?
A: “Definitely the diversity. You don’t have to go far to find your village. That has changed exponentially over the years.”
Q: Where do you see yourself in 5 or 10 years?
A: “In 7 years, I’ll be an empty nester at the age of 43. I have been a parent all of my adult years. I would like to believe that I will have a more balanced life of work, play, and rest. I’d like to be teaching some of these industry standards to other professionals and of always continuing to grow my team and further my reach. I definitely see myself moving towards a more online platform in the future.”
Q: (Even for friends or family), what is something interesting that most people don’t know about you?
A: “Most people don’t know that I actually jump in my car and drive down to FAU occasionally a few times a week. I take executive education classes at the College of Business on the FAU campus. I’m always learning and I believe in being a forever student. Usually, they’re 9+ weeks series and surprisingly I find myself in the company of people about my age. It’s very relevant and current industry knowledge.”
Q: What 3 words or phrases come to mind when you think of the word HOME?
A: “Peace, Sacred, and Safety.”
Q: If you had a full-time staff member that was fully paid for, who would you choose? Chef, Housekeeper, Driver, Coach, Physical Fitness Trainer, or Nanny?
A: “Totally a driver! I’m a multi-tasker and driving is an inconvenience because I have to make myself unavailable.”
Q: If you were cast into a major motion picture and had your choice of anyone to be your co-star, who would you choose?
A: “Madea because I can’t get enough of her. She’s my all-time favorite character, ever. She’s Tyler Perry’s most famous character. He is a genius.”
By Devi Khanna Ramprasad with expert insights from Dr. Andleeb Usmani, DO, FAOCD
Make sure you consider these tips before getting your skin care regimen from social media, the drug store, or the refrigerator.
Apps like TikTok promote to young audiences that in order to have an accepted lifestyle you have to keep up with the trending skincare regimens, which can get extremely expensive, and the advice given varies widely. “Tik Tok is making people aware of the importance of skin care,” says Dr. Andaleeb Usmani, D.O., board certified dermatologist and owner of TruDerm in Wellington, Florida. “Specific products shared on social media may be helpful but not always.”
Consider the source
TikTok trends almost always end due to conflicting counter-information. For example, social media mega brand Mario Badescu™ was a recent trend, but had an even more recent downfall, when competing social media skin care specialist Hyram Yarbro, also known as Skin Care by Hyram™, revealed on his YouTube and TikTok platforms that the brand Mario Badescu™ “offers no real benefits to the skin” and that they were adding fragrances in their products. Hyram is also well known for giving budget friendly, but effective, skin care alternatives, as well as pointing out faulty ingredients in the most popular brands.
You will undoubtedly have to do your own research, or consult with your dermatologist, before beginning each new skincare routine. “Off brand or generic skincare regimens often have inactive ingredients. If they are not well made they are not as stable. Examples are over-the-counter salicylic acid and especially vitamin C, which have the potential to be poor quality,” adds Dr. Usmani.
Also be mindful that organic does not necessarily mean better.
“Some over the counter products may claim to be organic but that doesn’t mean they are effective or well made,” says Dr. Usmani.
Consider the cost
Caring for your skin is very important but you don’t have to spend your life savings on it. “Effective skincare does not need to be expensive to be good, but it really depends on what we are treating to find the most effective option,” says Dr. Usmani.
Name brand skin care routines cost on average $75 and last 6-12 months while off-brand skin care routine costs on average $40 and also lasts 6-12 months according to my research. Knowing how long your products will last allows you make a more informed decision when investing in your skincare.
If splurging on a product that you aren’t even sure you will like is a concern, there are subscription skin care sample boxes. Ipsy, Birchbox, and Allure are three of my favorites that I’ve personally tried and have found their contents to be of quality.
Consider the kitchen
Homemade skincare masks are also a great alternative so long as you get the formula from a trusted source such as Formula Botanica. “There are ingredients such as Neem or Turmeric which promote anti-inflammatory benefits. We also use masks with honey and lemon in my culture,” says Dr. Usmani.
A common turmeric mask used in India is easily made by mixing a teaspoon of turmeric powder, a teaspoon of fresh lemon juice, one and half tablespoons of organic honey and a teaspoon or milk or yogurt, then applying to the face for ten to fifteen minutes before rinsing off. Use caution as this mixture can stain fabric.
Consider the glow up as you grow up
Hopefully my article encourages you to have the best skin possible and to not neglect your skin. “If nothing else, wear sunblock. It prevents (future) wrinkles, sun damage and skin cancer in one shot. Image is my favorite, at around $35, but Neutrogena is really good for younger people,” says Alyson Khanna, professional makeup artist and owner of Eyecon Cosmetics. Get ready for your middle school glow up on a middle school budget!
This Season Spread Holiday Cheer, not Holiday Contagion
By Julie Khanna
Of all of the challenges this year has brought us, the holidays are no exception. Most of us find ourselves longing for the familiar feeling of holiday traditions and the urge to indulge in some sense of normalcy. Sharing family recipes, exchanging warm holiday greetings, and thoughts of connecting with loved ones after months of virtual spaces are all welcomed thoughts.
But just like everything else in 2020, we are stumbling together trying to recreate a safer version of our new normal. How and who we choose to share the holidays with takes careful consideration now as we’re mindful of social distancing and smaller capacities.
So how does the host decide who’s safe to make the in person guest list and how to host a holiday safely?
For starters, don’t fall for the ol’ “I’ve already had COVID so I don’t need a mask” line.
With the immense number of COVID-19 cases, there’s a good chance at least one of your potential guests have had COVID-19 by now. “They should still wear a mask. Even though reinfections are rare, there have been a few reported cases. Plus, we don’t know if they are still shedding the virus. I’ve seen people shedding for two weeks and I’ve seen people shedding for 5-6 weeks. It’s hard to tell if they’re still infectious,” says Dr. Ravi Pandey, a board certified internal medicine physician and hospitalist in Palm Beach County.
“We also don’t want to give off the perception that it’s okay to be without a mask in a social gathering,” says Dr. Pandey.
Knowing if your guests are no longer contagious is necessary.
The onset of symptoms is an important benchmark to consider so don’t be shy to ask.
“For most people, 10 days after the onset of symptoms is when they’re not supposed to be contagious,” says Dr. Pandey.
According to the CDC website, “persons with mild to moderate COVID-19 remain infectious no longer than 10 days after symptom onset. Persons with more severe to critical illness likely remain infectious no longer than 20 days after symptom onset. For most persons with COVID-19 illness, isolation and precautions can generally be discontinued 10 days after symptom onset and resolution of fever for at least 24 hours, without the use of fever-reducing medications, and with improvement of other symptoms.”
“Re-testing is not recommended by the CDC. But a negative test documenting that you are negative after the infection is another indicator” that you are likely no longer contagious.
What if your guest assures you they’re no longer contagious but they’re still coughing and complaining of not feeling well.
We now know that some symptoms linger like fatigue, shortness of breath or cough. Some studies say lingering symptoms can last for weeks to months after the infection, despite the person not being contagious anymore.
“As long as they are wearing a mask and we are wearing a mask, and they are not considered contagious any longer per the CDC guidelines, it’s still okay,” says Dr. Pandey.
Being together for the holidays is important but so is your safety. Having the corona-conversation with your guests ahead of time is a necessity. For those that are choosing to forgo a virtual holiday, please make sure to allow for adequate social distancing, wear masks in social settings, host outdoors if possible, and follow CDC recommendations for your out of town guests.
As we learn our new normal together it’s vital that we remember there are still so many unknowns. “We are playing with something that we don’t know everything about so it’s better to err on the side of caution than not,” says Dr. Pandey.
Dr. Ravi Pandey is available for extended and weekend hours in his West Palm Beach office. (561) 867-0000
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Julie Khanna is the owner of Khanna Connections, a marketing, communications and relations firm with a niche in the medical, health and wellness industries.
This article was medically reviewed by Board-Certified Internal Medicine Specialist, Dr. Ravi Pandey.
Substance abuse can negatively affect your sleep, whether you are still using or in recovery. While the prevalence of sleep disturbances in both substance abuse and recovery may seem daunting, there are tangible steps you can take to take back control of your sleep as you work to improve your overall well-being. Our resource will explore the two-way relationship between substance abuse and sleep. We will assess how different types of substance abuse affect sleep, evaluate how sleep can negatively contribute to substance abuse, and explore the link between sleep disturbances and addiction recovery.
According to a study published in the journal Psychiatry, people with substance abuse disorders are5 to 10 times more likely to have trouble sleeping. Problems with sleep can persist into addiction recovery as the body adapts to new, healthier sleep-wake cycles. While substance abuse disorder is an umbrella term for all different types of substance abuse, it is important to note that each type of substance has its own two-way relationship with sleep. Continue reading to find out how different substances may be playing a role in your sleeping patterns.
How Substance Abuse Affects Sleep
As we mentioned earlier, different substances act differently on the body and the brain and affect sleep in different ways. Let’s take a closer look at how alcohol, prescription medications, and illicit drugs may be affecting your rest.
“Lack of sleep causes many negative effects such as stress, unhealthy food cravings, poorer relationships, and impaired judgment; this can lead to conditions such as depression that can drive people to self-medicate through substance abuse.” – Dr. Brian Wind, Clinical Psychologist & Chief Clinical Officer at JourneyPure Addiction Treatment Center.
Alcohol and Sleep
Many people enjoy a nightcap to help them fall asleep. But if you have too many glasses of wine or vodka tonics, it ends up working against you. Sure, alcohol can make you sleepy and cause you to conk out. But once the relaxing effects of the booze wear off, it reduces your time in restorative rapid eye movement (REM) sleep. The more you drink before bed, the more pronounced these effects. Alcohol can also cause you to wake during the night and leave you tossing and turning for hours, unable to fall back to sleep.
Alcohol consumption also inhibits breathing while you sleep because it relaxes the muscles in your throat and, thus, puts you at increased risk of snoring and obstructive sleep apnea, a condition in which the airway becomes blocked and breathing stops momentarily.
“Alcohol can prevent the brain from falling into a deep sleep while increasing the number of times a person wakes up during the night. Stimulant drugs like meth and cocaine can also make it harder to fall asleep, and some drugs can cause damage to parts of the brain that make it difficult to fall asleep and stay asleep.” – Dr. Brian Wind.
Stimulants are drugs that affect the central nervous system and include a long list of both illicit drugs and prescription medications. Legal stimulants are prescribed to treat various conditions such as attention deficit hyperactivity disorder (ADHD), narcolepsy/excessive daytime sleepiness, and depression.
Legal stimulants include brand-name drugs such as Vyvanse, Ritalin, Adderall, Concerta, Strattera, Dexedrine. Illegal stimulants include cocaine, crack, methamphetamine (meth), and ecstasy (MDMA).
While stimulants are known for often increasing how awake we feel, they can sometimes make it harder for people to fall asleep, resulting in a decrease in our sleep quality and quantity. The misuse of stimulants can also cause REM sleep rebound, a condition that occurs when REM sleep takes up an abnormally high percentage of total sleep time and shortens the amount of time it takes to reach the first REM sleep period. These REM sleep effects are sometimes not experienced until 1 or 2 nights after withdrawal.
Opioids and Sleep
Opioids are drugs that relieve pain, but they can also produce euphoric effects. This category of substances is notorious for its high abuse potential as users can quickly become physically and psychologically dependent. Opioid examples include OxyCotin, Vicodin, Codeine, Morphine, and Heroine.
Studies show that opioids can disrupt sleep by blocking access to REM sleep and the deeper restorative stages of non-REM sleep, leading to excessive daytime sleepiness. While opioids are often prescribed to treat chronic pain, roughly 21% to 29% of patients prescribed opioids for chronic pain misuse them. Opioids have been associated with a rising number of drug overdose deaths prompting the Centers for Disease Control and Prevention (CDC) to label opioid abuse a national epidemic.
Depressants and Sleep
Depressants are drugs that slow brain function and are used for a range of conditions. Depressants cause drowsiness, which is why they are sometimes prescribed for insomnia and other sleep disorders. People who become addicted to depressants can experience withdrawal symptoms that include difficulty falling asleep or staying asleep. These symptoms can begin as early as a few hours after the drug was last taken.
Some depressant medications include:
Barbiturates like the anti-seizure drug phenobarbital
Antipsychotics such as Zyprexa, Seroquel, and Haldol
Anti-anxiety medications (called benzodiazepines) which include Xanax, Klonopin, and Valium
Sedative-hypnotic sleeping pills like Lunesta, Ambien, and Sonata.
Illegal depressants include Quaaludes and GHB (gamma hydroxybutyrate), sometimes referred to as the “date rape drug.”
“Different types of substances can affect sleep differently. Alcohol can interrupt the REM cycle of sleep so that the person never gets to restorative sleep. Cocaine users may take longer to fall asleep and reach REM sleep, sleep less and have a reduced percentage of REM sleep. Marijuana users have more slow-wave sleep but less REM sleep.” – Dr. Brian Wind
How Lack of Sleep Contributes to Substance Abuse
Now that we have evaluated how the abuse and misuse of different substances can lead to trouble sleeping, it is time to turn this two-way relationship on its head and determine how sleep disturbances may be contributing to substance abuse.
To better understand the cycle of substance use and sleep deprivation, we first need to identify the two reasons individuals tend to struggle with sleep deprivation as a result of substance abuse.
People May Turn to Substances to Help Fall Asleep: People who have difficulty falling asleep or staying asleep at night sometimes turn to alcohol or depressant drugs to help them sleep. These substances may help someone nod off faster, but they can shorten REM sleep and prevent restorative non-REM sleep.
Using Stimulants to Combat Daytime Sleepiness: Individuals who are sleep deprived experience excessive daytime sleepiness and may turn to stimulants to help them stay awake during the day. But sleep deprivation can also fuel drug cravings and can be a major factor in relapsing if you are trying to overcome your dependence on substances.
If you are experiencing insomnia or daytime sleepiness, try your best to resist the urge to self medicate. If you have been prescribed medication to help you sleep, take only the dosage your doctor prescribed and do not mix the prescription medication with other drugs or alcohol, as doing so can have life-threatening results.
We realize that substance abuse is a serious condition that should not be taken lightly. If you feel that you are actively abusing substances and the issue is no longer in your control, please reach out to a medical professional to develop a plan that is right for you.
Now that we have covered the two-way relationship between sleep and substance abuse, let’s explore the role sleep can play in substance withdrawal and recovery.
The Link Between Sleep & Addiction Recovery
Good sleep is an important part of recovering from substance abuse. While we sleep, the brain regulates enzymes and hormones in the body which helps the mind better process information which can speed up the recovery process. On the flip side, inadequate sleep can disrupt this process and can cause anxiety, impulsivity, mood swings, and depression — emotions that increase the risk of relapse. According to the Journal of Addiction Medicine, individuals are 5x more likely to suffer from insomnia while recovering from substance abuse.
Sleep and Substance Withdrawal
Stopping or reducing alcohol or drugs can result in physical and mental symptoms known as withdrawal. The types of symptoms experienced depend on the substance you are quitting or cutting back on and may include anxiety, fatigue, sweating, vomiting, depression, seizures, and hallucinations.
Sleep disorders are also a common symptom for people recovering from substance abuse. That’s because abusing drugs or alcohol can disrupt the body’s sleep patterns. When you quit using, your body begins to regain its normal functions and adjust to a more regular rhythm. It’s not uncommon for sleep to be disrupted during substance withdrawal, but it is still a very important contributor to recovery. Thus, when it comes to substance withdrawal and recovery, sleep should be a top priority, even if it means carving out time to take naps throughout the day or spending extra time at night unwinding.
“Keeping your environment as calm and soothing as possible and doing some meditation and breathing can help to relax your nervous system,” according to Haley Neidich, licensed psychotherapist, LCSW.
“Anyone with a substance abuse issue who is experiencing withdrawal should be in contact with a doctor and have an approved withdrawal plan as many forms of withdrawal can be dangerous,” notes Neidich.
While it may feel like a heavy burden to carry now knowing just how connected your sleep is to your recovery process, try to take comfort in knowing that there are tools and resources out there to help you get the sleep that you need.
Addressing Sleep Disturbances and Substance Dependence
If you believe you are dependent on drugs or alcohol and it is affecting your sleep, consider talking with your doctor or a drug counselor to implement a plan that makes sense for you and your situation. Addiction is correlated to both mental and physical health, so it is important to have a treatment plan that addresses both pillars of health.
Addiction, Mental Health, and Sleep
Addiction is a serious disease that is often correlated with past trauma, PTSD, and mental illness and can be detrimental to your emotional and physical wellbeing as well as your sleep.
“Adversity in childhood is highly correlated to addiction in adulthood as many survivors of complex trauma feel dysregulated much of the time […] However, this maladaptive behavioral pattern can cause further pain, shame, and re-traumatization,” notes Dr. Gillian O’Shea Brown, psychotherapist and adjunct professor at NYU.
For this reason, it is important to seek medical help when it comes to substance abuse and addiction. If you are a heavy user, it is important that you consult with a professional as quitting or cutting back suddenly without support can lead to dangerous withdrawal symptoms. If you are not sure where to turn for help, contact the Substance Abuse and Mental Health Services Administration at 1-800-662-HELP (4357).
Additional Recommendations for Better Sleep
When it comes to recovery and sleep it is important to recognize that the road to recovery may not always run smooth but should require an emphasis on sleep hygiene and prioritizing mental health.
“I want to normalize for individuals, particularly those in early substance abuse recovery, that it is very common to experience sleep disturbance. Aspects of this will naturally decrease over time but taking sleep issues very seriously is essential as being tired is one of the top triggers for relapse,” notes Neidich.
“Everyone wants to be aware of HALT (Hungry, Angry, Lonely, Tired) in recovery and avoid experiencing any of these as much as possible. I encourage folks in recovery to take their sleep hygiene very seriously and to get professional help from a therapist trained in CBT-i if the sleep issues persist and to discuss frequently with your doctor proper medical recommendations for sleep,” she adds.
Additionally, you may want to consider these recommendations for better sleep:
Establish a sleep routine. About 30 minutes before bedtime, start preparing for bedtime by taking a warm bath or reading a book. Doing so can help you calm your mind and body so you are better able to fall asleep.
Eliminate screen time before bedtime. The blue light that emanates from tablet and phone screens and TVs actually helps keep the mind alert and interfere with falling asleep.
Improve your sleep environment. Your bedroom should be a sanctuary for sleep and sex only. Be sure it is conducive to both. Keep the thermostat set at a cool but comfortable temperature (experts suggest between 60 to 68 degrees), use blackout blinds or a sleep mask to block out unwanted light, and consider investing in a new mattress that helps regulate your body temperature.
The Takeaway
Substance abuse is a serious problem that affects millions of Americans. Not only does alcohol and drug addiction take a toll on mental and physical health, but it can also adversely impact sleep. In fact, sleep disorders are a common withdrawal symptom for people with substance use disorder. While the cycle seems never-ending, it doesn’t have to be. There are resources available to help you overcome your dependence on drugs or alcohol, so you can get a good night’s sleep.
By Julie Khanna with expert insights by Dr. Denzil Seedial, M.D., FCCP, a critical care medicine and pulmonologist at PCSI, the largest integrated pulmonary and chest specialty group in Palm Beach County.
Exercise Intolerance or Intolerant of Exercise?
Find out what’s stopping you from the powerful pandemic stress remedy.
Endless polls and studies cite the number one reason Americans give for not exercising is lack of time. The downtime of quarantine seems like the perfect opportunity to bring about ambitious goals of rekindling old exercise routines, or even starting new ones, especially since exercise is hailed as a powerful remedy to pandemic stress. But what if after giving neighborhood power walks a shot you realize it’s not just the time factor that’s holding you back.
The Centers for Disease Control and Prevention (CDC) report only about half (53.3%) of adults over the age of 18 meet the physical activity guidelines for aerobic physical activity despite the overwhelming supportive research proving exercise is fundamentally essential for vitality.
Exercise Intolerance
For some people, exercise intolerance is the underlying barrier that makes exercising seem impossible. The good news? Exercise intolerance doesn’t make exercise impossible, but it does need to be addressed to successfully incorporate something as vital as exercise into your lifestyle.
“Exercise intolerance is the inability to do things that you could have done prior to having an event,” Dr. Denzil Seedial, a critical care medicine/pulmonologist at Pulmonary, Critical Care and Sleep Disorders Institute of South Florida explains. For example, a major accident, certain illnesses, or a COVID-19 or respiratory tract infection would be considered an event. “It’s any change from baseline.”
Diagnosing the root cause of exercise intolerance may require a little more investigation if no events or obvious life changes can be identified.
“If you continue to be short of breath it’s usually cardiac or pulmonary related. If after slowly beginning to exercise a patient reports they’re finding themself more short of breath than the average person, and we don’t think it’s from deconditioning, then further diagnostic testing like a chest x-ray or a pulmonary function test are used to look for things like asthma, exercise induced asthma, or COPD,” adds Dr. Seedial. If those are unremarkable then further testing may be indicated like a cardiopulmonary exercise stress test.
Intolerant to Exercise
Our minds undoubtedly play a major role in everything that we do, including finding the motivation to do things and the relationship between how we accept the success or failure of personal goals. If we set exercise goals that are unrealistic, and subsequently can’t meet those goals, we may feel an unhealthy sense of failure, making exercise feel impossible. We might even feel a sense of self-betrayal for not being able to honor the exercise goals we promised ourselves.
“Everyone should see their PCP (primary care physician) for clearance before beginning a new exercise routine.” says Dr. Seedial. Your PCP can also help you identify realistic exercise goals and recommend exercises that have the highest potential for individual success and safety.
“Focusing on the now by staying present with your day and your movement of choice without worrying about what’s to come tomorrow, next week or next month can help you from becoming overwhelmed or discouraged,” says Crystal Hochman, a certified functional diagnostic nutrition practitioner and health coach.
“Shaming yourself into action only creates acting. Inspiring yourself into action creates change. If you want lasting commitment, create and connect with your personal ‘why’ and what it will mean to you to sustain an exercise regimen. Focus on how you will feel when it’s done, not only physically, but emotionally and mentally,” adds Crystal, who is also certified to teach yoga, breathwork and meditation.
It’s also important to find something you find interesting. Combining a hobby or art with fitness increases the chances you’ll engage long term, and there’s no shortage of opportunity with the fitness trends like kickboxing, mixed martial arts, Brazilian jiu-jitsu, pilates, beach walking, and even goat yoga.
Get Intolerant to the Intolerance
Fitness fads may come and go but medical endorsements for the benefits of exercise are permanent. Enlist the help of your medical provider if you suspect exercise intolerance. Starting small, setting realistic goals, focusing on the here and now, and finding an exercise program that interests you are all ways to combat intolerance to exercise. Whichever the cause, get intolerant to the intolerance and then “PR” (that’s fitness slang for a new “personal record”) right past, and on your way to pandemic stress relief, with the tips recommended in this article.
We’ve come a long way in preventative health. A quick Internet search will return an abundance of literature promoting mental, gut, skin, physical and fitness health, but with the insurgency of COVID-19, shouldn’t we be taking preventative lung health measures too?
The lungs’ main role is a process called respiration, or breathing, which involves exchanging oxygen from the air we breathe with a waste product called carbon dioxide. Air exchange takes place in the pulmonary capillaries housed inside the alveoli, which are the tiniest functional units of the respiratory system, located in the lungs. Incoming oxygen gets circulated throughout the bloodstream to be used by our body and organs. Conversely, carbon dioxide waste leaves the blood by way of the lungs. In addition to respiration, the lungs also act as filters. Mucous in the lungs collect and hold germs, dust and other foreign material. It is then expelled in the form of coughing, sneezing and clearing your throat.
As lungs age, they become less flexible and lose elasticity, resulting in making breathing more difficult. But by exercising your lungs and maintaining a healthy lifestyle you can prolong the vitality of your lungs and preserve lung performance even in your senior years. Dr. Luis Javier Peña-Hernández, a lung health specialist at PCSI, an integrated pulmonary and chest specialty group in Palm Beach County, Florida, says there are ways we can exercise and improve our lung health and prevent lung disease, especially during the COVID-19 crisis.
Clean your Cloth Masks
Homemade masks made for multiple uses need to be cleaned after each use to prevent bacteria from harboring in the material. You should own more than one so a mask is available to you at all times. According to the CDC, masks can be cleaned with your laundry in your warmest appropriate setting. Masks can also be washed by hand by mixing 4 teaspoons of household bleach per quart of room temperature water and soaking for 5 minutes. Do not mix household bleach with ammonia or any other cleanser.
Exercise
Exercise doesn’t just keep your body in shape; it keeps your lungs in shape also. Exercise increases the cardiac demand, making your heart beat faster and your lungs work harder. Healthy lungs rise to the challenge to deliver increased amounts of oxygen and expel the additional carbon dioxide in shorter faster periods of time. Over time, with consistent exercise, the lungs become conditioned to meet the requirements needed while exercising. The rewards are reaped even while resting through improved lung capacity, which is the amount of oxygen you take in with each breath.
Sing in the Shower
While karaoke may not be available to you during the pandemic, singing in a hot shower provides two benefits to lung health. Steam caused by hot showers can help to naturally loosen mucus for expulsion. Mucus is produced in your throat and lungs and helps trap particles such as dust, viruses and bacteria. Combined with singing, it can help by naturally clearing your lungs. Singing is a type of exercise that engages core muscles and challenges the diaphragm to fill your lungs deeper.
Stop Smoking
Focus on the positive benefits of smoking cessation: Success is obtainable, and the advantages of quitting might be noticeable sooner than you may think. Within just 20 minutes of your last cigarette, pulse and blood pressure begin to return to normal. Blood flow and lung performance begin to improve in as little as two weeks. “Finding a support system when quitting is important as well,” Pena says. He suggests a multidisciplinary approach that includes patient-family education, smoking cessation counseling, prescribed smoking cessation aids when indicated and follow-up ongoing monitoring. “We feel multiple avenues of support have better outcomes than unilateral modalities.”
Reduce Exposure to Pollutants
The lungs reduce the ability to resist infections and disease as you age. Reducing exposure to indoor and outdoor pollutants help take some burden off the lungs.
Make your home a smoke-free zone and avoid second-hand smoke.
Avoid exercising near heavy traffic areas or peak traffic times.
Be sure to change your AC filter regularly.
Keep your home clean. Vacuum and dust weekly. Pet dander, dust and mold are common lung irritants.
Use natural cleaning products when possible and ventilate your home by opening a window when using products that create fumes.
Avoid artificially scented home fresheners and candles that contain irritants such as formaldehyde and benzene. Aromatherapy diffusers, homemade candles and essential oils are a safer alternative to naturally scent the air.
Practice Breathing
Two popular beneficial lung exercises include pursed lip breathing and diaphragmatic breathing. Although these may seem easy, practice may be needed to work up to doing these two times a day for 5-10 minutes a day. When practiced regularly, breathing exercises can help mobilize stale air, increase oxygen levels and strengthen the elasticity of the diaphragm.
Pursed lip breathing. Begin by sitting with your back straight or laying down. Relax your shoulders. Inhale through your nose, feeling the air move in, causing your abdomen to fill. Purse your lips as if you’re whistling and slowly breath out. Make sure to exhale twice as long as it takes to breathe in. Repeat.
Diaphragmatic breathing. Lie on your back or a flat surface, bend your knees and support your head with a pillow. Place one hand on your upper chest and the other just below your rib cage so you can feel your diaphragm move as you breathe. While keeping your hand still on your chest, breathe in slowly through your nose, feeling your stomach move out against your hand, and exhale through pursed lips. Keep the hand on your upper chest as still as possible. As this exercise gets easier, you can try the diaphragmatic breathing technique while sitting in a chair.
Most people will benefit from implementing these tips.
Even people living with lung disease can reduce the impact by making adjustments. “Anyone with a history of lung disease planning on beginning a new exercise regimen, or for new or worsening shortness of breath, should consult with their physician first,” Pena says.
By Julie Khanna with expert insights and medically reviewed by Dr. Luis Javier Peña-Hernández, M.D., FCCP
We’ve come a long way in preventative health. A quick Google search will return an abundance of literature promoting mental, gut, skin, physical and fitness health, but with the insurgency of COVID-19 shouldn’t we be taking preventative lung health measures too?
Did you know there are exercises for your lungs that help to mobilize stale air? Or how often to clean your mask to prevent bacteria build up? We tell you how to keep your lungs healthy especially during the pandemic, according to a pulmonologist.
The lungs’ main role is a process called respiration, or breathing, which involves exchanging oxygen from the air we breathe with a waste product called carbon dioxide. Air exchange takes place in the pulmonary capillaries housed inside the alveoli, the tiniest functional units of the respiratory system, located in the lungs. Incoming oxygen gets circulated throughout the bloodstream to be used by our body and organs and conversely carbon dioxide waste leaves the blood by way of the lungs. In addition to respiration, the lungs also act as filters. Mucous in the lungs collect and hold germs, dust, and other foreign material. It is then expelled in the form of coughing, sneezing, and clearing your throat.
As lungs age, they become less flexible and lose elasticity, resulting in making breathing more difficult. But by exercising your lungs and maintaining a healthy lifestyle you can prolong the vitality of your lungs and preserve lung performance even in your senior years. Dr. Luis Javier Peña-Hernández, M.D., FCCP, a lung health specialist at PCSI -the largest integrated pulmonary and chest specialty group in Palm Beach County, with offices in Wellington and Atlantis, Florida, added expert insights on our tips on how we can exercise and improve our lung health and prevent lung disease, especially during the COVID-19 crisis.
Clean your Cloth Masks
Homemade masks made for multiple uses need to be cleaned after each use to prevent bacteria from harboring in the material. You should own more than one so a mask is available to you at all times. According to the CDC, masks can be cleaned with your laundry in your warmest appropriate setting. Masks can also be washed by hand by mixing 4 teaspoons of household bleach per quart of room temperature water and soaking for 5 minutes. Do not mix household bleach with ammonia or any other cleanser.
Exercise
Exercise doesn’t just keep your body in shape, it keeps your lungs in shape also. Exercise increases the cardiac demand making your heart beat faster and your lungs work harder. Healthy lungs rise to the challenge to deliver increased amounts of oxygen and expel the additional carbon dioxide in shorter faster periods of time. Over time, with consistent exercise, the lungs become conditioned to meet the requirements needed while exercising easier. The rewards are reaped even while resting by improved lung capacity which is the amount of oxygen you take in with each breath.
Singing in the Shower
While karaoke may not be available to you during the pandemic, singing in a hot shower provides two benefits to lung health. Steam caused by hot showers can help to naturally loosen mucus for expulsion. Mucus is produced in your throat and lungs and helps trap particles such as dust, viruses and bacteria. Combined with singing, it can help by naturally clearing your lungs. Singing is a type of exercise that engages core muscles and challenges the diaphragm to fill your lungs deeper.
Stop Smoking
Focusing on the positive benefits of smoking cessation, success is obtainable, and the advantages of quitting might be noticeable sooner than you may think. Within just twenty minutes of your last cigarette pulse and blood pressure begin to return to normal. Blood flow and lung performance begin to improve in as little as two weeks. “Finding a support system when quitting is important as well. We use a multidisciplinary approach including thorough patient-family education, smoking cessation counseling, prescribed smoking cessation aids when indicated, referral to Tobacco Free Florida and follow-up ongoing monitoring. We feel multiple avenues of support have better outcomes than unilateral modalites,” says Dr. Pena.
Reduce Exposure to Pollutants
The lungs reduce the ability to resist infections and disease as you age. Reducing exposure to indoor and outdoor pollutants aide in taking some burden off the lungs.
Start by making your home a smoke-free zone and avoiding second hand smoke.
Avoid exercising near heavy traffic areas or peak traffic times.
Be sure to change your AC filter regularly.
Vacuum and dust weekly. Pet dander, dust and mold are common lung irritants.
Use natural cleaning products when possible and ventilate your home by opening a window when using products that create fumes.
Avoid artificially scented home fresheners and candles that contain irritants such as formaldehyde and benzene. Aromatherapy diffusers, homemade candles and essential oils are a safer alternative to naturally scent the air.
Breathing Exercises
Two popular beneficial lung exercises include pursed lip breathing and diaphragmatic breathing. Although these may seem easy, practice may be needed to work up to doing these two times a day for 5-10 minutes a day. When practiced regularly, breathing exercises can help mobilize stale air, increase oxygen levels and strengthen the elasticity of the diaphragm.
Pursed lip breathing. Begin by sitting with your back straight or laying down. Relax your shoulders. Inhale through your nose, feeling the air move in, causing your abdomen to fill. Purse your lips as if you’re whistling and slowly breath out. Make sure to exhale twice as long as it takes to breathe in. Repeat.
Diaphragmatic breathing. Lie on your back or a flat surface, bend your knees and support your head with a pillow. Place one hand on your upper chest and the other just below your rib cage so you can feel your diaphragm move as you breathe. While keeping your hand still on your chest, breathe in slowly through your nose, feeling your stomach move out against your hand, and exhale through pursed lips. Keep the hand on your upper chest as still as possible. As this exercise gets easier, you can try the diaphragmatic breathing technique while sitting in a chair.
Most people will benefit from implementing these tips. Even people living with lung disease can reduce the impact by following these tips. “Anyone with a history of lung disease planning on beginning a new exercise regimen, or for new or worsening shortness of breath, should consult with their physician first,” says Dr. Pena.
