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