What Everyone Gets Wrong About Burnout

If you’ve been searching for new ways to get better slumber, you may have heard of vagus nerve stimulation (VNS) and, because you’ve tried a lot of things in vain, dismissed it.

But non-invasive vagus nerve stimulation (nVNS) is proving helpful for certain types of sleep disturbance. It’s not a universal cure, though. Details matter.

Here’s what the science says.

Why the vagus nerve affects sleep

The vagus nerve is the main arm of your parasympathetic nervous system — the system responsible for rest, recovery, and downregulation. It helps you shift out of fight-or-flight, slows your heart rate, reduces alertness and mental overactivity, and stabilizes breathing — all things you need to get good sleep.

If your nervous system stays subtly activated at night, if you go to bed in even a low-grade fight-or-flight state, you may feel that familiar tired-but-wired feeling.

One of the vagus nerve’s primary functions is to keep you coming back to rest-and-digest all through the day, especially before bed.

By stimulating the vagus nerve, you can enhance your body’s natural ability to find rest.

While vagus nerve stimulation has been studied for decades, the focus for a long time was on implanted stimulators. More recently, non-invasive vagus nerve stimulation (nVNS) — stimulation that happens through the skin — is growing in popularity as a promising tool to improve sleep quality.

Let’s explore what research shows about nVNS for sleep.

taVNS for post-stroke insomnia

One published case study using transcutaneous auricular VNS (taVNS) treated a patient with post-stroke insomnia.

After two weeks of receiving stimulation twice a day, not only did the patient’s sleep improve significantly but the patient was still getting better sleep at their three-month follow-up.

Brain imaging (fMRI) showed decreased activity in the default mode network (DMN) — a brain network often hyperactive in insomnia and rumination.

While this was only a single case, it supports the idea that vagus nerve stimulation may calm overactive brain networks linked to poor sleep.

Migraine-related sleep disturbance

People with migraines report more trouble sleeping than others.

A prospective observational study found that nVNS helped:

• Prevent migraines
• Treat acute attacks
• Improve migraine-associated sleep disturbance

This suggests vagus nerve stimulation may be particularly helpful when sleep issues are tied to nervous system dysregulation.

Ear stimulation and insomnia

Cranial electrotherapy stimulation (CES) — low-intensity electrical stimulation applied to the earlobes — is FDA-approved for insomnia, anxiety, and depression.

Although the earlobe has limited vagal innervation, brain scans show CES produces activation patterns similar to vagus nerve stimulation. The concha, cymba concha, and tragus are innervated by sensory branches of the vagus nerve.

These sensory nerve fibers carry the electrical signals of the stimulation into the brain, particularly the nucleus ambiguus, dorsal motor nucleus, hypothalamus, amygdala, and cortex. The hypothalamus controls your shifting between sleep and wakefulness.

The brain may be more receptive during sleep

Animal research shows that the brain’s response to vagus nerve stimulation changes across sleep stages.

Vagal-evoked brain responses are largest during non-REM sleep, suggesting the brain may be especially receptive to vagal input during deeper sleep phases.

We also know that vagal regulation differs across sleep states in newborns, highlighting the vagus nerve’s natural role in sleep architecture.

Are there risks?

Non-invasive VNS is generally considered safe.

However, implanted VNS devices (used for epilepsy and depression) have been associated with sleep-disordered breathing, increased obstructive apnea, snoring, and rare reports of insomnia.

These effects likely relate to stimulation intensity and influence on upper airway muscles.

Importantly, these findings do not automatically apply to modern non-invasive devices like your yōjō — but they do show that stimulation parameters matter.

So, can vagus nerve help me sleep?

Sleep isn’t just about melatonin levels. It’s about nervous system regulation.

Because the vagus nerve influences heart rate, inflammation, breathing, and brain network activity, stimulating it may help the body shift into a recovery state more effectively, beckoning sleep.

For people whose sleepless nights feel like a stress-response problem, vagal modulation could represent an important emerging option.

If you’re curious about vagus nerve stimulation (VNS) for anxiety, chances are there’s some hesitation on your part. So much about VNS is new, unclear, and unfamiliar. It’s sort of stressful.

This article is here to slow things down.

To begin with, yes, VNS works for anxiety. And there is loads of evidence to back us up here, but that’s not enough is it?

“Does this work?” is quite abstract.

Let’s look at the real reasons others hesitate when it comes to VNS for anxiety, reasons you might share with them. And let’s explore the relevant science.

Is this safe?

For many people, the first thing that comes to mind with vagus nerve stimulation is surgery.

That’s understandable. Invasive VNS has been used for years as an implanted treatment for drug-resistant epilepsy and depression. Hearing that can trigger fear around medical procedures, side effects, and long-term changes.

What often gets missed is that non-invasive vagus nerve stimulation (nVNS) also exists — yōjō’s VNS device is a non-invasive, ear-based stimulator.

Non-invasive VNS works through gentle stimulation through the skin. It does not involve surgery. Several studies show that these types of stimulators are safe, and come with very few side effects.

For people already living with anxiety, simply knowing that stimulation can be external, adjustable, and non-surgical removes a major barrier.

I don’t really understand what it does

“Stimulating a nerve” can sound vague or intimidating.

Without a clear mental model, it’s easy for VNS to feel abstract or even questionable.

Here’s the simple version:

1. The vagus nerve is a major communication pathway between the body and the brain.
2. It plays a key role in the parasympathetic nervous system, which supports calm, safety, and recovery.
3. Anxiety is strongly linked to overactivity in the body’s fight-or-flight response.
4. A vagus nerve stimulator sends gentle electrical current along the vagus nerve, activating it.
5. These bottom up signals travel from the body to the brain, helping shift the nervous system out of constant alert — supporting the body’s ability to regulate itself.

Read more about the vagus nerve and what it does.

Doing this regularly helps improve vagal tone, which improves the vagus nerve’s ability to function properly.

I’ve tried so many things already

Supplements, meditation, apps, therapy. The more of these we try that don’t land, the less hope we have of finding anything that will.

Burn me once…right?

The thing is, VNS research seldom starts with anxiety as the main target. Anxiety is always a secondary outcome in studies on depression or headaches. But it’s almost always recognised as an improvement.

For example:

• In a clinical trial using non-invasive VNS for depression, anxiety scores dropped significantly alongside mood improvements.
• Patients treated with VNS for certain pain and headache conditions also showed meaningful reductions in anxiety.
• A form of acupuncture that stimulates the vagus nerve has also been used to successfully reduce anxiety before surgery. Yes, this isn’t nVNS, but it uses the same mechanism.

The pattern is consistent: when the nervous system shifts from a sympathetic, fight-or-flight state, anxiety eases.

Unlike some of the other things you may have tried, ear-based vagus nerve stimulation is consistently accurate and convenient. You can yōjō while doing the cleaning up or commuting to work via train or bus, or while in a meeting. That makes it easy to do regularly.

Some of the things we try fail through inconsistency more than anything else.

What if nothing happens?

This sort of caution is perfectly normal. Uncertainty about something like vagus nerve stimulation raises the perceived risk.

The truth is VNS doesn’t always create dramatic changes right away.

It works through regulation over time — improving balance, recovery, and stress tolerance.

This is why yōjō created a nervous system care platform.

We know vagus nerve stimulation works best when it’s done daily. Irregular use makes it much harder for the nervous system to adapt.

And we’ve seen changes in our members’ heart rate variability, stress index, and parasympathetic activity scores. Better sleep and mood are two of the first things members notice a few weeks after starting with yōjō.

Changes are gradual. Consistency is key.

There’s no reason vagus nerve stimulation can’t work for you — especially when it’s used consistently and with guidance.

What if it changes or numbs me?

Vagus nerve stimulation does not work like medication. It doesn’t blunt or override your nervous system. Instead, it supports vagal activity, which naturally reduces excessive threat signalling.

Your body and your mind relax because there’re no immediate dangers. Your personality and emotional range have nothing to do with it.

Studies show that vagus nerve stimulation:

• Reduces activity in the amygdala, the brain’s fear center
• Lowers activity in the hippocampus, involved in emotional memory
• Increases activity of GABA, a calming brain chemical that reduces overstimulation

I don’t want to do it wrong

Without guidance, even simple tools can feel overwhelming.

When should I use this? How often? How do I know it’s helping?

Unlike some cervical VNS options (devices that target the vagus nerve through your neck), ear-based vagus nerve stimulation for anxiety has simplicity on its side.

The earpiece fits snugly and stimulates the branches of the vagus nerve that sit very close to the surface of your ear. Either ear is fine.

A yōjō session lasts 30 minutes, and you can adjust the intensity.

Relax Mode for relaxation, Stress Mode for resilience, Energy Mode for vitality, and Sleep Mode for, well, sleep. Each mode is carefully engineered to provide the appropriate stimulation.

The only way you can go wrong, really, is by NOT using your yōjō vagus nerve stimulator at least once a day.

So a VNS stimulator will work for my anxiety?

Yes. The evidence shows that vagus nerve stimulation can reduce anxiety by:

• calming overactive fear circuits in the brain
• increasing neurotransmitters that calm signalling in the brain
• shifting the body out of chronic fight-or-flight and into rest-and-digest
• supporting a physiological state of safety

A good stimulator works by calming your body’s stress response and changing how certain parts of your brain behave. Changes take time, so you may want more than just a device. A support system that helps you stick to vagus nerve stimulation like a ritual you can’t live without, perhaps?

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Vagal tone describes how responsive the vagus nerve is, particularly in regulating heart rate and stress responses, and how effectively the nervous system can return to balance after activation.

In simple terms, vagal tone reflects how easily your body can calm itself after stress.

The vagus nerve is the main nerve of the parasympathetic nervous system — the branch responsible for rest, digestion, recovery, and repair. Vagal tone reflects how strongly, and how flexibly, this system can influence the body to maintain internal balance, also known as homeostasis.

At a physiological level, vagal tone affects heart rate, breathing, digestion, inflammation, and emotional regulation. When vagal tone is high, the body can respond to stress and return to baseline efficiently. When it’s low, the nervous system is more likely to remain in a heightened state of activation.

The vagus nerve acts as a two-way communication pathway between the brain and the body, continuously carrying information about internal conditions and environmental demands. Vagal tone tells us how well that communication supports regulation.

In research and clinical settings, vagal tone is most often discussed in relation to stress resilience, emotional regulation, and cardiovascular health.

Why ‘tone’?

In physiology, ‘tone’ refers to baseline activity.

Muscle tone, for example, describes a muscle’s constant, low-level readiness to contract and relax. A muscle with healthy tone is responsive, not tense or rigid.

Vagal tone follows the same principle. It describes the ongoing influence of the vagus nerve at rest, and how easily that influence can increase or decrease as conditions change.

High vagal tone doesn’t mean the vagus nerve is constantly active. It means the nervous system has a strong capacity for regulation — the ability to slow things down when needed, and to release that influence when action is required.

How vagal tone works

One of the most important features of vagal tone is known as the vagal brake.

The vagus nerve contains fast, myelinated fibres that connect directly to the heart’s pacemaker (the sinoatrial node). These fibres act as a brake on heart rate.

When vagal influence is high, the brake is applied, slowing the heart and supporting calm, restorative states. When reduced, the brake is released, allowing heart rate to rise and support attention, movement, or mobilization.

This braking and releasing happens continuously. A well-functioning vagal brake allows the body to respond to changing demands without becoming stuck in a prolonged stress response.

How vagal tone is measured

Vagal tone isn’t measured directly. Instead, it’s inferred from patterns in heart rate — most commonly through respiratory sinus arrhythmia (RSA).

RSA refers to the breath-by-breath changes in heart rate that occur naturally as you breathe. Heart rate increases slightly during inhalation and slows during exhalation.

The size of this breath-linked change in heart rate reflects how strongly the vagus nerve is influencing the heart.

• Higher RSA is associated with stronger cardiac vagal tone
• Lower RSA suggests reduced vagal regulation

RSA is widely used in research as a marker of autonomic flexibility: the nervous system’s ability to adapt to stress and return to baseline.

Vagus nerve stimulation (VNS) and vagal tone

Vagal tone is shaped by repeated signals to the nervous system, particularly signals that support parasympathetic activity and recovery.

Both invasive and non-invasive forms of VNS influence vagal activity, often reflected as increases in heart rate variability and improvements in autonomic balance. By directly stimulating vagal pathways, VNS can engage the same regulatory circuits involved in slowing heart rate, reducing inflammation, and supporting recovery.

Far from forcing relaxation, regular VNS changes how efficiently the nervous system can apply and release vagal influence over time, which is a core feature of healthy vagal tone.

Why vagal tone matters

Vagal tone is widely considered a physiological marker of stress vulnerability and resilience.

Lower vagal tone is associated with poorer emotional regulation, chronic low-grade inflammation, cardiovascular disease, depression, and stress-related disorders.

Higher vagal tone supports emotional stability, physiological calm, and the processes involved in growth, restoration, and repair.

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