The past couple of months I have been working on vagus nerve stimulation in order to increase my vagal tone. By that I mean that I have been practicing different ways to activate my parasympathetic nervous system side of my vagus nerve. I have been doing this in order to practice better mindfulness and calm my anxiety and inflammation. My anxiety isn’t at a high level daily, but I do get quite worried about the long-term costs associated with having Sjögrens Syndrome. And I worry about my ability to continue working long enough to pay for future major expenses. I hate that feeling. And of course, I always have a high level of inflammation. I hate that too.
As I began to investigate the different methods to stimulate my vagus nerve and activate my PSNS (parasympathetic nervous system), I became more and more fascinated. This post explains why.
Or you can just stop reading now and start singing, loud and proud, like your favorite rock star!
Why Vagus Nerve Stimulation?
The Vagus Nerve is the longest cranial nerve in our body that runs from our brain all the way down to our abdomen and connects to almost every organ in our body. It actually is a pair of nerves, but is usually referred to in the singular. It has both parasympathetic and sympathetic functions, but my focus is the parasympathetic nervous system. The PSNS is responsible for my “rest, relax and digest” activities as opposed to my sympathetic nervous system which is responsible for “fight or flight”. The PSNS is also responsible for sexual arousal, salivation and tears. Hmmm.
Now is a good time to remind you that I am a patient and a business person. My profession is not in the medical field, so I am conveying information as I understand it from personal interest and research.
Vagus Nerve Stimulation decreases anxiety
Let’s first talk about how we can help calm ourselves from the anxieties, depression, anger and sadness that having a chronicle illness (like Sjögrens) presents. The goal here is to stimulate our vagus nerve to bring a sense of calm to our bodies and minds. In fact, the more one practices these activities, the stronger your “vagal tone” becomes which means you will be able to relax yourself quickly (when challenges arise). My goal is to be able to sense when anxiety might start brewing and stop it dead in it’s tracks with a new technique. This is the part that most of us know about but need the occasional reminder to practice.
What I did not know is that good vagal tone is also associated with increased intimacy and social bonding, and acts as an anti-depressant (by activating hormones such as oxytocin). Conversely, isolation can decrease vagal tone. Chronically ill people (like Sjögrens Syndrome patients) need to have this particular awareness! Sometimes I can feel isolated working from home and when I need to reduce social activities due to Sjögrens flares up. I now know to put in extra time on vagus nerve exercises to increase vagal tone during those times!
Vagus Nerve Stimulation Reduces Inflammation
Could this be the ticket to healing ourselves? Could it be that the isolation and anxiety I can feel actually weakens my vagal tone and therefore increases my inflammation? Hmmm.
Here is a direct Wikipedia quote regarding vagus nerve stimulation and inflammation reduction:
The discovery by Kevin J. Tracey that vagus nerve stimulation inhibits inflammation by suppressing pro-inflammatory cytokine production has led to significant interest in the potential to use this approach for treating inflammatory diseases ranging from arthritis to colitis, ischemia, myocardial infarction, and congestive heart failure. Action potentials transmitted in the vagus nerve activate the efferent arm of the inflammatory reflex, the neural circuit that converges on the spleen to inhibit the production of TNF and other pro-inflammatory cytokines by macrophages there. This efferent arc is also known as the cholinergic anti-inflammatory pathway. Because this strategy targets the release of TNF and other pro-inflammatory cytokines, it may be possible to use vagus nerve stimulation instead of anti-inflammatory antibodies (e.g., biologic) to treat inflammation.
So if you think about those biologics that are attempting to block TNF production in order to decrease inflammation (Humira, Enbrel, Remicade, Simponi, Cimzia), it could be that a more aggressive form of vagus nerve stimulation could achieve similar results. Take a look at this post from the Arthritis Foundation presenting hopeful findings of a study conducted between 2011-2016. The study uses an implantable VNS (Vagus Nerve Stimulators) that showed reduced rheumatoid arthritis markers.
Lat year, a clinical trial was completed for a pilot program on an implantable VNS for RA patients. I wonder what the full clinical trial will look like and when the product and procedure will be available for other autoimmune disease patients. Anytime something looks very interesting for RA, I’m always curious what it might do for me, a Sjögrens patient.
Vagus Nerve Stimulation Exercises
Since I’m not implanting a medical device in my chest any time soon, I think I’ll keep working on my vagus nerve stimulation au naturel. There are quite a number of ways to build vagal tone, but I have listed some of my favorites here. A key thing to remember is that the vagus nerve runs from your brain through your throat and continues down to the bottom of your abdomen. So think about how you can “wake up” your throat, chest and core as you try some of these techniques.
Sing
Sing loud, proud and often. The reverberation of your vocal chords and the deep breathing it takes to sing loudly (and with phrasing) is a great exercise. And it is fun.
Breathe Deeply
When breathing deeply, concentrate on activating and controlling your diaphragm. Inhale through your nose to a count of 4 or 5. Then hold your breath for a count of 2. Exhale through your nose to a count of 8 or 10 (or as long as you feel in control of the exhale and comfortable). Do this for 3 minutes (in a relaxed seated position with good posture) and see how your anxiety level changes.
Yoga
Take a class and activate more than just your vagus nerve. Then reap the benefits of post class relaxation. The social interaction is great as well. If you are concerned about it being too difficult, look for a class that’s called Restorative Yoga or Nidra Yoga. These are meant to heal and are restful.
Chant
You know that OM associated with yoga? That’s no accident. Try chanting OM loudly and hold the note for as long as you can with your mouth closed. Feel that reverberation in your chest? Try this for 2 minutes a couple of times a day and see if you feel better.
Laugh Hard
This does far more than just stimulate the vagus nerve! Find something you find funny (perhaps a YouTube channel that delivers laughs) and watch it every day. If you have a funny friend, even better because being social also activates the vagus nerve. And there is nothing better than laughing hard with a friend.
Massage
This one is passive and fantastic for so many reasons.
Meditate
There are many methods of meditation. I actually meditate while I do the deep breathing stated above. I sit on the floor in a comfortable cross-legged position, spine straight but relaxed, and a folded towel under my “tush” for extra “cush”. Then I breathe for four minutes and clear my mind for four minutes. Counting my breath helps clear my mind for the first half of my meditation.
You can also chew gum, gargle, cough and more. But those aren’t very fun. (If you like them then add them to your list).
So get to singing, or chanting, or anything that causes that deep reverberation or relaxation down to your core! It may be the ticket to help our emotional challenges and reduce the inflammation that causes us pain and damage.
Namaste!
For more ideas on managing your daily challenges living with chronic illness like Sjogrens, check out my post Tips to Move Through Autoimmune Stages.
WOW!!! This makes so much sense to me. I teach Yoga classes, I will be doing some more research on this one. Thanks so much for sharing.
Hi Donna, great to hear from you. I actually just start my yoga teacher certification training tonight! I’m really into this now and hope we can spread the word!
Great article with really good information. I have practiced yoga since high school glad to hear it is beneficial. I am the rare male Sjogren’s sufferer and have primarily pulmonary problems, I was a flight attendant for 20 years and can no longer work that job, devastating. I am in a clinical trial in MA for an RA medication. I am in my second week and hope for positive results, not just for me but for all of us!
HI Thomas, I’m so glad you enjoyed the article and that you posted a comment! I do have a few readers that are male SS patients, and I highly value your comments and participation. I’m sure it can seem that you don’t get much attention or support as a male patient. I’m thrilled to hear about your participating in a clinical trial and I hope you find relief. Please do let us know how you feel and what your experience is participating in a clinical trial.
Thanks Janet, I appreciate your acknowledgement. I sent the article to my kids, one of whom is a movement/dance therapist, they loved it. You go girl!
I think there could be a lot to this. I have found a particular version of QIgong (Chi gong) that does this– which is nice because I have joint hypermobility and most yoga is not possible for me to do safely. Also, I would say I feel the most grounded and balanced during and after my daily swim, which does too many wonderful things to document.
The other thing I would note is that in the few studies of autonomic dysfunction (parasympathetic and sympathetic balance), the majority of Sjogren’s patients have some sort of manifestation. Most common one are heart rate / blood pressure control, sweating, in addition to the components of autonomic dysfunction seen in tear and salivary secretion.
Thank you , Sarah, for adding great comments. I have not tried Qigong and I think it’s a great recommendation for us!
Dear Janet Church. I was glad to read about you on this blog. I got to know you through the letter you sent to SSF members. I was diagnosed with Sjogrens in 2011 after more than 7 years of misdiagnosis. I must point it out however that managing Sjogrens is 10 times more difficult for those of us living in developing countries in Africa. I live in Nigeria and I have no Rheumatologist managing my health. I rely on my general practitioner and self medication based on what I read online.
I have never come in contact with any Sjogrens patient in Nigeria, that however does not mean that they do not exist. I believe that there will be many who are currently being misdiagnosed as I was for several years. In the 7 years many doctors attributed my ailment to “spiritual attack” , Africans believe in a lot of voodoism. But I was determined to have a medical explanation for my symptoms which I eventually had in 2011.
Is there anyway SSF can benefit Sjogrens patient living in this part of the world where access to good healthcare is lacking?
Although the SSF is a US based organization, we do work with other world organizations and research centers dedicated to Sjogrens. I do not know about any relationships built with organizations in Africa, but I will ask! Any local advocacy you personally do will certainly start the grassroots efforts, but I certainly understand how difficult this is. I wish we could help everyone! Please keep voicing your knowledge! Janet
I so appreciate any info/insights about this lousy syndrome. I can’t begin to tell you how deviestating it has been to my life. I have done a trial for treatments with no results. I continue to treat and maintaine but my life as a flight attendant has ended after 20 years due to pulmonary complications from this. No Boo Hoo”s or “Poor Me”, I just want to fight this!
Tom
Thank you for sharing a little of your story, Tom. We do understand your comment about “no boo hoo’s”, and this is a place you can voice your feelings about our “lousy syndrome” with a sympathetic ear. Few of us want pity, but we all want people to understand that our lives have been altered because of Sjogrens. For some people, the change in quality of life has been severe. Take care of yourself and feel free to share here in the future.