hey there everybody and welcome to this presentation on the vagus
nerve vagal tone and vagal massage i'm your host dr donnelly snipes
the vagus nerve is one of the most connected nerves in our body and has been proposed to
mediate diverse physiological responses including indirectly regulating body temperature regulating
heart rate and functioning decreasing blood pressure helping send the signal to your body that
you're full or increasing satiation and it's also been involved in the reduction of inflammation in
acute like after a bone break or surgery and in autoimmune issues or chronic inflammation the
vagal nerve is a major component of the hpa axis which is involved in coordinated neural behavioral
and endocrine responses including those responses of immunity inflammation and heart rate they have
found in studies that vagus nerve stimulation can alter cardiovascular autonomic control in
healthy humans this is interesting so people who have difficulty with autonomic functioning their
hpa axis dysregulates this is something that we see in patients with trauma histories as well as
people with pots and other conditions and they've also shown that the vagus nerve tells the gut
when or responds with from signals from the gut and tells the brain when you're satiated
but people who are obese or who eat high fat diets
that signaling is compromised so the vagus nerve doesn't tell the brain in time that
you are satiated so people tend to overeat which is kind of interesting
it also mediates responses including stomach acidity blood sugar regulation so those
people with hypo or hypo hyperglycemia or diabetes bile release and production
water and sodium balance and saliva and tear production so it's got its little you know
nerve endings in just about everything which is why understanding uh vagal massage and
vagal stimulation can be helpful for people with anxiety disorders with autonomic disorders where
they have tachycardia or their blood pressure suddenly drops there are a lot of different
ways that vagal massage and vagal nerve stimulation may be helpful
vagal nerve stimulation and this is the medical vagal nerve stimulation and we're going to talk
about the other approaches including massage in a minute but it's been associated with a significant
improvement in cardiac function quality of life scores and even exercise performance
vagal nerve stimulation was approved by the fda for the treatment of drug resistant epilepsy
and depression in 1997 and 2005 respectively and more recently was approved to
treat migraine so those are three things that are really common in our society that are
approved that can be treated with vagal nerve stimulation it's currently under investigation for
use to address inflammation in autoimmune issues including crohn's rheumatoid arthritis colitis
lupus as well as post-operative atrial fibrillation cognitive impairment opioid use
disorders diabetes and ptsd and fear extinction you can go to clinicaltrials.gov and type in vagal
nerve stimulation to find some of these really fascinating studies that they are doing right
now in order to explore the applicability of vagal nerve stimulation for treatment
now auricular stimulation of the vagus nerve is different than vagal nerve stimulation where they
do surgically implant a device that stimulates that vagus nerve auricular means around the
ear and auricular stimulation of the vagus nerve um can be helpful the auricular branch
of the vagus nerve innervates the skin parts of the ear and the outer ear canal regarded as the
main parasympathetic output of the autotomic autonomic nervous system sorry y'all the vagus
nerve has an extensive distribution throughout the abdomen heart lungs liver adrenal medulla
and the gastrointestinal tract i told you this little bugger was kind of involved in everything
auricular stimulation of the ear or the auricular branch of the vagus nerve can be electrically
electrically like with a tens unit or manually massage stimulated through the skin
which may provide a therapeutic alternative with widespread clinical use
including heart rate variability reducing inflammation and addressing depression
so the auricular branch of the vagus nerve
is located in the tragus and the concha now think conch shell those shells you hold up
to your ear that have that hollow inner core you know that's the concha is the inner part
of your ear right here and you can see it on the diagram better than you can see it on me
and the tragus is that little flap of skin right in the front of the ear and that's where you have
a lot of nerve endings for the vagus nerve and then the main branch of the vagus nerve
goes down right behind your jaw bone and kind of right along this this muscle in your neck down
kind of to your throat because it's also involved in you know your voice box and everything but
um so when you're massaging you can put a finger um i usually use my middle finger on the tragus
and my index finger behind my ear and gently you don't need to press this is not acupressure
you just gently massage around in circles and then you can work your way down just bringing both
fingers together as you move down your throat again not pressing hard just gently massaging
all the way down to your neck and then you can repeat that
but a lot of people find that they find relief with just that other people find more relief
by massaging the concha um whatever works for you you need to try out a few different things to see
if it helps most people who try doing it report that they can notice a
sensation when they do it
other ways that you can improve your vagal tone which is your vagus nerve's ability to
effectively respond and not over respond or under respond to sensory input include yoga meditation
and biofeedback with yoga you are getting yourself into a position and you are holding it it is not
easy you know you are using a lot of muscles and it can get um a little uncomfortable sometimes as
you are getting into those positions but through slow breathing you are training your vagus nerve
to not over respond you're training your vagus nerve to maintain that calm relaxed
state meditation is the same way with deep breathing and focused meditation it
helps kind of calm that vagus nerve and it helps you develop more conscious control
over your your breathing and your heart rate you know they are going to when you're triggered
they're automatically going to be you know kicked off because that hpa access goes into um goes into
overdrive but you are able as you start developing more um control or effective control of your vagus
nerve you are able to slow your breathing and consciously start slowing your heart rate which
is where biofeedback comes in you know people can use one of those little finger monitors
that monitors your oxygen saturation and your pulse rate so when you get stressed you can
practice that deep breathing and that relaxation or you can even practice the vagal massage and
get to the point where you have where you're able to gradually reduce your your stress
response your breathing your heart rate and by consequence probably your blood pressure
most people don't have a blood pressure monitor handy to monitor that but that is something
else you can monitor pretty easily on your own with a over-the-counter blood pressure monitor
i hope this was helpful because a lot of people are talking about the vagus nerve and vagal tone
and this can be one strategy that is helpful for developing a healthier vagal nerve