Break and Breathe: Stress Relief for Healthcare Professionals

Written by: Jordan Zawaydeh BS, Healing Breaths Research Associate

Reviewed by: Somya Ramrakhyani MD, Healing Breaths Research Specialist

Introduction:

In the fast-paced and demanding environment of healthcare, maintaining mental and physical well-being is crucial for healthcare professionals. Micro-breaks, brief intervals of rest taken throughout the workday, offer a simple yet effective way to rejuvenate. These short breaks can be used to practice a variety of wellness promoting activities, notably including controlled breathing techniques, which provide a moment to ‘reset’ the nervous system. Integrating breathing exercises into micro-breaks helps manage stress, maintain focus, and preserve energy, ensuring that healthcare workers remain at their best throughout their demanding shifts.

What Are Micro-Breaks?

Micro-breaks are brief pauses taken frequently throughout the workday, typically lasting from a few seconds to a few minutes. Unlike longer breaks, such as lunch breaks, micro-breaks are designed to provide quick relief and re-energization without significantly disrupting the workflow.

Suggested Frequency and Duration:

Research suggests that brief minute-long micro-breaks should be taken approximately every 20-30 minutes [1, 2]. These shorter breaks can be as short as a few seconds to as long as a couple of minutes. Importantly, longer micro-breaks (10-15 minutes) after each 90 minutes of work are suggested to further enhance performance and well-being [3]. 

Types of Activities for Micro-breaks 

The most effective micro-breaks are those that allow individuals to detach from their tasks. Shorter (1-2 minute) micro-breaks allow for exercises such as relaxing the eyes, controlled breathing, and hydration. Longer (10-15 minute) micro-breaks allow for a larger diversity of activities that promote wellbeing and optimal functioning, while still minimally disrupting the workflow. The key is to choose activities that are enjoyable and relaxing to the individual.

Some suggested activities to perform during 10-15 minute micro-breaks are: 

1. Non-Sleep Deep Rest (NSDR)

For longer breaks, consider engaging in Non-Sleep Deep Rest (NSDR) practices, as recommended by Dr. Andrew Huberman, a neuroscientist at Stanford University [4]. NSDR involves techniques like Yoga Nidra or deep relaxation exercises, which can help reset the nervous system, enhance learning, and improve cognitive function.

2. Physical Movement

A short walk around the hospital or outside can refresh mind and body, providing a change of scenery and promoting physical activity. Further, physical movement can be particularly effective during longer breaks. Simple stretches, even if sitting, can alleviate physical tension, improve circulation, and boost energy levels. This not only enhances physical well-being but also helps maintain mental clarity and focus. 

3. Healthy Social Interaction

One often overlooked benefit of micro-breaks is their potential to foster healthy social interactions and connections among colleagues. During these interactions, healthcare professionals can interact informally, share experiences, and offer mutual support, allowing for relationship building, reduction in isolation, and enhancement in communication. The cohesion and sense of community that results from these interactions may lead to better coordination and collaboration in the workplace and ultimately enhance the quality of care provided to patients. 

4. Controlled Breathing

Incorporating controlled breathing during micro-breaks can also be highly beneficial. Techniques such as alternate nostril breathing or Ujjayi breathing can reduce stress, improve focus, and enhance overall well-being [5]. These practices are simple to do, can be performed at your desk, and can be executed during both shorter and longer micro-breaks. 

Benefits of Micro-Breaks for Healthcare Professionals

1. Reduction in Fatigue

Micro-breaks are particularly effective in reducing muscle fatigue and physical discomfort, which are common in healthcare roles that require repetitive movements or prolonged standing and sitting. Studies using tools like electromyography (EMG) and inertial measurement units (IMU) have shown that these short breaks can lead to better posture and less physical strain over time [6]. For healthcare workers, this can mean fewer musculoskeletal issues and better overall physical health. 

2. Improved Well-being

A meta-analysis of 22 studies revealed that taking micro-breaks is associated with increased vigor and decreased fatigue [1 3]. These breaks help prevent energy depletion, which is crucial for maintaining productivity and mental health throughout the workday. For healthcare professionals, maintaining high levels of well-being is essential for providing optimal patient care and reducing burnout.

3. Enhanced Focus and Attention

Short breaks, such as standing up, stretching, or taking a quick walk, can improve focus and prevent the decline in performance that typically accompanies extended periods of continuous work. These breaks are particularly beneficial for tasks that require sustained attention, such as patient monitoring or surgical procedures.

**Since controlled breathing is accessible in both shorter and longer micro-breaks, let’s dive a little bit deeper into how breathing enhances the use of micro-breaks as a strategy for managing stress during increased workload in the healthcare setting.**

Controlled Breathing:

Healthcare professionals frequently operate under high-stress conditions, which can lead to chronic activation of the sympathetic nervous system (SNS). This state, often described as the “fight or flight” response, is necessary for acute periods of stress but can be detrimental when sustained over long periods. The parasympathetic nervous system (PNS), or the “rest and digest” system, counterbalances the excitatory responses of the SNS. Engaging the PNS through specific breathing practices can be a valuable tool for stress management among healthcare workers. 

The Autonomic Nervous System: Sympathetic and Parasympathetic Imbalance

The autonomic nervous system (ANS) regulates many of the body’s involuntary functions, including heart rate, digestion, respiratory rate, pupillary response, and blood pressure. 

Chronic stress in healthcare settings often leads to an imbalance where the SNS is overly activated, which can lead to burnout, fatigue, and decreased immune function, among many other long-term health challenges [7]. To counter this imbalance, one may use controlled breathing to decrease SNS activation and increase PNS activation, effectively calming the nervous system.

Mechanisms of Breathing Practices Modulating the ANS

How does controlled breathing impact the SNS imbalance?

Vagus Nerve Stimulation

The vagus nerve, a critical component of the PNS, can be stimulated through various breathing techniques, such as Ujjayi breathing, which is characterized by constricting the back of the throat during inhalation and exhalation. This action not only slows down the breath but also creates a gentle massaging effect on the vagus nerve, enhancing parasympathetic tone and promoting relaxation and recovery [8].

Respiratory Rate Influence

The pace of breathing significantly affects autonomic function. Breathing at different paces can stimulate either the SNS or the PNS. For instance, breathing at a slow rate of three or fewer breaths per minute can activate the PNS, thereby inducing a state of calm and relaxation [9]. Conversely, rapid breathing rates exceeding 20 breaths per minute can trigger the SNS, heightening alertness and stress responses.

Biochemical Effects

Controlled breathing affects the levels of carbon dioxide (CO2) and oxygen (O2) in the blood. By managing the balance of these gasses through practices such as deep, slow breathing, one can increase the arterial CO2 concentration, which in turn enhances the Bohr effect — a physiological phenomenon where higher CO2 levels lead to increased oxygen release by hemoglobin. This process can improve tissue oxygenation and facilitate a state of calm by reducing the physiological symptoms of stress [10, 11, 12]. Additionally, nitric oxide (NO) is produced in the paranasal sinuses and is continuously released into the nasal airways. Especially during nasal breathing, NO typically reaches the lungs with inspiration. NO may similarly facilitate a state of calm by reducing the physiological symptoms of stress [13]. 

Conclusion

Incorporating breathing techniques and micro-breaks into the daily routine of healthcare professionals can significantly mitigate the detrimental effects of chronic stress without significant cost. By understanding and leveraging the autonomic nervous system, healthcare workers can enhance their well-being, improve their focus, and maintain a higher level of patient care. Simple practices like Ujjayi breathing and alternate nostril breathing, while taking brief, restorative micro-breaks can create a more balanced, healthy work environment. By fostering these habits, healthcare professionals can achieve better physical and mental health, ultimately benefiting both caregivers and patients. Engaging in these breathing exercises during micro-breaks not only helps in immediate stress relief but also builds resilience against long-term stress, ensuring a sustainable and effective approach to healthcare work.

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