Specialist article: nervous system
Stimulating the vagus nerve?What your resting nerve really needs
Breathing exercises, ear devices, humming or cold water: there are many tips circulating about the vagus nerve. Here you will find out what the nervus vagus actually does, what studies show about stimulating it, and why, in our view, breathing, swallowing and head balance provide it with its most important signals.
Does this sound familiar?
You want to unwind, but your body won’t switch over?
What applies to you?
Tap whatever applies to you.
If several of these apply, it is worth taking a look at the processes that accompany your nervous system throughout the day. The vagus nerve is not a switch that can be flipped from outside. It reports to the brain how breathing, swallowing and head balance are currently working, and these processes can be trained.
What the vagus really reportsWhat exercises and devices can doThe key points at a glance
- The vagus nerve is the main nerve of the parasympathetic nervous system. Most of its fibres carry signals from the body to the brain. It is primarily a sensor, not a relaxation switch.
- Slow breathing measurably changes the vagal control of the heart. For many devices and tricks, the evidence is thinner than the advertising suggests.
- In our view, breathing, swallowing and head balance provide the vagus with its most important signals around the clock. That is why we focus on training these patterns rather than on a single stimulus.
Video
The vagus nerve, your resting nerve: how to bring it into balance
Das Video lädt erst nach dem Klick. Dann werden Daten an YouTube (Google) übertragen.
Anatomy
Nervus vagus: the wandering nerve
Hardly any nerve is mentioned as often when it comes to stress, sleep or digestion. Its course explains why.
The nervus vagus is the tenth of twelve cranial nerves. Its name comes from Latin and means “wandering”. It leaves the skull at the skull base, runs down the neck alongside the major blood vessels and branches out in the chest and abdomen. Its fibres reach the oesophagus, airways, heart, liver and the entire digestive tract1.
What do you think: in which direction do most of the fibres in the vagus nerve run?
of the fibres in the vagus run upwards from the body to the brain, only around 20% downwards to the organs2
in humans. The vagus is the tenth and the only one that reaches far into the abdominal cavity
The vagus is the most important nerve of the parasympathetic nervous system, the part of the autonomic nervous system associated with rest and digestion2. Its counterpart is the sympathetic nervous system, which prepares the body for performance. The two do not work against each other like two switches but constantly work together. Being healthy therefore does not mean having the highest possible vagal tone, but a system that can switch between tension and recovery depending on the situation.
Brainstem
More sensor than switch
Anyone who wants to stimulate the vagus often imagines a relaxation button. Its structure suggests a different picture.
The ascending fibres of the vagus end in the brainstem, in a group of nuclei called the nucleus tractus solitarii. Signals from the airways, heart, circulation and digestion converge there. The sensors at the ends of the fibres detect stretch, pressure, temperature and chemical signals1. The brainstem evaluates these status reports and responds.
It reports
The stretching of the lungs and stomach, the pressure in the large blood vessels, chemical signals from the gut and stimuli from the throat and larynx.
It controls
Via its descending fibres, it slows the heartbeat, acts on digestion and supplies the muscles of the pharynx, soft palate and larynx.
It connects
In the brainstem, its signals meet the pacemakers for breathing and swallowing. This is where the two are coordinated.
The vagus is first and foremost a sensor, not a switch.It tells the brain what is happening in the body. How calmly or tensely the system reacts therefore depends above all on what it has to report.
This group of nuclei also houses the nerve cells that trigger, shape and time the swallowing pattern. André Jean of Aix-Marseille University described this in a major review3. The swallowing centre and the main entry point of the vagus are therefore located in the same place. For us, this is the heart of the matter, because this is where the basic functions and the autonomic nervous system meet.
Like a control centre
A control centre does not decide on a whim, but on the basis of the reports that come in. If unclear reports keep arriving, it stays on standby, even when nothing is happening outside. This is roughly how we see the brainstem. In our view, calm arises there when the incoming reports form a coherent picture.
Breathing
Vagus nerve and breathing: your heartbeat breathes along
The work of the vagus on the heart is easiest to observe through breathing, even without a measuring device.
When you breathe in, your heart beats a little faster; when you breathe out, it slows down again. This respiratory sinus arrhythmia arises mainly because the vagus slows the heart more strongly during exhalation than during inhalation. It is a major component of heart rate variability, or HRV for short, the variation in the intervals between heartbeats. A high, vagally mediated HRV is considered a sign of an adaptable nervous system.
Try it out. Place two fingers on the inside of your wrist and breathe calmly and slowly through your nose. With a little patience, you will feel your pulse get slightly faster as you breathe in and slower again as you breathe out. That is your vagus at work.
on slow, deliberate breathing were analysed by a research group at the German Sport University Cologne. Vagally mediated HRV increased during the exercise and immediately afterwards4
of these examined programmes spanning several sessions. Vagally mediated HRV was also elevated after these programmes4
The nose plays a special role here. Air flowing through the nose meets greater resistance than air flowing through the open mouth. In our view, this is one reason why nasal breathing naturally becomes calmer and deeper, while mouth breathing tends to encourage rapid, shallow breaths.
What matters is the pattern, not a number. In our view, there is no breathing rate that is equally good for everyone. What is important is that the mouth is closed and the body finds its own rhythm.
Swallowing
Swallowing and the vagus: an underestimated signal
Hardly anyone thinks of swallowing when they hear the word vagus. Yet the nerve is involved in every single swallow.
With its descending fibres, the vagus supplies the muscles of the throat, soft palate and larynx. Together with the glossopharyngeal nerve, its ascending fibres report what is happening there. We swallow many hundreds to a thousand times a day5, both awake and asleep. Each swallow is a short, precisely ordered sequence involving the tongue, throat, larynx and breathing.
For this, breathing and swallowing must be exactly coordinated. Swallowing preferably occurs at the transition to exhalation, breathing pauses briefly, and an exhalation often follows6. The pacemakers for both lie close together in the brainstem and continuously coordinate with each other.
was the average rise in pulse with each single swallow when lying down, and 8.5 when standing, measured in 23 healthy people7
after the swallow, the heartbeat was back in its baseline range. According to the authors, the brief acceleration is mainly due to a decrease in vagal activity8
This is surprising if you know swallowing as a relaxation trick. A single swallow releases the vagal brake for a moment; it does not apply it. What it delivers to the brainstem is a strong, precisely timed stimulus at exactly the point where the vagus arrives. Whether many correct swallows shift the baseline tone of the nervous system in the long term has not yet been measured.
The frequency of swallowing is a learning argument, not a dose.Even many hundreds of swallows a day take up only a few minutes. Their power lies in the fact that a pattern becomes ingrained through repetition, with every single swallow.
3D film
Swallowing and head balance in one sequence
In 50 seconds, the film shows the head balance rotation, an exercise that brings swallowing and head balance together.
The pharynx, larynx and the muscles of head balance work together here in one sequence. This produces signals from swallowing and from head balance at the same time. The exercise is added to the basic training from around week 6.
The triad
What the vagus experiences around the clock
Breathing, swallowing and head balance run without interruption. In our view, they are therefore the most important senders of signals to the brainstem.
Breathing
With every breath, stretch receptors in the lungs report to the brainstem via the vagus. Slow, calm nasal breathing is associated with stronger vagal control of the heart. In our view, shallow, rapid mouth breathing shifts the picture in the other direction.
Swallowing
The pharynx and larynx report every swallow to the brainstem. The starting point is the tongue reference position. If the tongue lies low and you swallow by pressing, in our view a different, less ordered signal arrives there.
Head balance
The organ of balance and the sensors in the neck report every change in the position of the head, and the circulation adjusts. If the head moves forward over a long period, in our view this stream of signals also changes.
In our view, this is usually the reason why many people do not feel rested despite breathing exercises. If breathing, swallowing and head balance deviate from their reference pattern over a long period, the brainstem receives a picture around the clock that does not look like safety. This triadic functional circuit stands at the beginning of many causal chains.
The pattern deviates
Mouth breathing, a low-lying tongue or a forward head posture, often ingrained over years.
The signals change
Different signals reach the brainstem from the airways, pharynx and neck than with a coherent pattern.
The system stays alert
In our view, the brainstem lacks the feedback that everything is fine. The baseline tension remains elevated.
Recovery becomes harder
Switching off, falling asleep and regeneration can suffer as a result, even without external stress.
The search for the switch
Many people then try tricks and devices. The stream of signals from everyday life stays as it is.
Research
The vagus nerve and inflammation: what the evidence shows
You often read that a strong vagus dampens inflammation throughout the body. There is some truth in this, but less than is often claimed.
The mechanism exists and is called the inflammatory reflex. In 2000, a research group near New York showed that acetylcholine, the messenger substance of the vagus, reduces the release of inflammatory messengers such as TNF in cultures of human macrophages. In rats with experimentally induced sepsis, electrical stimulation of the vagus prevented circulatory shock9. These are findings from cell culture and animal experiments.
of the 242 rheumatism patients in a sham-controlled study improved by at least 20 % on a standard measure after three months, with an implanted stimulator on the cervical vagus compared with sham stimulation. Employees of the manufacturer are among the authors10
in humans mostly showed that higher HRV is associated with lower inflammatory markers. This is an association, not proof of cause and effect11
The statement supported by evidence is therefore this: targeted electrical stimulation of the vagus can reduce inflammatory messengers in humans and improve an inflammatory disease to a moderate extent. This does not show that breathing exercises, humming or swallowing dampen inflammation via this pathway.
Measured
The inflammatory reflex in cell culture and animal experiments, the effect of implanted stimulators in rheumatism and the association between HRV and inflammatory markers.
Reasoned
In our view, a coherent pattern of breathing, swallowing and head balance can improve the conditions for this reflex, because it changes the stream of signals to the vagus.
Open
Whether training the basic functions measurably changes vagal tone or inflammatory markers has not been studied. We see this as a reasoned assumption, not a promise of effect.
Methods
Activating the vagus: what exercises and devices can do
Under “stimulating the vagus nerve” you will find breathing techniques, ear devices, humming, gargling and cold water. The evidence on these varies greatly.
Slow breathing, as described above, is the best studied. The evidence is considerably thinner for devices that stimulate the auricular branch of the vagus through the skin. This transcutaneous auricular vagus nerve stimulation, or taVNS for short, is often promoted as an easy route to relaxation. The auricular branch supplies the skin of the outer ear canal; it is responsible, for example, for the urge to cough when cleaning the ear.
in healthy people compared ear stimulation with sham stimulation. Taken together, it did not change vagally mediated HRV12
with sepsis received five days of ear stimulation or sham stimulation. Inflammatory markers fell more, but the clinical scores did not differ between the groups13
Humming, gargling or immersing your face in cold water have been little studied as ways of strengthening the vagus in the long term. They can briefly trigger an autonomic response. Whether more comes of it is an open question.
It is not about stimulating the vagus somehow.In our view, what matters is what the nerve has to report all day long. An external stimulus sets a signal that the brainstem cannot read as movement. A correct swallow delivers a signal that this nuclear region is built to process.
If you have a vagus nerve stimulator implanted by a doctor, for example for epilepsy, or if you take medication for your heart or circulation, do not change anything about this without consulting your treating practice. Training the basic functions can be combined with it.
Training
Vagus nerve exercises: training the basic functions
Resolving to breathe calmly through the nose works for a while. Under tension, in conversation or during sleep, the old pattern takes over again. A pattern is not a resolution but a stored sequence. If it has been repeated for years with mouth breathing, a low-lying tongue or a forward head, it is stored just as firmly as a physiological pattern. That is why it holds out against good intentions.
Automatic does not mean correct.What is learned wrongly is learned stably. Frequent repetition does not make a deviating pattern correct; it consolidates it. It can be changed through an exercise that repeats the correct pattern frequently and precisely.
Our approach is therefore training the basic functions of breathing, swallowing and head balance. A device that delivers electrical current to the vagus nerve is not part of it.
In FaceFormer training, the FaceFormer sits in the oral vestibule, behind the lips and in front of the teeth. The tip of your tongue rests on the small ridge behind your upper front teeth, you breathe through your nose, and your head is balanced upright.
In the basic exercise, you press the lip wedge together with your lips, bite down briefly with your back teeth and swallow once. The negative pressure draws the tongue to the palate, and the oral cavity is sealed. In training, you swallow in a much closer sequence than in everyday life, and this repetition imprints the pattern.
From around week 6, the breathing exercise is added. You breathe in through your nose for about six seconds, briefly hold your breath, bite down and swallow, and then breathe out for six seconds.
Here, slow breathing and correct swallowing come together in one sequence. In the Head Balance Rotation, head balance is added, and in the Head Balance Rotation with Breathing, all three basic functions come together at once.
- From day 1
Basic exercise
A few minutes three times a day with the FaceFormer ZERO; you increase the repetitions week by week.
- From around week 3
Pull exercise and night
The pull exercise is added. At night you wear the FaceFormer ZERO as soon as you have mastered the basic exercise.
- After a few weeks
Switching to the ONE
During the day, you train with the FaceFormer ONE. It is the same size and shape as the ZERO, just made of firmer material.
- From around week 6
Breathing exercise and Head Balance Rotation
The breathing exercise combines the training with calm nasal breathing, and the Head Balance Rotation combines it with head balance.
- Over months
The pattern runs by itself
The exercise manual allows six to twelve months until the new sequences run without thinking.
The free FaceFormer app guides you through the basic exercises, and you can find all modules on the exercise pages. You can train on your own. If you train with a practice, they can adapt the plan to you. Children have their own exercise plan; find out more under FaceFormer for children.
Everyday life
Supporting the vagus in everyday life
Let the out-breath be longer
Breathe in calmly through your nose and let the out-breath become a little longer than the in-breath. Don’t force yourself to reach a particular count; the calm should come on its own.
Lips closed, tongue up
Your lips rest lightly together, with the tip of your tongue at the reference point. This keeps your mouth sealed, and the air takes the route through your nose.
Swallowing without clenching
If you catch yourself clenching your teeth, release them, place the tip of your tongue and swallow once, gently, with your lips closed.
Head balance at the screen
Set up your screen and seat so that your head balances over your body and does not drift forwards.
Quick checks throughout the day
Link a quick inward check to something you do often, such as unlocking your phone. Are you breathing through your nose? Where is your tongue, and where is your head?
Patience with the pattern
A pattern changes over weeks and months, not in a single evening. Practising briefly and regularly does more than practising at length now and then.
Questions
Frequently asked
What is the vagus nerve?
The vagus nerve, Latin nervus vagus, is the tenth cranial nerve and the most important nerve of the parasympathetic nervous system. It runs from the brainstem through the neck into the chest and abdomen and supplies, among other things, the throat, larynx, heart, lungs and digestive tract. Around 80% of its fibres carry signals from the body to the brain.
How can I stimulate my vagus nerve?
The best-studied approach is slow, calm breathing. It measurably increases vagally mediated heart rate variability. In our view, however, what matters most is what the vagus reports throughout the day, that is, how you breathe, swallow and balance your head. That is why we focus on training these basic functions rather than on a single stimulus.
What vagus nerve exercises are there?
Common ones are slow breathing, humming, gargling and cold water. Slow breathing has the strongest evidence. In FaceFormer training, you practise nasal breathing, swallowing and head balance in one sequence, for example in the basic exercise, the breathing exercise and the head balance rotation.
What does breathing have to do with the vagus nerve?
When you breathe out, the vagus slows the heart more than when you breathe in, so your pulse fluctuates with your breath. Slow breathing amplifies this fluctuation.
Is it enough to breathe consciously through the nose and hold the tongue against the palate?
Conscious nasal breathing and a held tongue help as long as you think about them. In conversation, at work and during sleep, the old pattern takes over. In our view, the tongue finds its tongue reference position even without attention when the lips are sealed, the nose is clear and the swallow runs completely, because then the negative pressure in the mouth holds it there. A held position does not replace this interplay.
Does a vagus nerve stimulator on the ear help?
The evidence is mixed. An analysis of 16 studies in healthy people found no change in vagally mediated heart rate variability compared with sham stimulation. Individual small studies in people with illnesses show changes in inflammatory markers. A stimulator used under medical supervision is something different from a device for home use; do not change any prescribed treatment without consulting your practice.
Can you activate your “self-healing powers” via the vagus nerve?
The term describes the fact that the body continuously regulates and repairs itself. The vagus is involved in this as a signalling pathway and through the inflammatory reflex. However, there is no switch that can set these processes in motion from outside. We therefore speak of self-regulation, and in our view this requires well-coordinated basic functions.
Is my vagus nerve blocked or pinched?
These terms often come up in searches, but they are not diagnoses that can be derived from restlessness, digestive complaints or neck tension. In our view, more often there is a pattern behind it in which breathing, swallowing and head balance have become unbalanced. Heart rhythm disorders or new swallowing difficulties should be examined by a doctor.
Does the FaceFormer stimulate the vagus nerve?
Not in the sense of a device that emits stimuli or electrical current. The FaceFormer is the training device of FaceFormer therapy, which you use to practise lip closure, the tongue reference position, nasal breathing, swallowing and head balance. Whether this measurably changes vagal tone has not been studied.
More articles from the knowledge section
Where to go next
Sources
- Berthoud HR, Neuhuber WL (2000). Functional and chemical anatomy of the afferent vagal system. Autonomic Neuroscience 85(1-3):1-17. PMID 11189015. Source
- Bonaz B, Bazin T, Pellissier S (2018). The Vagus Nerve at the Interface of the Microbiota-Gut-Brain Axis. Frontiers in Neuroscience 12:49. PMID 29467611. Source
- Jean A (2001). Brain stem control of swallowing: neuronal network and cellular mechanisms. Physiological Reviews 81(2):929-969. PMID 11274347. Source
- Laborde S, Allen MS, Borges U et al. (2022). Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta-analysis. Neuroscience and Biobehavioral Reviews 138:104711. PMID 35623448. Source
- Lear CS, Flanagan JB, Moorrees CF (1965). The frequency of deglutition in man. Archives of Oral Biology 10:83-100. PMID 14262163. Source
- Bautista TG, Sun QJ, Pilowsky PM (2014). The generation of pharyngeal phase of swallow and its coordination with breathing: interaction between the swallow and respiratory central pattern generators. Progress in Brain Research 212:253-275. PMID 25194202. Source
- Sherozia OP, Ermishkin VV, Lukoshkova EV (2003). Dynamics of swallowing-induced cardiac chronotropic responses in healthy subjects. Bulletin of Experimental Biology and Medicine 135(4):322-326. PMID 12910298. Source
- Numata T, Ogawa Y, Kotani K, Jimbo Y (2015). Extraction of response waveforms of heartbeat and blood pressure to swallowing. Methods of Information in Medicine 54(2):179-188. PMID 25396222. Source
- Borovikova LV, Ivanova S, Zhang M et al., Tracey KJ (2000). Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin. Nature 405(6785):458-462. PMID 10839541. Source
- Tesser JRP, Crowley AR, Box EJ et al. (2026). Vagus nerve-mediated neuroimmune modulation for rheumatoid arthritis: a pivotal randomized controlled trial (RESET-RA). Nature Medicine 32(1):369-378. PMID 41429981. Source
- Williams DP, Koenig J, Carnevali L, Sgoifo A, Jarczok MN, Sternberg EM, Thayer JF (2019). Heart rate variability and inflammation: A meta-analysis of human studies. Brain, Behavior, and Immunity 80:219-226. PMID 30872091. Source
- Wolf V, Kühnel A, Teckentrup V, Koenig J, Kroemer NB (2021). Does transcutaneous auricular vagus nerve stimulation affect vagally mediated heart rate variability? A living and interactive Bayesian meta-analysis. Psychophysiology 58(11):e13933. PMID 34473846. Source
- Wu Z, Zhang X, Cai T et al. (2023). Transcutaneous auricular vagus nerve stimulation reduces cytokine production in sepsis: An open double-blind, sham-controlled, pilot study. Brain Stimulation 16(2):507-514. PMID 36801260. Source
Get started
Ready for the training?
The free FaceFormer app guides you through the basic exercises, counts along and reminds you of your sessions. If you wish, a practice from the practitioner directory can support you.
FaceFormer ZERO + ONE
Both material hardnesses for getting started, day and night. The set for adults.
FaceFormer ZERO
The softer FaceFormer for getting started, for children and for the night.
FaceFormer ZERO Children’s Set
ZERO with hygiene box, plush bag and success book with stamp.
FaceFormer training aims to restore the physiological setting of the basic functions of breathing, swallowing and head balance, with lip closure and the tongue reference position, thereby creating the conditions under which symptoms can improve. It does not replace a medical assessment. You can find practitioners near you in the practitioner directory.
