Now that winter is here, we all take the time to enjoy the fresh air and the warm evenings. But to an increasing number of patients presenting to my OPD these days, the season has brought a somewhat undesirable
visitor: the nagging and aching headache that never leaves.
And in case you are finding yourself waking up with a heavy head or with a dull ache behind your eyes following a commute, then you are not alone. This is not merely winter apathy, it is usually a straight-forward neurological reaction to the poisonous air that we inhale.
Dr Atampreet Singh, Senior Director and Head, Department of Neurology, Sharda Care Healthcity shares all you need to know:
The “Smog Headache”: What Is It?
When we think of pollution, we think of coughing, burning eyes but the brain is not immune. Inhaling, the microscopic pollutants, such as PM2.5 (30 times smaller than a hair), go around the natural filters that your body has. They get into your blood and may reach the brain, where they cause neuroinflammation (inflammation of nerve tissue) and oxidative stress.
Basically, to your brain, these poisonous particles are considered an attack, and thus, an immune response that is expressed in the form of a headache is initiated. This is added on in the winter by vasoconstriction, or tightening of blood vessels by cold weather, which further inhibits blood supply and oxygen delivery to the brain.
Popular Winter Triggers That You may Miss
Although the smog out there is blatant, certain causes are less evident, and peculiar to our winter ways:
• The Morning Walk Paradox: It is said that exercise is good however, when you are in the early morning in the smog, you tend to breath heavily therefore you are essentially super-dosing your brain with toxins as an effect.
• The Car Heater Trap: Driving: With the windows closed and the heater on, one is likely to re-circulate high-levels of Carbon Monoxide (CO) and CO2 in the cabin. This insufficiency of fresh oxygen is a conventional stimulus to drowsiness as well as headaches.
• Dehydration: It is natural that we drink less water during winter. This, together with dry winter air and indoor heating, results in dehydration, as the brain pulls slightly away form the head, and brings about pain.
• Indoor Pollutants: To keep the cold out we close our homes. This traps the inside pollutants of cooking fumes, incense (agarbatti), and dust making the indoor air quality sometimes even more unpleasant than the outside.
How to defy old age (winter): How to protect your brain
The air outside cannot be controlled, but exposure can be controlled. The following is the advice I would give my patients:
1. Look at the AQI, Not Only the Temperature: Use the Air Quality Index as a weather forecast. When the AQI is either Very Poor or Severe, avoid the outdoor cardio. Replace outdoor yoga and strength training with indoor.
2. Stay Hydrated: Consumingly drink water, regardless of whether you feel thirsty or not. Lemon or herbal teas used in warm water are also very good in keeping the levels of hydration high and flushing the toxins out.
3. Dietary Shield: Take more anti-oxidants. Vitamin C (oranges, amla), Vitamin E (almonds, spinach) are foods that aid in combating the oxidative stress pollution causes in the brain. Jaggery (Gur) has also been known to clear the respiratory tract.
4. Ventilation: Ventilation is counterintuitive, but open the window during the afternoon when the sun is up and smog concentration is less. And in case you have a car heater in place, make sure that the fresh air mode is sometimes switched on.
5. Wear the mask properly: The mask made out of cloth is not effective against PM2.5. The only useful barrier is the N95 mask in case you have to be outside in heavy smog.
When to See a Neurologist
The headache caused by pollution typically goes away after being exposed to the clean air and after taking some water. But when your headache or pains are coupled with vomiting, blurred vision and slurred speech or it is interfering with your sleep do not write it off as but another weather related incident.
It should be the season of happiness and not sadness. It only takes a few little adjustments in your everyday routine to be your own big shield, and your head will be pain-free and your mind will be clear.
