• Shannon Sims, PhD

Healing Breathwork for Long COVID Recovery

Updated: Nov 21



The Diaphragmatic Vagal Repair Method

(DVR-M)

For Long COVID Recovery

(copyright pending)


>>> Watch the Video: Part I - DVR-M Explained

>>> Click Here for Part II - Guided Practice


Long COVID can be a disabling condition that impacts about 15% of people after a COVID-19 infection (1,2). While there is not yet a universal definition for Long COVID, also referred to as post-COVID syndrome, it is generally categorized by worsening and/or new symptoms that persist for more than four weeks following a COVID-19 infection (3). One circulating theory for the cause of Long COVID symptoms is vagus nerve dysfunction, which could explain some of the prolonged symptoms, including dyspnea, cognitive dysfunction (e.g., memory issues and “brain fog”), dizziness, tachycardia (elevated heart rate), dysphagia (difficulty swallowing), and orthostatic hypotension (low blood pressure).


What is Somatic Breathing?

Somatic breathwork allows the mind and body to connect intentionally with the experience of breathing. Research shows that COVID-19 wreaks havoc on the autonomic nervous system (ANS) (4,5), causing an imbalance among many of the body’s systems, including the cardiovascular system. A key player in the ANS is the vagus nerve, which helps the body handle stress and maintains balance among all the body’s systems. The vagus nerve helps to regulate the ANS, but this function is thrown out of balance during a COVID-19 infection (6). One study found that 27% of participants had an inflamed or thickened vagus nerve after COVID-19 (7). When the ANS is out of balance, the body is stuck in a constant “fight or flight” stress response, which leads to elevated heart rate, high blood pressure, lower immune system functioning, increased anxiety, depression, poor sleep, and memory issues (to name a few!).


The Vagus Nerve and Long COVID

The vagus nerve is the 10th cranial nerve that originates at the base of the brain, wanders through the abdominal cavity, and connects to the diaphragm (the balloon-like muscle attached to the lungs). The movement of the diaphragm that comes from deep breathing helps to stimulate the vagus nerve, which sends an immediate signal to the brain, telling the body to override the stress response and bring about relaxation. This relaxation response helps to balance the nervous system and restore homeostasis in the body. Improved vagal tone, or vagal activity (achieved through vagal stimulation), is the primary driver for re-balancing and calming the overactive nervous system.


Many people with Long COVID report difficulty with breathing, which can lead to many issues such as poor oxygen saturation, anxiety, post-exertional malaise, deep fatigue, elevated heart rate, and high blood pressure. According to recent studies, there are some of the primary post-COVID symptoms (3,8-10), all of which are functions mediated by the ANS and the vagus nerve. One way to immediately tap into the ANS is by stimulating the vagus nerve through breathing deeply into the lungs. Research is beginning to emerge suggesting that stimulating the vagus nerve and enhancing vagal tone can be one potential treatment pathway for Long COVID recovery (11-13).


Boiling it Down

Based on her personal Long COVID recovery, extensive work with Long COVID patients, and expertise in mind-body medicine, Shannon McLain Sims, PhD, developed a 2-step somatic breathwork practice to recondition the diaphragm and re-balance the nervous system following a COVID-19 infection. With the combination of intentional breathing and localized healing touch, the Diaphragmatic Vagal Repair Method (DVR-M) is designed to ignite vagal stimulation and increase vagal tone to help individuals better manage the numerous and persistent Long COVID symptoms.


The DVR-M Practice


The DVR-M is a 2-step somatic breathwork practice developed by Shannon Sims, PhD, to recondition the diaphragm and re-balance the nervous system following a COVID-19 infection. Through intentional breathing and healing touch, the DVR-M can help individuals better manage the numerous and persistent symptoms following a COVID-19 infection, often referred to as post-COVID syndrome or Long COVID.


>>> Guided Practice Video


Begin by finding a comfortable position, either seated or lying down. Remove or loosen any clothing that restricts your breathing.


Step 1: Diaphragmatic Release

Using two fingers (on both hands – index and middle fingers, or middle and ring fingers), locate the soft spot below the sternum where the ribs meet. Press the fingers into the body with light to medium pressure and slowly draw the fingers down towards the belly button (like you are stretching taffy) - this is where the diaphragm connects with the vagus nerve. You will likely begin to feel a release that allows the breath to be longer and fuller. Continue this motion of pressing in and stretching down several times before moving to Step #2.


Step 2: Breathwork

After releasing the diaphragm, you may begin the breathwork process: Inhale (through the nose), hold, and exhale slowly (through pursed lips). Try to allow for the exhale to be slightly longer than the inhale.


Breathing in this way helps to stimulate the vagus nerve, which sends a signal to the brain telling the body to relax.


Tip #1: Instead of focusing on breathing deeper, try to focus on breathing lower and slower. If this is still difficult, check out tip #2.


Tip #2: Take care not to force your breath too much. If you are finding it hard or painful to breathe, try making the breath shorter (but still allow the exhale to be longer than the inhale), or don’t hold the breath as long.


Duration: 5-20 minutes daily. The more you work with this practice, the more you will feel the benefits.



Written by: Shannon Sims, PhD



About the author: Shannon is an integrative wellness coach with Aila Health. She holds a PhD and master’s degree in mind-body medicine from Saybrook University's College of Integrative Medicine and Health Sciences. Dr. Sims also carries two certificates from Saybrook: integrative wellness coaching and integrative and functional nutrition. In addition to her coaching with Aila, Shannon is a Saybrook University faculty member, Long COVID recovery specialist, and a mind-body medicine practitioner. Her teaching and practice philosophy is predicated on her commitment to helping each individual reach their fullest potential by achieving a balanced, empowered, and meaningful wellness-oriented lifestyle. She is passionate about educating on the importance of the mind-body connection and the various avenues in which self-healing can be achieved. Dr. Sims recognizes and acknowledges the intimate connection between mind, body, spirit, and person-centered wellness through an integrative and holistic lens.



References


1. Greenhalgh, T., Sivan, M., Delaney, B., Evans, R., & Milne, R. (2022). Long covid—An update for primary care. BMJ, 378. https://doi.org/10.1136/bmj-2022-072117


2. Perlis, R. H., Santillana, M., Ognyanova, K., Safarpour, A., Trujillo, K. L., Simonson, M. D., ... & Lazer, D. (2022). Prevalence and Correlates of Long COVID Symptoms Among US Adults. JAMA Network Open, 5(10), e2238804-e2238804. https://doi.org/10.1001/jamanetworkopen.2022.38804


3. Sampogna, G., Di Vincenzo, M., Giallonardo, V., Perris, F., Volpicelli, A., Del Vecchio, V., ... & Fiorillo, A. (2022). The Psychiatric Consequences of Long-COVID: A Scoping Review. Journal of Personalized Medicine, 12(11), 1767. https://doi.org/10.3390/jpm12111767


4. Dani, M., Dirksen, A., Taraborrelli, P., Torocastro, M., Panagopoulos, D., Sutton, R., & Lim, P. B. (2021). Autonomic dysfunction in ‘long COVID’: Rationale, physiology and management strategies. Clinical Medicine, 21(1), e63. https://doi.org/10.7861/clinmed.2020-0896


5. Dotan, A., David, P., Arnheim, D., & Shoenfeld, Y. (2022). The autonomic aspects of the post-COVID19 syndrome. Autoimmunity Reviews, 21(5), 103071. https://doi.org/10.1016/j.autrev.2022.103071


6. Rangon, C. M., & Niezgoda, A. (2022). Understanding the Pivotal Role of the Vagus Nerve in Health from Pandemics. Bioengineering, 9(8), 352. https://doi.org/10.3390/bioengineering90803527.


7. American Association for the Advancement of Science. Pilot study suggests long COVID could be linked to the effects of SARS-CoV-2 on the vagus nerve: Reports and proceedings: European Society of Clinical Microbiology and Infectious Diseases EurekaAlert! 2022 Feb 11.


8. Bourmistrova, N. W., Solomon, T., Braude, P., Strawbridge, R., & Carter, B. (2022). Long-term effects of COVID-19 on mental health: A systematic review. Journal of Affective Disorders, 299, 118-125. https://doi.org/10.1016/j.jad.2021.11.031


9. Rudroff, T., Workman, C. D., & Bryant, A. D. (2022). Potential Factors That Contribute to Post-COVID-19 Fatigue in Women. Brain Sciences, 12(5), 556. https://doi.org/10.3390/brainsci12050556


10. Tang, S. W., Leonard, B. E., & Helmeste, D. M. (2022). Long COVID, neuropsychiatric disorders, psychotropics, present and future. Acta Neuropsychiatrica, 1-18. https://doi.org/10.1017/neu.2022.6


11. Badran, B. W., Huffman, S. M., Dancy, M., Austelle, C. W., Bikson, M., Kautz, S. A., & George, M. S. (2022). A pilot randomized controlled trial of supervised, at-home, self-administered transcutaneous auricular vagus nerve stimulation (taVNS) to manage long COVID symptoms. Bioelectronic Medicine, 8(1), 1-10. https://doi.org/10.1186/s42234-022-00094-y


12. Basharat, S., & Mahood, Q. (2022). Vagus Nerve Stimulation for the Treatment of Post–COVID-19 Condition. Canadian Journal of Health Technologies, 2(9). https://doi.org/10.51731/cjht.2022.452


13. Mastitskaya, S., Thompson, N., & Holder, D. (2021). Selective vagus nerve stimulation as a therapeutic approach for the treatment of ARDS: A rationale for neuro-immunomodulation in COVID-19 disease. Frontiers in Neuroscience, 15, 415. https://doi.org/10.3389/fnins.2021.667036




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