Q&A: Addressing vocal manifestations of ‘Zoom fatigue’

Since the start of the pandemic, people from various professions have turned to Zoom and other video conferencing services instead of in-person meetings to protect themselves and others from COVID-19.

However, the continuous use of these services has led some to develop “Zoom fatigue,” which may worsen already present functional voice issues from continuous overuse.

Healio Primary Care spoke with Brandon Baird, MD, director of the Voice Center at the University of Chicago Medicine, to learn more about these effects and what patients can do to avoid them.

Q: What is Zoom fatigue?

A: Many patients are coming in with complaints of increased vocal fatigue and hoarseness related to the number of hours per day that they’re talking on the computer or via Zoom. This voice overuse may lead to functional voice issues or exacerbate already present voice problems. Anecdotally, many of these patients are noting a lot of difficulty getting through the end of their day because of how much they’re using their voice on apps like Zoom.

Q: What are the potential vocal manifestations Zoom fatigue?

A: People may notice that their voice sounds off, or that they are having to strain hard to be heard over the virtual platform. This added effort may be associated with extra vocal cord tension or strain. These people might have to take days off or may find that they’re less vocal in virtual meetings due to the perceived effect and occasional discomfort. Some people also report limiting voice use in their personal life due to vocal fatigue, such as avoiding talking to friends/family over the phone or not being able to read to their kids by the end of the day.

Q: What tips can be offered to patients to alleviate Zoom fatigue?

A: Being mindful of one’s vocal demands and taking small breaks throughout the day may be helpful to prevent exacerbation of already present issues. Good vocal hygiene, drinking plenty of water, and avoiding caffeine and other substances that can cause dehydration are generally good practices. If you are experiencing Zoom fatigue-related voice problems, see an ear, nose and throat specialist (specifically one trained in voice/vocal rehabilitation — also called laryngology) who can identify structural or functional pathology that might be contributing to the patient’s symptoms.

Q: Which patients are at an elevated risk for Zoom fatigue?

A: People who are more vocally active tend to run into these problems, such as lawyers, schoolteachers and other people who had heavy voice requirements throughout the day. Patients who already have an underlying voice disorder — those who have a raspy voice at baseline or have some difficulty getting their projection high enough to be heard by people on the other side of the Zoom call — may also note increased issues related to using Zoom more frequently. Some people with voice disorders will occasionally overcompensate by trying to speak louder so that they can be heard over ambient noise. One thing that can help these patients is using a specialized microphone to improve the ability of their computer to pick up their voice. Another helpful tip is conducting all meetings in a noise-free environment.

Q: Should physicians treat Zoom fatigue in telehealth visits?

A: Primary care physicians should be listening for these changes in patients’ voices. If their patients say that they’re having difficulty allowing their voice to be heard on Zoom and in-person, referral to a laryngologist should be considered prior to initiating treatment. Flexible laryngoscopy, and oftentimes stroboscopy, is the gold stand for diagnosis of vocal cord pathology.

Q: Are physicians suffering from Zoom fatigue? If so, what is your advice to them?

A: Now that the health care industry is engaging in more telemedicine, it is likely that physicians are affected by the vocal manifestations of Zoom fatigue as well. Taking breaks between patients, drinking plenty of water and remembering to use things like microphones and other adjuncts to help improve vocal clarity may help to improve one’s vocal health.