Getting Through the Holidays: Illness, Sleep, Food, and the Stress Nobody Books Time For

The holidays are not a health risk because of the food. They are six weeks of disrupted sleep, crowded rooms, long travel, altered routines and compressed emotional load — and the food is the part everyone writes about because it is the easiest to make a list out of.

So this page is ordered by what actually goes wrong, which is not the order you are used to.

1. Sleep, which is the one that causes the others

Almost everything difficult about the holidays gets worse with less sleep, including immunity, appetite regulation, patience, and the ability to handle a relative you see once a year.

Children first, because their sleep is what determines whether anyone enjoys this. A child who is up two hours past bedtime for four nights running is not being difficult on the fifth day — they are exhausted, and an exhausted child looks like a badly behaved one. Late nights cost more than early mornings, so if a routine has to give, protect the bedtime and let the wake time drift a little.

• Keep the wake time roughly fixed, even when the bedtime slips. It anchors everything
• Travel with the sleep cues rather than the whole routine — the same blanket, the same book, the same order of operations. The place changes; the sequence does not
• A tired child at a party is a short visit. Leaving early is a strategy, not a defeat
• Protect one quiet day in the middle. Not a day of activities. A day of nothing

For adults, the trap is the last hour of the evening — the one that gets spent wrapping, cooking or catching up. Two weeks of six-hour nights is what people mean when they say they got ill over the holidays.

2. What is actually going around

Not the cold. The cold does not cause colds. What causes them is exactly what the holidays are: many people, indoors, in shared air, from several households, for hours. Add air travel and school ending on an epidemic note.

The practical version:

• Handwashing, and soap and water rather than gel for stomach bugs. Norovirus — the winter vomiting bug — is not killed by alcohol hand sanitiser
• Get the flu shot before the travel, not after. It takes about two weeks to take full effect, so early December is late but not useless. In Arizona a December shot is still well worth getting, because our season often runs into March
• If someone is ill, they stay away. This is the hardest sentence in the holidays and it is the one that protects everyone. Specifically: a new baby, a pregnant person, anyone on chemotherapy or immune-suppressing medicine, and the very old. A cough that is a nuisance to a healthy adult is a hospital admission for a six-week-old
• Do not share the serving spoon, or the cup, or the fork someone is “just having a taste” with
• Ask about adult boosters before a new baby’s first winter. Most adults are years past due on the tetanus booster that includes whooping cough, and most infected infants catch pertussis from an adult at home

3. Travel, which is mostly a medication problem

The illness people get from travel is usually a virus. The emergency people get from travel is almost always a prescription left at home.

• Pack medication in hand luggage, in its original labelled container, with more days than the trip
• Take a written list of everything you take, including doses. A phone photograph counts
• Know what a refill looks like away from home before you need one
• For anyone with a serious allergy: two adrenaline auto-injectors, carried, in date. Unfamiliar kitchens and buffet food are exactly the setting
• Asthma inhalers and spacers travel with you, not in a checked bag, and a reliever that is nearly empty gets replaced first
• Diabetes needs its own plan for time zones, altered meal timing and a much longer day than usual
• Long drives and long flights: get up and move, and drink water. If you have had a clot before, or you are recovering from surgery, ask us before a long journey rather than after

4. Food, briefly, because it deserves less space than it gets

Two weeks of eating differently does very little to a healthy person. The pressure of the food conversation does more harm than the food.

• Eat before the party, not after. Arriving hungry is what produces the outcome people then feel bad about
• Alcohol is the calorie nobody counts, and it is also what wrecks the second half of the night’s sleep
• With children, do not make it a battle. A few unusual days do not undo a year of ordinary eating, and treating holiday food as transgression teaches something that lasts much longer than the sugar
• Keep the water going, particularly in Phoenix, where the air is dry even in December and people stop noticing thirst in cool weather

If you have diabetes, this is different and it is not about willpower. Altered meal timing, unfamiliar food and disrupted routine make blood sugar genuinely harder to manage. It is worth a plan rather than good intentions, and worth asking about before December rather than in January.

And one specific hazard: the cheese board and the raw dough. Unpasteurised cheese and raw flour or egg in dough carry real risk for pregnant people, young children and anyone immune-suppressed.

5. The stress, which is the part that gets left out

This is the section the other posts did not have, and it is the reason this page exists.

The holidays are genuinely hard for a lot of people, and the reasons are rarely the ones in a stress-management listicle. A first holiday after a death. Family you do not get on with, at close range, for days. Money that does not stretch. Being alone while everyone photographs not being alone. A recovery that gets harder when every event involves drinking. None of that is solved by a bath or a breathing exercise, and being told it is can make it worse.

A few things that genuinely help:

• Decide in advance what you are not doing, and say it early. Most holiday exhaustion is the accumulated cost of not having declined anything
• Keep one thing that is yours. A walk, a gym session, an hour with a book. The first thing people drop is the thing that was holding them together
• Plan the exit. Knowing when you are leaving makes staying easier
• A budget decided in November is a different thing from a bill arriving in January
• Breathing exercises are genuinely useful for the acute moment — our page on that covers what works, and also where self-management stops being the right tool

And the clinical part. If low mood, anxiety or hopelessness has been there most days for two weeks or more, that is not the holidays and it will not lift with them. Come and talk to us — raise it with your provider, and we will offer guidance or arrange a referral.

If you have any thought of harming yourself, please do not wait for an appointment. Call or text 988, the Suicide and Crisis Lifeline, at any hour.

If you are worried about someone else, ask them directly. It does not plant the idea. It is usually a relief.

Before December, not during

Two things worth doing while it is still possible to get an appointment:

Refills and prescriptions, ahead of the holiday closures.

Anything you have been putting off all year — and there is a practical reason to do it now rather than in January, because if your insurance deductible resets on 1 January, what you have already paid toward this year stops counting. Our year-end page covers that properly.

Call us if

• A fever lasting more than three days, or one that goes and comes back
• Symptoms that improve and then get worse again
• Any fever in a baby under one month — an emergency at any hour, holiday or not
• Any difficulty breathing, or a child with asthma needing their reliever more than usual
• Vomiting or diarrhoea with signs of dehydration — no urine in eight hours, no tears, a dry mouth
• Chest pain, pressure or tightness — call 911, and do not wait to see whether it passes
• You have run out of a medication, or are about to
• You are not coping. That is a reason to call, and the holidays are the season people are least likely to make it

Sources

2. Pertussis — MedlinePlus Medical Encyclopedia, U.S. National Library of Medicine. https://medlineplus.gov/ency/article/001561.htm
9. Flu — MedlinePlus Medical Encyclopedia, U.S. National Library of Medicine. https://medlineplus.gov/ency/article/000080.htm

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