From cold plunges to digital detox retreats—there are now so many ways to regulate the nervous system, we can get decision fatigue in the search for stress relief alone. But the solution may be simpler than we’d expect—rather than looking outside ourselves for the latest trending treatment or mindfulness product, we can find support by turning inward. Enter: the vagus nerve. An essential nerve of the parasympathetic nervous system (our “rest and digest” system).
Over a decade ago, neuroscientist and board certified psychiatrist Dr. Dave Rabin, MD, PhD, noticed a commonality among his patients with anxiety, depression, and severe post-traumatic stress disorder (PTSD)—they all had vagus nerve disregulation. “I realized the vagus nerve is more important than we were taught in medical school and that we need to be activating it in our patients more often.”
The problem? In clinical settings, the vagus nerve is typically activated with an electrical simulator, by delivering mild electrical pulses to the nerve. With unwanted side effects like shocking and burning the skin, Dr. Rabin observed his patients were disincentivized from using the simulator regularly. So he brainstormed how he could deliver the same effects more conveniently. With the help of his research team at the University of Pittsburgh Medical Center, he developed a wearable, non-invasive technology that stimulates the vagus nerve through sound waves. After seeing stress-reduction among the majority of the 3000 people that tested the device in clinical trials, he launched the consumer technology—Apollo—with his wife, Kathryn Fantauzzi, in 2020.
As the vagus nerve gains attention in wellness, it can be hard to distinguish the buzz from the facts. So we chatted with Dr. Rabin to learn more about the nerve everyone’s been talking about.
Anna Haines: What is the vagus nerve?
Dr. Dave Rabin: The vagus nerve is easily one of the most important nerves of the human body. It’s the 10th of 12 key cranial nerves that start in the brain stem and extend throughout the entire body. A lot of people are under the misconception that it’s only located in certain parts of the body. It was nicknamed, around 100 years ago, the “wandering nerve” because it effects every part of the body.
The vagus nerve is the core nerve of the parasympathetic nervous system that governs all rest and recovery activities of the entire body. The body has two parts of the nervous system that are running in the background to keep us alive, sane, and functional: the sympathetic system is our stress, or “fight or flight” side, while the vagus nerve is the rest and recovery side.
All animals with a nervous system have something similar to a vagus nerve. It’s not unique to humans, it’s been hardwired for hundreds of millions of years.
How does the vagus nerve work?
It slows everything down—it decreases heart rate, blood pressure, breathing rate, the speed of your thoughts, and increases activity in all of the systems responsible for recovery that are not useful for survival like digestion, immunity, creativity, empathy, reproduction, and rest.
Do you think the vagus nerve is overhyped in wellness lately?
I don’t think it’s overblown. If anything, we need to be talking about the vagus nerve even more. It’s the single most important critical nerve in our bodies for regulating sleep, recovery, metabolism, cardiovascular health, immunity, reproduction, and empathy, our ability to connect with one another. That’s everything that makes our lives good. When our vagus nerve is not being activated properly and it’s misfunctioning because we are under chronic stress, this can lead to disease.
We need to revamp western medical education to create curriculum that can educate the community on the importance of this nerve and how we need to be talking about it differently. It’s not just something that’s running in the background, it’s something we can positively influence by changing our behavior.
Why do we need to practice activating the vagus nerve?
Your stress system turns on when you’re facing a survival threat, but the “fight or flight” system also responds to newness, contrast, and stress, like overstimulation and our phones. Too much information coming in can trick our bodies into thinking we’re in danger when we’re not. Your sympathetic nervous system turns on and takes all of the available blood and resources in the body away from the vagus nerve recovery system and directs it toward the sympathetic system.
Once you have established safety with certainty, you want your sympathetic system to come down and vagus nerve activity to come up. When the vagus nerve activity rises, it sends a signal to all the blood vessels going to all of the systems that are deprioritized when you’re stressed like the immune system, digestion, reproduction, sleep, and recovery.
When we look at the data and statistics, common issues like irritable bowel syndrome and infertility, appear to be due to chronic stress and anxiety first. Most people don’t have a biological reason for these systems not to be functioning.
What are some proven clinical benefits of stimulating the vagus nerve?
There are countless benefits. Vagus nerve simulators are used to treat seizure disorders, depression, PTSD, gut issues, anxiety, and chronic pain. This explains why people who have these conditions benefit from deep breathing, yoga, meditation, and soothing touch, because all of these activities activate the vagus nerve.
How can we activate the vagus nerve?
The most important thing to know about the vagus nerve is it has a diverse set of inputs so you can activate it in many different ways. The two ways you can activate through the skin are by rubbing the inside of the ear, and by massaging the pressure receptor on your neck around your corroded sinus.
Without touching yourself you can activate it by slow deep breathing; slow movements like yoga; meditation; soothing touch; surrounding yourself with calming sensations, music, sights, smells, and tastes; holding pets; humming; and singing.
Making sure your ambience is consistent with how you want to feel is really important. Fluorescent white light, being surrounded by loud sounds all the time, fast-moving objects, too much news and screen time—all these activities shut down vagus nerve activity.
Safety is the core theme here. Things that signal biological safety to the body will increase vagus nerve activity.
How does humming activate the vagus nerve?
Because humming requires deeper, slower breathing. But humming has a more powerful effect than deep breathing because when you hum at certain tones—like om—you are inducing a resonant state. Most of the time, your heart and lungs sound like an orchestra warming up and playing out of tune and time. But when you hum you induce this resonance that brings the heart and lungs into harmony; humming takes the internal orchestra of your body—all the parts that are functioning at the same time—and brings them in tune and in time, so they produce a magnificent symphony.
What do you think is the easiest and most effective way to activate the vagus nerve?
Soothing touch-based techniques and slow deep breathing work instantaneously and you can do them anytime, whether you have people around or not. Somatic techniques are effectively body awareness techniques that involve directing your attention to a part of the body and noticing it without judging it. Observing your breath, the air coming in and filling your nose, wind pipes, and lungs, and the feeling of that air leaving, and how your heart rate changes as you change your breath. This kind of somatic listening technique allows you to tune into your body and easily stimulates the vagus nerve.
How often should we be trying to activate the vagus nerve?
As often as possible, with one caveat. If you’re someone who have low heart rate issues or too much fatigue, you don’t need more vagus nerve stimulation. But for ninety plus percent of people, the more light amounts of continuous vague nerve activity you have in your life, the better. Think of it like training a muscle.
The conversation has been edited and condensed for clarity.
