Explore the Science Behind Pulsetto
Understand how your autonomic nervous system shifts between “fight-or-flight” and “rest-and-digest” and how Pulsetto’s cervical stimulation is designed to support that shift for calmer stress recovery, better sleep, and steadier daily performance.
When "Stressed" Becomes Your Normal
Most people don't feel dramatically stressed — they just feel stuck. Light sleep, slow recovery, constant worry, digestive issues, and trouble handling everyday demands. The common thread? Your nervous system has trouble switching back to calm mode after stress hits (1-3).
Fight-or-Flight vs Rest-and-Digest
Your body has an automatic control system that’s constantly shifting between “fight-or-flight” (sympathetic) and “rest-and-digest” (parasympathetic) modes.
When stress is frequent or you never fully recover, your system can get stuck in “fight-or-flight” making it harder to relax even when you want to (1–4).
Why the vagus nerve matters
The vagus nerve is your body's main communication line to the brain. It carries signals that coordinate your stress response, sleep, heart rate, and gut function. Stimulating it helps restore balance (1,4,5).
|Non-invasive vagus stimulation: | a growing research area
Non-invasive vagus nerve stimulation delivers gentle, controlled electrical pulses through the skin on the neck to engage vagal pathways, and it’s becoming a growing focus in human research—especially for measurable effects on stress/autonomic signals and performance during stress and sleep deprivation (5–8).
Scientific evidence
What Pulsetto studies have measured so far — scientific rationale, methods and results
A science-led overview of non-invasive cervical vagus nerve stimulation (nVNS) and Pulsetto’s scientific evidence — including physiology, mechanism, and results from a randomized, open-label study comparing unilateral vs bilateral stimulation.
A randomized, open-label, parallel-group, comparative study designed to evaluate the use of Pulsetto for psychological stress, anxiety, and disturbed sleep in individuals.
|Aim:| To evaluate Pulsetto’s effects on self-reported stress, anxiety, and sleep quality and on biological stress markers (hair cortisol and cortisone), and to determine whether bilateral stimulation provides greater benefits than unilateral stimulation.
After 4 weeks of Pulsetto tVNS, participants reported significant improvements in depression (PHQ-9), anxiety (GAD-7), and sleep quality (PSQI).
Bilateral stimulation stood out for stress biomarkers: hair cortisol decreased significantly with bilateral tVNS, while unilateral stimulation showed no significant change.
Hair cortisone showed a trend toward reduction overall and tracked moderately with cortisol changes, suggesting a shared stress-physiology (HPA-axis) signal.
Acute Transcutaneous Cervical but not Auricular Vagus Nerve Stimulation Increases Alpha Wave Brain Activity and Lowers Arterial Blood Pressure
|Aim:| To examine whether non-invasive transcutaneous cervical vagus nerve stimulation (cVNS) is associated with changes in arterial blood pressure and frontal electroencephalographic (EEG) activity, and to compare these effects with auricular VNS and no intervention conditions.
Cervical, but not auricular, VNS was associated with a reduction in systolic blood pressure.
cVNS showed a trend toward increased frontal EEG alpha activity.
No changes in heart rate were observed across interventions.
Evaluating the Efficacy of Bilateral Non-Invasive Vagus Nerve Stimulation in Reducing Migraine Symptoms: A Prospective Observational Study
|Aim:| To evaluate whether bilateral non-invasive vagus nerve stimulation (BnVNS) is associated with changes in migraine frequency, pain intensity and pain days, and to explore effects on mood, stress levels, and migraine-related quality of life over a 6-week intervention period.
BnVNS was associated with a 40.35% reduction in migraine frequency and a 42.46% reduction in pain intensity (p < 0.001 for both).
Pain days were reduced by 27.66% across the intervention period.
Participants reported improvements in mood (13.89%) and stress (20.29%), while migraine-specific quality of life decreased by 9.48%, potentially influenced by external life stressors.
Non-Invasive Vagus Nerve Stimulation (nVNS) for Pain Management in Bechterew Disease (Ankylosing Spondylitis): A Prospective Open-Label Pilot Study (Pulsetto)
|Aim:| To explore whether non-invasive vagus nerve stimulation (nVNS) delivered with the Pulsetto device is associated with improvements in pain intensity and related daily symptoms (spinal stiffness, range of motion, sleep, mood, concentration) in patients with Bechterew disease.
Most participants reported reduced morning spinal stiffness after stimulation.
Joint pain dropped substantially from pre- to post-stimulation, and the reduction was statistically significant (p < 0.001).
Spinal mobility generally improved, with increases reported far more often than decreases.
Sleep quality and mood improved for a meaningful subset of participants, while most others reported no change and only a few reported worsening.
Calling All Researchers
Let’s collaborate to drive meaningful progress. Reach out to explore partnership opportunities – we’re excited to learn more about your research.
References
- Thayer JF, Lane RD. A model of neurovisceral integration in emotion regulation and dysregulation. J Affect Disord. 2000;61(3):201–216. doi:10.1016/S0165-0327(00)00338-4. Available from: https://pubmed.ncbi.nlm.nih.gov/11163422/
- Porges SW. Cardiac vagal tone: a physiological index of stress. Neurosci Biobehav Rev. 1995;19(2):225–233. doi:10.1016/0149-7634(94)00066-A. Available from: https://pubmed.ncbi.nlm.nih.gov/7630578/
- Thayer JF, Mather M, Koenig J. Stress and aging: A neurovisceral integration perspective. Psychophysiology. 2021;58(7):e13804. doi:10.1111/psyp.13804. Available from: https://pubmed.ncbi.nlm.nih.gov/33723899/
- Prescott SL, Liberles SD. Internal senses of the vagus nerve. Neuron. 2022;110(4):579–599. doi:10.1016/j.neuron.2021.12.020. Available from: https://pubmed.ncbi.nlm.nih.gov/35051375/
- Soltani D, Azizi B, Sima S, et al. A systematic review of the effects of transcutaneous auricular vagus nerve stimulation on baroreflex sensitivity and heart rate variability in healthy subjects. Clin Auton Res. 2023;33(2):165–189. doi:10.1007/s10286-023-00938-w. Available from: https://pubmed.ncbi.nlm.nih.gov/37119426/
- McIntire LK, McKinley RA, Goodyear C, McIntire JP, Brown RD. Cervical transcutaneous vagal nerve stimulation (ctVNS) improves human cognitive performance under sleep deprivation stress. Commun Biol. 2021;4(1):634. doi:10.1038/s42003-021-02145-7. Available from: https://pubmed.ncbi.nlm.nih.gov/34112935/
- Jigo M, Carmel JB, Wang Q, Rodenkirch C. Transcutaneous cervical vagus nerve stimulation improves sensory performance in humans: a randomized controlled crossover pilot study. Sci Rep. 2024;14(1):3975. doi:10.1038/s41598-024-54026-8. Available from: https://pubmed.ncbi.nlm.nih.gov/38368486/
- Zhang S, Zhao Y, Qin Z, et al. Transcutaneous auricular vagus nerve stimulation for chronic insomnia disorder: A randomized clinical trial. JAMA Netw Open. 2024;7(12):e2451217. doi:10.1001/jamanetworkopen.2024.51217. Available from: https://pubmed.ncbi.nlm.nih.gov/39680406
