Insomniacs, would you believe a little buzz could send you to sleep? Traditional Chinese Medicine (TCM) practitioners say that giving a little electric shock to the acupressure point in your ear could be the solution to troubles with falling asleep. ‘Acupressure?’ I know what you’re probably thinking, but this acupoint just happens to be right on the vagus nerve. This alternative therapy could have some traditional science behind its effects, and effective, it seems to be. Could transcutaneous vagus nerve stimulation -TVNS treat insomina?
TVNS, a treatment for insomnia?
Bejing based TCM researchers put TVNS via a pressure point on the ear through a randomized controlled trial to find out whether stimulating the vagus nerve helps you to fall asleep. This new mode of treatment, still under investigation, has the potential to help insomniacs sleep better, feel less grumpy, and become more productive during the day.
Chronic insomnia is a major health problem affecting about 12% of Americans. [2] People with the condition struggle to fall asleep or to get adequate rest. While doctors often prescribe hypnotics to alleviate symptoms, the search for an effective non-medicinal solution has continued. Traditional drug based sleep aids can have unwanted side effects. Previously, the idea of employing TVNS to treat lack of sleep had been explored, but there was no concrete evidence on how to administer it successfully and for how long.
Why stimulate the vagus nerve?
Scientists have explored the health benefits of vagus nerve stimulation extensively, and it is now a treatment option for migraines, depression, and even epilepsy. In 2021, the FDA approved [3] a form of vagus nerve stimulation for the rehabilitation of stroke patients.
The vagus nerve runs from the brain to the abdomen and branches to many organs along its path, including the ear.
Researchers have determined that by stimulating the nerve, they can trigger desired changes in the nervous system. In this study, the scientists identified areas of the outer ear with a rich supply of vagus nerve branches. These were used as the sweet spots where they attached the electrical device that generated stimulating impulses. As we reported last year, TVNS via the ear helped POTS patients regulate their autonomic nervous responses.
The Study at a Glance
Zhang and his team conducted the research at the Acupuncture and Moxibustion Hospital from October 2021 to December 2022. The participants had experienced insomnia for at least three months and had not been on sleep medication for at least a month before the treatment. The participants ranged in age from 18 to 70 years. The investigators provided an extended treatment period of eight weeks.
For comparison, the study included two groups of participants: those who received the therapy and those who received a dummy form of the treatment-the ‘sham group’. After the initial evaluation, the researchers narrowed the sample to 72 participants and placed them into two groups, each containing 36 people. Each participant was assigned a random number and was not initially informed whether they would receive the treatment or the sham.
The treatment sessions lasted 30 minutes and were administered twice a day, five consecutive days a week, for eight weeks. The participants were required to complete a sleep diary, which was essential for assessing sleep quality and the impact of the treatment. So did TVNS treat insomnia?
Did TVNS successfully treat insomnia?
The researchers found that participants who received transauricular cutaneous vagus nerve stimulation experienced improvements in sleep quality, sleep latency, and sleep efficiency. They assessed the changes starting four weeks after initiating treatment, then again at eight weeks, and finally at 20 weeks.
The group receiving vagus nerve stimulation had better scores than the sham group at all the stages of evaluation. When evaluated for anxiety and depression symptoms, the group that received trans auricular vagus nerve stimulation had significant improvement compared to the sham group.
How Safe Is Transcutaneous Vagus Nerve Stimulation?
In this study led by Zhang, a few participants experienced some side effects. Four participants in the treatment group and three in the sham group reported slight clamping pain in the outer ear. This discomfort was relieved by pressing and kneading after treatment. One participant in the treatment group experienced bleeding gums, while another in the sham group experienced vertigo. Fortunately, both symptoms resolved within two to three days after stopping the treatment. No severe adverse events were reported during the study.
This study sets the stage for further research on the efficacy of transcutaneous vagus nerve stimulation in the treatment of chronic insomnia. Once additional comparative assessments determine the optimal duration of treatment, the appropriate stimulation currents, and a more comprehensive evaluation of safety, we will be on the path to expanding treatment options for sleep disorders.
References
[1] Zhang, S., Zhao, Y., Qin, Z., Han, Y., He, J., Zhao, B., … & Rong, P. (2024). Transcutaneous auricular vagus nerve stimulation for chronic insomnia disorder: a randomized clinical trial. JAMA Network Open, 7(12), e2451217-e2451217.[2] American Academy of Sleep Medicine. (2024, June 14). Survey shows 12% of Americans have been diagnosed with chronic insomnia. AASM. https://aasm.org/survey-shows-12-of-americans-have-been-diagnosed-with-chronic-insomnia/[3] U.S. Food and Drug Administration. (2021, August 27). FDA approves first-of-its-kind stroke rehabilitation system. FDA. https://www.fda.gov/news-events/press-announcements/fda-approves-first-its-kind-stroke-rehabilitation-system
