Are you constipated? The vagus nerve is involved. Got diarrhea? The vagus nerve plays a role. Anxiety? Yes, the vagus nerve has a part to play here as well.
Remember that song by Sting, “Every breath you take?” Well, since exhalation is independently controlled by the vagus nerve, it is literally “watching” (monitoring) your every breath like a crazy stalker! Okay… That was pretty cheesy… But the vagus nerve is THAT important!
The vagus nerve innervates all of the major organs and plays a huge role in how they function! It has the most extensive distribution of all the cranial nerves. Wandering from the brain to the colon, its cardiac branches act to slow the rate of heartbeat; its bronchial branch acts to constrict the bronchi (passages in the lower respiratory tract that allow air into the lungs). Its esophageal branches control involuntary muscles in the esophagus, stomach, gallbladder, pancreas, and small intestine, stimulating peristalsis (a wavelike sequence of muscular contraction and relaxation that passes food along the digestive tract) and gastrointestinal secretions.
The vagus nerve contains both afferent (sensory) and efferent (motor) fibers. This means it is responsible for not only carrying motor (function) signals to the organs it innervates, but it also carries sensory information from these organs back to the central nervous system (brain & spinal cord).
In addition, the vagus nerve is the major player in a primary neural reflex mechanism—the inflammatory reflex; which controls innate immune responses and inflammation.
Inflammation is normally a local and temporary event. We get hurt, and we heal. Generally, after the injury has healed or the problem goes away, homeostasis (normality) is restored.
Sometimes however, disrupted innate immune regulation can result in excessive or chronic inflammation. This viscious cycle is seen in a broad range of conditions, from rheumatoid arthritis to fibromyalgia, CRPS, and much more; and you’d better believe the vagus nerve is directly involved. Like a bad roommate that shits the bed, plays heavy metal music at odd hours, and refuses to pick up after themselves.
Proper communication between the immune system and the brain is essential for controlling inflammation and maintaining homeostasis. When we talk about homeostasis, think about the condition of optimal function within the human body. It is the ideal state, where steady internal, physical, chemical, and social conditions are maintained. Sometimes something comes along and knocks us out of balance, and that is where a healthy working knowledge of the vagus nerve, and how it functions, can be very beneficial.
Poor vagal tone can cause a wide range of issues, not just limited to autoimmunity. Vasovagal syncope is a type of vagal-reflex syncope that occurs when the body's normal ability to control blood pressure doesn't work like it should, causing fainting. This is most commonly seen in people who pass out on the toilet, but another example could be people who faint at the sight of blood. The lower your vagal tone (or activation level), the less control you might have over your autonomic functions like heart rate or digestion. On the other hand, the higher your activation level (or "tone"), the better control you could have over these functions.
It may be obvious by this point, but vagal tone bears a direct correlation to the overall health of an individual. Vagal tone is a measure of cardiovascular function that facilitates adaptive responses to environmental challenge. It is directly associated with emotional and attentional regulation and has been conceptualized as a marker of sensitivity to stress. As such, a high vagal tone means a higher capacity to successfully manage stress, change, and challenges. It also means a higher capacity to adequately rest, recharge, and recover. Conversely, a low vagal tone means less tolerance for stress, change, and challenge while making it more difficult to rest, recharge, and recover. People with low vagal tone may feel stuck in a state of hyperarousal for a long period of time after a stressful incident has ended, or they may experience drastic fluctuations between states of being amped up and then very drained, or very angry followed by a drastic shift to feeling very sad and depressed.
Poor vagal tone can result in emotional instability, and an inability to cope with stress, resulting in poorer quality of life and even overreaction to situations, including violent outbursts of rage.
Aside from pharmaceutical interventions, there are a number of ways to stimulate vagal tone for better mental, emotional, and physical health. We have a neurostimulation protocol at Pure Neurology which uses a gentle electrical current to increase vagal tone. It places the individual into a relaxed, meditative state, and has even been shown to increase Alpha brainwave activity and decrease Beta brainwave activity. Alpha waves are associated with a state of relaxation. Beta waves are associated with a state of alertness and mental activity, they are also heightened in states of stress and anxiety.
Two of the ways that I used to teach people to stimulate a vaso-vagal response as a Paramedic to control a fast heartrate, I have also taught to my CRPS clients as a rescue technique for pain flares. One is to place a cold wet rag around the neck, and another is to bear down like you are trying to have a bowel movement. While this may work in a pinch, it is not the same as training the vagus nerve. Studies have shown that cold exposure can stimulate the vagus nerve and greatly increase vagal tone. Not to worry, if ice baths aren’t your thing, there are other ways. You can sing or hum to increase vagal tone, and focusing on songs that bring you joy can elevate to your mood.
One of the main ways that you can stimulate healthy function of the vagus nerve is through deep, slow, diaphragmatic belly breathing. You can even learn to use deep breathing exercises and meditation to shift your focus away from stress or pain.
We teach this method in great detail at Pure Neurology, and when we have enough interest we will even do classes from time to time. However, this method can be practiced in the comfort of your own home, or wherever you can get alone in a quiet space for a few minutes. The results of performing this exercise correctly are very impactful.
TO BEGIN:
Schedule a time during the day when external distractions can be eliminated for a minimum of 10 - 15 minutes.
Next, find a quiet and comfortable place to begin the breathing exercises.
Either while sitting on a chair, or on cushions or lying down on a yoga mat or soft surface.
Sit or lie down comfortably, resting your hands below your navel.
Tune in to the way you breathe. Inhale and exhale naturally through your nose for a few minutes, noticing the slight rise and fall of your hand. Consider the way the air feels as it enters and exits your nostrils. Start to count silently forward (one, two, three...), then backward (...three, two, one), as you breathe in and out.
Gradually make each exhalation twice as long as each inhalation. Focus on breathing slowly and smoothly, humming each time you exhale. The slight vibration of the vocal cords can activate the vagus nerve resulting in increased parasympathetic nervous system activity.
To put it simply, it will calm you.
The 4-4-8 is a basic breathing technique designed to help you relax and focus. This technique is great if you feel stressed or tense. Using this technique can help you get rid of the tension so you can focus on what you need and want to do.
No matter what your goal is, deep breathing can help you focus, clarify your thinking, and feel less stressed as you move forward.
However, it is important to prolong your exhalation because exhalation is independently controlled by the vagus nerve.
This breathing technique has four easy steps:
1. Breathe in through your nose for a count of 4, taking the breath into your stomach.
2. Hold your breath for a count of 4 seconds.
3. Release your breath through your nose (NOT MOUTH) for a count of 8 seconds. Think of emptying a glass of water.
4. Without a break, breathe in again for a count of 4 seconds, repeating the entire technique three to four times in a row, then resume normal breathing and activity.
As you progress in this technique, you can work your way up to 3-4 minutes of continuous diaphragmatic box breathing, which will drastically increase your vagal tone and parasympathetic function.
This technique can be used to break the vicious cycle of chronic inflammation and anxiety, and as healthy blood flow and function is returned to the digestive organs, normal function is restored.
Focus on counting when breathing in, holding the breath, and out. You may find yourself feeling mildly light-headed after doing this. It is actually a sign that the technique is working and the sensation will quickly pass.
Feel free to do this as often as you want, but you may need to get used to it first. It doesn’t really matter if each count lasts an actual second; it only matters that you count evenly so the ratio of 4-4-8 is maintained.
In future posts, we will discuss progressive relaxation techniques which can be incorporated with diaphragmatic box breathing to further the effects.
But for now… Just breathe.
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