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Evidence Based

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Does Vagus Nerve Tapping Live Up to the Hype?

Written by Dr. Michael Ruscio, DC on December 31, 2021

Written by Dr. Michael Ruscio, DC on December 31, 2021 — Reviewed by Dr. Hannah Hamlin

Your Guide to Vagus Nerve Stimulation 

• Role of the Vagus Nerve|
• Measuring Vagal Tone|
• Health Benefits of Vagus Nerve Stimulation|
• 5 Ways to Increase Vagal Tone|
• Alternative VNS Techniques|
• The Verdict on Vagus Nerve Tapping|

Can we tap our way to better health? Vagal nerve stimulation is a fairly new concept in functional medicine, but it is being touted for its wide array of health benefits. Vagus nerve tapping, massage, and laughter are just a few of the methods that aim to restore balance to the nervous system by healing the vagus nerve (the primary component of the parasympathetic, or “rest and digest”, nervous system). 

While the research behind some of these methods, including tapping, is limited, vagus nerve stimulation has been shown to have significant health benefits. Some of the more invasive forms of vagus nerve stimulation have even been FDA-approved for certain conditions, like treatment-resistant depression.

The article will explore the power of the vagus nerve, the various methods of vagal nerve stimulation beyond vagus nerve tapping, simple lifestyle techniques for improving vagus nerve health, and what it means to have good vagal tone. 

The Important Role of the Vagus Nerve

The vagus nerve is classified as a “cranial nerve” and is the main component of our parasympathetic nervous system (PNS). The PNS is the branch of our autonomic nervous system known as the “rest and digest” branch. It helps us to relax and counteracts the “fight or flight” response by inhibiting the sympathetic nervous system (SNS).

Having a properly functioning vagus nerve allows us to recover more quickly after having a stress response. With chronic stress now running rampant in our modern society, our ability to quickly recover after daily stressors is crucial to our physical health.

A properly functioning vagus nerve 1 2 3:

• Slows down our heart rate and breathing
• Lowers our blood pressure
• Combats the release of stress hormones
• Regulates our digestive system 

Here are some benefits for psychological health 3 4 5:

• Helps regulate our mood, emotions, and cognition
• May play a crucial role in psychiatric disorders

The vagus nerve is an important modulator of our immune systems, and it has largely anti-inflammatory effects on the body. Researchers are currently investigating the role of the vagus nerve in treating various inflammatory conditions 3.

In the gut, the vagus nerve 1 6 7:

• Lowers inflammation
• Regulates the speed of the digestive tract
• Improves digestion and secretion

The vagus nerve provides a direct pathway from the GI tract to the brain. It transports neurotransmitters that are made in the digestive tract, like serotonin, dopamine, acetylcholine, and norepinephrine, to the brain. Once in the brain, these powerful chemicals can then directly influence our appetite, ability to feel pain, mood, and even memory 5 7 8.

Having an under-functioning vagus nerve, otherwise known as poor “vagal tone,” is linked to several health conditions, such as high blood pressure and cardiovascular disease, seizures, and diabetes 9. 

Studies show that those with irritable bowel syndrome (IBS) and irritable bowel disease (IBD), which are characterized by abnormal gut inflammation and motility, have worse vagal tone 10.

Other conditions thought to be linked with poor vagal tone include: 

• PTSD 11
• Epilepsy 12
• Headaches 13
• Parkinson’s disease 14
• Anxiety and panic disorder 15
• ADHD 15
• Schizophrenia 15
• High blood pressure and cardiovascular disease
• Diabetes and metabolic syndrome 16 17 18
• Cardiovascular disease and high blood pressure 3 19

However, it is unclear at this time what the exact relationship between these conditions and vagal tone is. It is possible that low vagal tone does not cause these conditions but is simply a symptom of these disorders.

How to Measure Your Vagal Tone

As the vagus nerve is a main regulator of our heart rate, we can estimate vagal nerve tone through a test called heart rate variability (HRV) 6. HRV measures the fluctuations in time between our heartbeats. More fluctuations in our heart rate, or “higher vagal tone,” indicates more activity in the vagus nerve and a balanced autonomic nervous system 20 21.

However, even though we have the ability to measure vagal tone, there are no definitive ranges that tell us exactly where our HRV should be 10.

Higher HRV is considered an independent marker of better health and is linked to stronger resilience of our nervous systems. It is associated with our body’s ability to return to “normal” after experiencing a stressful event 22.

Less variability in heart rate is considered “low vagal tone” and is an indicator of poor health outcomes 9. Lack of sleep, alcohol consumption, and a sedentary lifestyle are all linked to lower HRV levels.

Tracking HRV is fairly easy with the recent technological developments in mobile healthcare. All that is needed is a device, such as a smartwatch or smartphone application, that measures your heart rate and automatically calculates HRV for you. This gives us a simple and straightforward way to gauge the health of our nervous systems at home. 

Does Vagus Nerve Tapping Provide Health Benefits?

There are a myriad of new techniques that claim to restore the balance of our nervous systems by strengthening the vagus nerve. But do these techniques really work, and, more importantly, can they lead us to better wellness?

There is currently no research on the health benefits of vagus nerve tapping or its ability to improve vagal tone (activity of the vagus nerve). This particular technique involves tapping different parts of the chest to stimulate the vagus nerve and balance our autonomic nervous system. 

There are a few YouTube videos that demonstrate how to perform vagus nerve tapping, but there is very little information regarding the science or evidence behind the technique.

Despite the underwhelming research on vagus nerve tapping, there are several similar methods that stimulate vagal function which are backed by a small amount of evidence. But first, let’s discuss the basics of vagal nerve stimulation and some of the more heavily researched methods.

What Is Vagus Nerve Stimulation?

Vagus nerve stimulation or “VNS” is either the mechanical or electrical stimulation of the vagus nerve 4. This stimulation of the vagus nerve is thought to directly activate it and produce many positive health effects on the body.

Fortunately, the science behind VNS holds up, particularly with electrical VNS. There are methods that deliver electrical VNS, which can be done either surgically or by placing electrodes on the skin 1 23.

Invasive VNS requires surgical implantation of a device that delivers electrical stimulation to the vagus nerve, forcing the body to enter a relaxation response. This is a fairly invasive procedure where an electrode is embedded under the skin, near the collarbone. It comes with a higher risk of side effects, including 1:

• Vocal changes and hoarseness
• Cough
• Facial tingling
• Facial nerve paralysis 

Invasive VNS is actually FDA-approved for the treatment of epilepsy and treatment- resistant depression 1. Even though it may come with a higher risk of side effects, it gives those with psychiatric and seizure disorders another option for when traditional medications do not work.

In patients with Crohn’s disease, invasive VNS calmed inflammation in the GI tract and reduced overall activity of IBD symptoms after 4-6 months of use 24. It is also currently being researched for use in migraines, tinnitus, Alzheimer’s, Parkinson’s disease, autism, inflammatory bowel disease, and infertility 1.

Non-surgical electrical VNS uses electrodes that are placed either on the ear or the neck to increase vagal tone. Research shows that this method of vagal stimulation reduces inflammation, abdominal pain, indigestion, irritable bowel disease, and migraines 25 26.

In two clinical trials, this approach provided considerable improvement in anxiety and depression symptoms, making it a promising therapy for treating mental health concerns 26 27.

5 Easy Ways to Increase Your Vagal Tone

Vagus nerve tapping may not be the best way to improve vagal tone, and not everyone has access to electrical VNS. Fortunately, there are several easy ways to improve both your overall health and the health of your vagus nerve.

It is important to highlight that many of these methods are known to produce many physiological changes in the body, and their benefits may not be limited to their direct effects on the vagus nerve. That being said, they are safe and simple lifestyle changes that can be easily incorporated into your daily routine.

1. Yoga and Meditation

Studies show that those who practice yoga daily have higher HRV (heart rate variability, an indirect measurement of vagal tone), a higher quality of life, and can recover from a stressful event more quickly 28 29.

Having a daily meditation practice may strengthen your vagus nerve and restore balance to your nervous system. Those who practice mindfulness, a form of meditation that focuses on living in the present moment, also had significantly increased HRV and vagal tone 30.

2. Laughter

“Laughter is the best medicine” may not be just an expression. One study showed that laughter may improve HRV, anxiety, and overall mood 31. One study that looked at over 20,000 participants found that those who laughed less had a higher prevalence of heart disease, even after controlling for other cardiovascular factors 32.

3. Breathing exercises 

Research shows that breathing exercises can improve heart rate variability, a common measure of vagus nerve function 33.

One study looked at the effect of slow breathing on the symptoms of patients with brain injuries. These exercises were designed to directly target the vagus nerve by controlling the rate at which the participants breathed. The results showed that this practice improved the function of the vagus nerve and the patients’ emotional regulation 34.

Singing, humming, and mantra chanting also can stimulate the vagus nerve through the vibration of our vocal cords. These techniques are linked to increased vagal tone, but this finding may be more related to the effect that these exercises have on our breathing patterns 35.

Fortunately, breathing exercises are easy to do while you are on the go. They can be incredibly beneficial in restoring the nervous system when performed after experiencing stressful events throughout the day. 

Diaphragmatic breathing, or “belly breathing,” is a useful method that helps to slow down your breath. The goal with this technique is to fully engage the abdominal muscles while inhaling, in order to draw the breath deeper into the lungs.

One simple breathing technique you can try is called “box breathing”. This technique involves breathing in for 4 seconds, holding your breath for 4 seconds, breathing out for 4 seconds, and then holding your breath again for 4 seconds. Repeat this sequence for 4 minutes.

This helps relax the muscles of the chest that are constantly engaged during shallow and rapid breathing — the pattern we unconsciously slip into when stressed.

4. Diet

Many diets that support gut health and overall wellness also appear to benefit vagal tone. Diets high in omega-3 fatty acids and low in trans fats, like the Paleo diet, are linked to better vagal tone. 

Food rich in polyphenols, minerals, and vitamins — particularly B12 — may also help to improve vagus nerve health 36 37. Incorporating leafy green vegetables, fresh fruits, tea, dark chocolate, and red wine into your diet can boost your polyphenol levels. Foods that are high in B12 include hormone-free meats, seafood, and eggs.

Probiotics may also benefit vagal tone 9 and can easily be implemented into your diet as supplements or foods that promote good gut bacteria, like kombucha, kimchi, sauerkraut, kefir, and yogurt.

5.  Exercise

Exercise is one of the best ways to quickly improve your heart rate variability. The first place to start is to ensure you are getting daily movement in. A good goal is at least 5,000 steps per day (up to 8-10,000 steps per day if you are feeling ambitious). One study showed that walking five days per week improved HRV and vagal tone 38.

Once you are engaging in daily movement, you can then layer in formal exercise. One of the best places to start is aerobic exercise. This includes low-intensity cardio on a bike, treadmill, rower at a target heart rate of 110-150 beats per minute for 10-60 minutes. Start slow and work your way up to a longer duration.

High-intensity exercise also showed significant benefit in increasing HRV and even reduced abnormal heart contractions in those with heart disease 39. However, repeated high-intensity exercise without adequate rest and recovery may actually do the opposite to your vagal nervous system.

Alternative Methods of Vagus Nerve Stimulation

Non-electrical forms of vagal stimulation are significantly less researched and include 9 40 41:

• Vagus nerve tapping
• Deep breathing exercises
• Cold water exposure/ cold showers
• Apollo Neuro device
• Massage
• Laughter
• Exercise
• Yoga and stretching
• Biofeedback

Biofeedback (Possibly Effective) 

Heart rate variability (HRV) biofeedback is another method that aims to regulate the vagus nerve by monitoring your heart rate. It may be a potential treatment for improving cognition in those with post-concussive syndrome 42. When combined with slow breathing exercises, HRV biofeedback may help improve vagal tone and lower blood pressure 43.

Massage (Possibly Effective) 

Patients who performed carotid sinus massage, a technique that emphasizes massage of certain neck muscles, had reduced heart rate and improved vagus nerve function. However, carotid sinus massage may be unsafe for people with certain cardiovascular conditions. Talk to your doctor prior to trying it 44.

One study looked at the effects of massage with tap and ice water, which stimulates the vagus nerve through temperature and pressure. Ice massage can be performed by massaging any area of the body with an ice cube or frozen ice pack. Massage with either water temperature has a positive effect on vagus nerve function and produces a decrease in heart rate 45.

Gargling, Tapping, and Gagging (Not Effective)

Gargling with salt water, self-induced gagging by touching the back of the throat, and vagus nerve tapping are all techniques rumored to stimulate the vagus nerve. However, there is currently no research that supports that any of these methods have any effects on the vagus nerve or offer health benefits.

It is important to note that several of the above techniques are well-known to produce many beneficial effects on the body. It is not clear if the benefits of these therapies are directly due to vagus nerve stimulation or through other physiological processes 35.

Overall, some of the less invasive forms of vagal nerve stimulation may likely provide health benefits, without the risks that come with electrical VNS. Start with techniques that improve vagal tone along with overall health, as opposed to techniques like gargling or tapping that may not be as beneficial.

The Verdict on Vagus Nerve Tapping

While vagus nerve tapping may not have much evidence to back up its effects on our nervous system and overall health, many other forms of vagal nerve stimulation show benefits.

Electrical VNS has the most evidence-based benefits for its ability to stimulate the vagus nerve and treat many chronic health conditions like depression, pain, epilepsy, and migraines. However, electrical VNS can be invasive and a difficult therapy for people to access. 

Deep breathing exercises, exercise, laughter, cold water therapy, and massage are all forms of mechanical vagus nerve stimulation that are associated with increased HRV and vagal tone. They are easy to perform, come with minimal risks, and make VNS a more practical therapy. 

Even making simple lifestyle changes, like adjusting your diet, exercising, and implementing mindfulness can help to restore balance to the nervous system and provide numerous health benefits.

For more information on healing the gut and re-establish the gut-brain axis, check out my book, Healthy Gut, Healthy You.