Best Vagus Nerve Stimulation Device

Many health conditions we might consider ordinary can drastically reduce our quality of life. A poor night’s sleep can drain the tank before the day truly starts, and headaches or stress can make it feel as though the day will never end.

Vagus nerve stimulation is a potential solution to these problems, as well as others. In this guide, we discuss the five best vagus nerve stimulation devices on the market and examine the science that supports their applications. Along the way, we relay our personal use experiences, along with some tips for minimizing your expense.

Check out our summary of recommendations directly below for the quickest rundown. Then read further to get the finer details that informed our choices.

Please keep in mind: “Not all of these devices are FDA-cleared or FDA-approved,” notes our medical reviewer Dr. Jennie Stanford, a board-certified physician. “Expert judgment is recommended when deciding if vagus nerve stimulation is right for you. It’s important to remember that individual medical recommendations will vary, and this guide is not meant to provide individual medical advice. Speak with your physician or healthcare provider if you have health concerns.”

Over the past two decades, Innerbody Research has helped tens of millions of readers make more informed decisions about staying healthy and living healthier lifestyles.

Our research into vagus nerve stimulation has involved more than 200 hours with our eyes on the scientific literature and our hands on the devices themselves. To date, we’ve consulted around four dozen credible scientific sources on the subject, including trials on the specific products we’ve tried, and we’ve put several weeks into personal testing so that we can provide a first-hand perspective on what it’s like to be a frequent user.

Additionally, like all health-related content on this website, this guide was thoroughly vetted by one or more members of our Medical Review Board for accuracy and will continue to be monitored for updates by our editorial team.

Our assessment of the best vagus nerve stimulation devices centered on five criteria that are likely to influence consumer choice:

• Effectiveness: Based on clinical studies and our own testing experience, how likely is a device to provide symptom relief?
• Safety: Which device poses the least risk of common side effects, such as dizziness and treatment site reactions?
• Total cost of ownership: Is the device within reasonable financial reach? If there are any ongoing costs, what do they amount to?
• Ease of use: What hurdles or learning curves, if any, might you need to overcome?
• Comfort: How does it feel to use the device? Does the experience facilitate or hinder compliance with therapy?

Let’s see which products rose to the top in each category.

Effectiveness

Advantage: Sona

For pure effectiveness, in our testing experience, the nod has to go to Sona. To achieve that, Sona surpassed stiff competition from Truvaga Plus as the most effective vagus nerve stimulation device.

Truvaga Plus has several things going for it. One is certainly its electrical operating frequency of 25Hz, which is within the 20–100Hz range used in successful clinical studies.1 2 But frequency doesn’t reveal the whole picture. All of our recommendations operate within that range, after all, and each one boasts proprietary characteristics that are difficult to rank in terms of being more or less efficacious for therapeutic benefit.

Then there's Truvaga’s similarity to another product: gammaCore, a prescription device that the FDA has cleared as a treatment for cluster headache.3 Made by the same parent company (electroCore, Inc.), Truvaga Plus and gammaCore both emit 5,000Hz electrical pulses at the aforementioned 25Hz frequency, which are the same parameters that evidence suggests are effective in treating stress-related psychiatric disorders and increasing mental responsivity.4 5 Also, gammaCore was evaluated in a head-to-head study in which it outperformed Xen (another of our recommendations) in enhancing mental recall and improving markers of fatigue and focus.6 Because Truvaga Plus is similar to gammaCore but available without a prescription, the research evidence helps support its status as one of the most effective vagus nerve stimulators on the commercial market.

But the final variable we considered was the subjective testing experience. In our assessments, we found that Truvaga Plus provided fast and noticeable effects for focus, stress, and sleep quality. Sona's effects for us were on par with Truvaga Plus, but the circumstances surrounding the testing made this parity all the more noteworthy for Sona. Sona produced comparable effects under conditions in which it would have been forgiven for not quite stacking up. (More on that later.) Xen, Pulsetto, and VeRelief were also therapeutic, but they either yielded milder effects or had usability issues that seemed likelier to dampen the therapeutic experience for some.

Safety

Advantage: Truvaga Plus

Here, we focused much of our attention beyond the scientific literature to designate Truvaga Plus as the winner.

Truvaga rose to the top because of its technical similarity to gammaCore. Remember, gammaCore is FDA-cleared, meaning that it’s “substantially equivalent” to an existing marketed device deemed to be safe.8 It’s also CE-marked, which indicates it has been assessed by the European Commission to “meet high safety, health, and environmental protection requirements.”9 Truvaga’s being near-identical to its cleared and marked cousin offers us assurances that it, too, meets such safety standards.

That's not to say that our other recs are unsafe. Far from it. According to a 2018 systematic review, vagus nerve stimulators are generally safe and well-tolerated when used within common parameters, and all of our recommendations fulfill the “common parameters” criterion.7 In our testing, as well, side effects were minimal across most devices. The only one that raised any immediate safety issues was Xen, as its high intensity and earpiece form factor can feasibly cause inflammation of the ear canal.

Total cost of ownership

Advantage: Pulsetto

We think a chart should clearly lay out the cost advantage that Pulsetto provides:

You’ll notice that Pulsetto potentially costs more up front than VeRelief. You’ll also notice that VeRelief, at its lowest price point, requires an $11/month subscription, with a $5 shipping charge. The subscription keeps you in stock of VeRelief’s proprietary, not to mention necessary, gel tips. After a year of ownership, then, VeRelief costs at least $24 more than Pulsetto. Pulsetto is therefore the most cost-effective option in this guide.

What’s missing from the table is that Pulsetto charges $139 for 12-month access to its premium app. If you pay for this access, then Pulsetto’s one-year cost of ownership easily exceeds that of VeRelief. But we’ve tried the premium app, and found it to be lacking meaningful value. Just pretend it doesn’t exist and take stress-relieving comfort in refusing to add another subscription expense to your life.

Ease of use

Advantage: VeRelief Prime by Hoolest

VeRelief Prime wins our Ease of Use category because of its self-contained operation. By that, we mean two things:

• No app: The whole thing works by way of two buttons on the device itself. These buttons allow you not only to increase or decrease intensity but also to cycle through the five output modes.
• No gel or spray: VeRelief’s gel tips come generously applied with conductivity medium. All you have to do is replace the gel tips every month.

While using VeRelief involves a slight learning curve, it’s a much shorter and gentler curve than, say, Xen’s. All you do is hold down both buttons to access your output mode selection, click either button to select a mode, and hold both buttons again to enter the selected mode. From there, just place the gel tips on the side of your neck and press the buttons to adjust your intensity.

If you prefer an app-connected device, our recommendation for convenience is Truvaga Plus. Besides being the most effective device we’ve studied and tried, it works with an app whose interface is simple and intuitive. There’s no visual clutter, and you could probably navigate it fully without a glance at the user manual.

Comfort

Advantage: Xen by Neuvana

Xen is the only vagus nerve stimulator we’ve found that feels good. By “good,” we mean the way that acupuncture can feel good: enjoyable in a highly unusual sense. It’s like scratching an itch in your ear canal. In contrast, with most of our other recs, the sensation was more like a mild, transient paralysis of the jaw muscles. Not painful, but initially alarming, as transient paralysis tends to be.

Xen is comfortable to wear on the move, too. It’s light, and the earphones fit snugly. The only other ostensibly hands-free devices we recommend, Sona and Pulsetto, weren’t nearly as good in this regard:

• Sona doesn’t comfortably fit all ear shapes. You may need to press it actively into your head to maintain electrode contact, which makes it not a universally hands-free unit.
• Depending on which model you purchase, Pulsetto may be too big or too small for some users. For slender necks, it can hang like a collar on a cartoon canine; on broader necks, it feels like a barber’s cape wrapped too tightly.

(Note: Our recommendation here comes with a caveat that relates to the safety issue we’ve mentioned. Should you over-intensify a Xen session, you risk causing a site reaction in your ear canal, an area of thin, vulnerable skin. The reaction may then lead to inflammation, which is absolutely not a feel-good sensation.)

Vagus nerve stimulation is a type of therapy that entails altering the signals in the vagus nerve through electrical pulses.

The dual-branch vagus nerve is the longest nerve of the autonomic nervous system, which regulates involuntary bodily functions such as heart rate, blood pressure, and breathing.10 It’s also the primary communication channel in the gut–brain axis, a bidirectional network of signaling pathways with physiological, emotional, and cognitive health implications.11 12 As such, the vagus nerve can affect not only your bodily functions but also your cognition and mood.

Originally, vagus nerve stimulation involved implanting a device that transmitted pulses from within the body, like a pacemaker. But nowadays we have transcutaneous vagus nerve stimulation, a noninvasive form of therapy that emits electrical pulses via electrodes on the skin’s surface.

The vagus nerve originates from the lower brainstem, at the medulla oblongata, which helps control critical processes such as breathing, blood pressure, and heartbeat.13 From there, it extends behind the ears and down the neck, beside the carotid artery and internal jugular vein, down to the digestive tract. Between its origin and its endpoint, it passes through or connects to structures within the neck, heart, and lungs.14

Transcutaneous vagus nerve stimulation requires the use of a specialized electrode-fitted device prepared with electroconductive medium, such as a gel or saline. To stimulate the nerve, you must place the electrodes in or onto an area where electrical stimuli can easily access it:

• The ear canal (transcutaneous auricular vagus nerve stimulation)
• The sides of the neck (transcutaneous cervical vagus nerve stimulation)

When the electrical pulses pass through the electrode and medium and into your skin, they activate neurotransmitters and their receptors in your brain.15 In the case of something like a mood disorder, where neuronal communication may be disrupted, this ability to facilitate neurotransmission may help restore and stabilize the correspondence between neurons for healthy function.16 17

Early research has also evaluated transcutaneous vagus nerve stimulation in the treatment of other health conditions, like epilepsy and poor sleep.52 18 19 Additionally, because of the vagus nerve’s role in the autonomic nervous system, electrical stimulation can impart healthful effects on disorders related to physiological homeostasis, such as headache,20 chronic pain,21 and inflammation.22

In clinical studies, researchers have used specific frequency ranges to achieve health outcomes in these areas. Most successful studies have used a range of 20–30Hz, but frequencies as low as 10Hz and as high as 100Hz have also yielded pronounced effects.1 33 2

The potential benefits of vagus nerve stimulation are wide-ranging. Below, we outline some of the clinical research detailing the extent to which it can help in diverse areas of health.

Per a 2018 systematic review, commercial vagus nerve stimulation devices are generally safe and well-tolerated when used within common parameters (e.g., 10–100Hz frequencies).7All of the recommended products in this guide meet that criterion, and one of them (Truvaga Plus) is technically similar to a device that’s FDA-cleared and CE-marked for treating cluster headaches. But we’re dealing with devices that transmit electrical currents into your body, so there are indeed some risks to be aware of.

Xen, for example, can achieve a maximum output of 84mA, which is high enough to cause shifts in your heart’s regular beat pattern.39 Even the gentlest device on our list (VeRelief Prime) exceeds an output of 10mA, which poses a risk of respiratory paralysis in some people.39 Various other side effects, both minor and major, may also occur:7 15

• Heart palpitations
• Vertigo
• Localized skin reactions (and possible complications thereof)
• Headache
• Dizziness
• Nausea
• Voice alteration
• Hoarseness
• Coughing
• Tingling
• Shortness of breath

With all of this in mind, we urge you to speak with your doctor before using a vagus nerve stimulator yourself. A review of your history and a physical examination can rule out risk factors that may exclude you as a candidate.

Broadly speaking, the vagus nerve stimulation devices in this guide are for adults who (a) are not pregnant or breastfeeding, (b) are comfortable with transmitting electrical pulses into their bodies, (c) have no device-related contraindications, and (d) have one or several indicated health conditions, such as:

• Mood disorder
• Migraines or cluster headaches
• Chronic inflammation
• Gastrointestinal problems
• Anxiety or stress
• Trouble sleeping
• Trouble focusing

Research also suggests that vagus nerve stimulation may help with cardiovascular disorders, as well, but you shouldn’t go all-in on a device if you have a heart condition. The application of electrical stimuli itself can pose a cardiovascular risk, especially at high enough current outputs.

Ultimately, whether or not you’re heart-healthy, you should speak with your doctor to ensure that any vagus nerve stimulator is suitable for you.

Who are they not for?

Even if you meet the abovementioned criteria for vagus nerve stimulation, you may have a health condition that excludes you as a suitable candidate. The American Association of Neurological Surgeons warns that any one of the following health conditions would contraindicate you for vagus nerve stimulation:40

• Being prone to ulcers
• Being prone to fainting
• Currently receiving other forms of electrical stimulation
• Having a heart abnormality, such as arrhythmias
• Having an abnormally functioning autonomic nervous system
• Having a chronic lung disorder such as asthma or shortness of breath
• Having preexisting hoarseness
• Having only one branch of the vagus nerve (e.g., because one has been removed to treat a health condition, such as severe peptic ulcers)41

To the above list of no-go populations, one or more brands in our guide add the following:

• People with implantable medical devices, such as pacemakers or hearing aid implants
• People with metallic implants near the neck, such as stents, plates, or screws
• People with a history of cancer or head trauma (because of the slight risk introduced by radio frequency signals)
• People who are pregnant or breastfeeding

The last one is worth examining further. Although some studies suggest that vagus nerve stimulation is safe and effective during pregnancy,42 and one 2025 preprint claims that it can even increase breast milk production,43 the research is currently insufficient for anyone to be confident that vagus nerve stimulation poses no harm to the developing fetus or newborn. Similar uncertainties surround the risk of radiofrequency exposure during gestation.44

Apart from contraindications, you should keep in mind that vagus nerve stimulation isn’t a guaranteed or absolute solution for everyone with a mood disorder, sleep disorder, anxiety, or other relevant complaint. Someone with treatment-resistant depression, for example, isn’t likely to see meaningful relief with any product in this guide. The same might be said about people with severe ADHD or insomnia. Because these issues may have complex underpinnings, they require a thorough medical workup. If a vagus nerve stimulator has a place in physician-guided treatment, it would be alongside more traditional methods such as prescription medication and psychotherapy.

It should be clearly stated that none of these devices — including our top pick, Truvaga Plus — has undergone the FDA approval process, so they aren’t subject to the testing requirements and regulations of FDA-approved devices. Rather, they are over-the-counter health products whose efficacy claims are not subject to stringent review. In the case of auricular devices, like Xen, therapeutic use is considered investigational by many professional societies that cite the need for additional research to demonstrate conclusive benefits.

You should follow your own physician’s treatment recommendations for medical advice.

Best overall vagus nerve stimulation device

Truvaga Plus, like most of our recommendations, is a cervical stimulation device — you place it on your neck, not in your ear. But what distinguishes it from our other recommendations is its pedigree.

The Truvaga brand belongs to the same company that makes gammaCore, a prescription vagus nerve stimulation device cleared by the FDA to treat cluster headaches.3 Truvaga Plus is technically similar to gammaCore in that it emits the same 5,000Hz pulses at a 25Hz frequency and a 60mA maximum output, the same parameters found to relieve stress-related psychiatric disorders and increase mental responsivity in clinical studies.4 5 Truvaga’s primary differentiators from gammaCore are that it doesn’t require a prescription and has a lower maximum voltage, so it’s more accessible and potentially more comfortable to use than gammaCore.

Pedigree aside, Truvaga Plus gave us the best combination of convenient usability and consistent results in our product testing. Using it primarily for focus and sleep, we found that our two-minute Truvaga sessions led to noticeable clearances of brain fog, faster sleep latency, and better overall sleep quality.

Our experiences weren’t without problems. On a few occasions, we encountered connectivity issues between the Truvaga device and our mobile phones. Truvaga Plus is an app-connected device, so poor connectivity effectively bricks it until the problem resolves. Had we needed to use Truvaga for, say, a migraine remedy, we imagine our pain symptoms would present a near-blinding obstacle to troubleshooting any Bluetooth problems.

While it’s true Truvaga isn’t the only app-connected device in this guide, it certainly was the only one that showed reluctance to communicate with the app it relies on to function.

Pricing, shipping, and returns

Truvaga Plus costs $499 for the device itself. That’s $50 more than Xen but $460 less than Sona. It comes with a tube of SignaGel, which you’ll need to replace once it runs dry. A six-tube box of the stuff costs $45 through Truvaga, but you can find it for as little as $2.99 per tube elsewhere. We know which price we’d prefer.

Shipping is free when you purchase directly from Truvaga, and our experience tells us that it will arrive fast. It took just three days for our order to reach us from Truvaga’s distribution center in New Jersey.

From the time you receive your device, you have 30 days to decide whether it’s working for you. If you aren’t satisfied, Truvaga will refund your purchase. Considering that clinical vagus nerve studies have seen positive health outcomes in 2–4 weeks, we think Truvaga provides a reasonable guarantee period. Granted, it might be a narrow window between seeing results and deciding on a return, but you’ll scarcely find anything more generous in the vagus nerve space. Sona, Xen, and Pulsetto each offer a 30-day guarantee, as well. Only VeRelief’s guarantee period is longer.

You’ll be responsible for the return shipping cost, and note that the satisfaction guarantee is available only to first-time customers.

Runner-up for best overall, best earpiece device

I’m going to shift into the first person personal for a spell, since my specific experience may help illustrate why newcomer Sona has made it so high on our list of recommendations, as well as where there is room to improve customer experience.

The day I began testing Sona, I was having a bad one. Thunderstorms had fragmented my sleep for the second time in a week; my kitchen’s garbage disposal went kaput, punctuating its lifespan with a black, gritty leak; and between my city’s weekly tornado drill siren and a neighbor whose cherished pastime is revving his car’s engine in his driveway, competing sets of decibels were obliterating any weak semblance of focus I’d maintained up to that point.

What better crucible for a vagus nerve stimulator’s capabilities?

So I opened the box, downloaded the app on my phone, and was all set to be vagally stimulated. Which is when I noticed the conductivity gel was missing. Sona had neglected to slot it into its place in the box. My already-high stress level ticked up.

Anyway, I borrowed Pulsetto’s gel, and now I was ready. But then I had trouble getting Sona to fit in my ear. One problem was that the arm of my eyeglasses was interfering; another was that the forward electrode, which is supposed to lean against the skin toward the temple, tended to lean away instead. To get the device to work as intended, I had to remove my glasses and press the device into my head with my hand. None of this did anything to lower my stress level. Meanwhile, my neighbor was still revving his cursed engine.

By this point, I had little confidence in Sona, and I wasn’t in the mood to be persuaded otherwise. Yet in spite of my adamance, when I finally started my Sona session, my mood started to loosen, and improvement was gradual and steady. After 3–4 minutes I didn’t mind so much about my engine-revving neighbor, or even my trashed-out garbage disposal. My stress level felt close to baseline. The overall effect seemed roughly on par with what our testers and I had experienced with Truvaga Plus. Considering the strong headwinds it was contending with, Sona’s effects actually seem more dramatic.

And in theory, the Sona experience should get even better with time. That’s because Sona uses real-time biometric sensing to track your heart rate and breathing, and feeds the data into an algorithm to personalize future sessions. Such technology has been tested on pigs, as in a 2024 vagus nerve study which concluded that “a complex set of neural stimulation parameters can be optimized in real-time for a patient to achieve a personalized precision dosing.”53

Sona is clearly gaining popularity — we were initially waitlisted when ordering — and we can see why. It would seem that Sona has all the makings of being the best vagus nerve stimulator on the market. But for several reasons, it falls just short of being our top recommendation at this time:

• The aforementioned fitment issue: Something like Truvaga will provide equal relief without the frustration.
• Absence of clinical research: Anecdotal evidence goes only so far, and there’s little in the way of human studies validating AI-driven algorithms in vagus nerve stimulation, much less supporting superior efficacy compared with a non-AI approach. We can tell you that we found it highly effective, but that's not as compelling as a clinical study.
• Logistics: Failing to include conductivity gel speaks to a flaw in Sona’s packaging oversight, one that could likely be attributable to the newness of the operation. Plus, Sona ships from the United Kingdom, so U.S. customers may have to wait longer than usual to receive their device.
• Cost: See next section.

The device is very new, and we suspect Sona’s issues will resolve with time. We’ve seen it happen with Pulsetto, which introduced the FIT model to resolve fitment issues. Should Sona make improvements as well, it would move up even higher in our esteem.

Pricing, shipping, and returns

Sona costs $959, or almost twice as much as Truvaga Plus. For many, the price is prohibitive. Others will consider it well worth the price.

Shipping is free, even to the United States. So are returns, which is better than Truvaga offers. And as with most of our recommendations, Sona offers a 30-day satisfaction guarantee, providing you with plenty of time to determine whether it’s working for you. None of that “restocking fee” business, either: returns yield a full refund.

This means, as long as you can afford the device, Sona would be well worth ordering; if you find it doesn’t fit your ear and face, you could return it for a full refund at no cost. But if it does fit well, you’d have what proved in our testing to be an impressively therapeutic device.

Best earpiece alternative, most comfortable

Xen is like Sona if you increase the intensity, complicate the app, and stick it directly into your ear. Its conflicting characteristics make for an effective vagus nerve stimulator whose positives each have a corresponding negative:

The negatives can be overcome, at least. Avoid higher intensities unless you feel that your symptoms require them, charge your device overnight at least every 2–3 days, and spend a session or two every day trying out a different setting combination.

Pricing, shipping, and returns

At $449, Xen by Neuvana has the third-highest initial cost on our list, with only Truvaga and Sona being more expensive up front. It’s HSA/FSA eligible, though.

Shipping is free, too, and expect it to be fast. Our order arrived in just four days — only one day slower than Truvaga.

As with most of our recommendations, Xen comes with a 30-day satisfaction guarantee starting on the date of delivery. Returns, however, are subject to a 10% restocking fee, so the most you might get back on your original purchase is around $404.

Most cost-effective vagus nerve stimulation device

Pulsetto is another hands-free device: you wear it like headphones, except the ends, each with two electrodes, clamp onto your neck instead of your ears.

Like most of our recommendations, it’s also an app-connected device. The app differs, however, in that it’s available in two versions:

• Basic (free): includes the Stress, Anxiety, Sleep, Burnout, and Pain programs
• Premium (paid): includes the Head Pain, Inflammation, and Gut Health programs, plus options for meditation, breathing exercises, affirmations, and a neuromuscular function test

All programs emit waveforms at a 25Hz repetition frequency, but each one also emits a pulse frequency between 4,500Hz and 5,200Hz. You’ll notice this pattern is similar, though not identical, to that of Truvaga and gammaCore. As it stands, there’s no unaffiliated research examining Pulsetto’s exact parameters. The only studies that support such parameters are Pulsetto-funded master’s theses, which are hardly on the same level as peer-reviewed, placebo-controlled trials.

Yet our subjective experience with Pulsetto was largely positive. We all experienced appreciable relief from headache, stress, and sleeplessness during our week of daily, multi-session use. The effects weren’t as dramatic as what we felt with our other recs, but they were noticeable.

With the Lite (i.e. original) model, however, we had trouble getting Pulsetto to fit properly. One of our testers has a slender neck, so the device hung loose on her like a collar on a cartoon canine. The poor fit didn’t preclude use — she moved the device backward so that the ends clamped on her neck — but it did make for a less comfortable experience.

The newish, upgraded model should resolve such fitment issues. Appropriately called Pulsetto FIT, it comes with two detachable neck pads that increase the inner bulk of the headset where it rests against the neck. With a neck pad affixed, even our slender-necked tester could wear the device fully hands-free. It even clings well to the neck of a small-to-medium-sized (non-animated) dog.

Pricing, shipping, and returns

In the context of this guide, Pulsetto’s pricing is primo:

Only VeRelief Prime has a lower starting price point, but that’s for the device only. Because VeRelief requires an ongoing subscription for gel tips, its cost of ownership exceeds that of Pulsetto within the first year.

Pulsetto App Premium is an additional $139 per year, but it’s an optional expense. Probably not a worthwhile expense, either — we didn’t see much difference in our outcomes between the Basic and the Premium programs — but maybe you’ll see some value in it.

On the returns front, Pulsetto offers the standard 30-day guarantee, but it deducts the cost of return shipping from your refund. That’s $5–$35 less your purchase price, depending on your location.

By the way, Pulsetto is HSA/FSA eligible and comes with a two-year warranty. Those are also pluses on the financial side.

Easiest-to-use vagus nerve stimulation device

VeRelief Prime ought to be the go-to option for anyone who’d rather not fuss with a mobile app. Its operation is entirely self-contained. Two buttons — “+” and “-” — are all you need to switch between output modes and adjust the intensity. There’s only a gentle learning curve involved, which entails knowing that you have to hold down both buttons to switch and select modes. After that, it’s pretty intuitive.

Each of VeRelief’s output modes corresponds to either a frequency or a modulated stimulation cycle that Hoolest claims can help users achieve greater calm:

• Mode 1: 8Hz of constant stimulation. Though the frequency is lower than that of other devices on this list, a 2007 study found that it can impart a mood-enhancing effect.47
• Mode 2: 25Hz of constant stimulation. This is the frequency used by our other picks and most often in clinical studies, including those related to stress-related psychiatric disorders.4
• Mode 3: 100Hz of constant stimulation. In a 2020 study, this frequency imparted a significant effect on a brain region involved in “survival-related responses and homeostatic regulation important for affective responses, nociception, and stress.”48
• Mode 4: 100Hz with a modulated stimulation cycle. Your session proceeds in an on-off pattern of five-second stimulation followed by a five-second rest.
• Mode 5: 100Hz with a different modulated stimulation cycle. Here, the pattern is 15 seconds of stimulation followed by five seconds of rest.

Modes 4 and 5 involve you, the user, exhaling for the duration of each “on” cycle and inhaling during the “off” cycle. With Mode 5, for example, you would breathe out for 15 seconds, breathe in for five seconds, and repeat — a total of three inhalations and exhalations per minute. Such breathing exercises constitute a natural therapy called respiratory vagus nerve stimulation, which a 2018 review found to show promise for improving mental health and cognitive performance.49 Paired with the external pulses from your VeRelief device, it can potentially increase the stimulating effect on the vagus nerve.

It’s apparent that VeRelief’s parameters are well-supported. But what isn’t supported is a claim that Hoolest seems to make on its website: that VeRelief, specifically, has been the subject of numerous vagus nerve studies.

On the Research page, under a heading titled “Safety Proven in Thousands of Users,” Hoolest either outright states or implies VeRelief has been used in at least four large-scale safety trials, but the linked sources make no mention of VeRelief or Hoolest, and the one uncited study is nowhere to be found online. There are also efficacy studies referenced on the page, but most of them are uncited as well. The link for the lone cited efficacy study leads to a 2019 preprint partly authored by Hoolest’s founder, and whose subject isn’t VeRelief Prime but an auricular prototype.50 (Interestingly, the founder wasn’t the paper’s lead author, yet he’s given lead author byline placement on the Hoolest Research page.)

None of this is to say that VeRelief isn’t effective — other studies indicate that its parameters are sound, and we ourselves experienced noticeable stress relief in our three-to-ten-minute sessions on Modes 3–4 — but it does point to deceptive marketing practices at Hoolest.

Pricing, shipping, and returns

You can purchase VeRelief Prime with either the Stress Protection Plan or the Lasting Relief Bundle. The difference lies in cost and the number of gel tips you receive up front.

VeRelief’s use of proprietary gel tips ties you to the brand, which is decidedly a downside. You might experiment with “reconstituting” your gel tips with an aftermarket conductivity gel or spray, but we can’t guarantee how effective it would be.

On a happier note, VeRelief ships for free and ought to arrive in about a week.

On a less-happy note, return shipping is the customer’s responsibility. There’s also a 15% restocking fee, deducted from your refund, if you fail to return the product in its original packaging.

For those of you who aren’t keen on electrical stimulation, there are many good supplemental alternatives on the market. They may not boast as broad a therapeutic range as a vagus nerve device, but they have a much more familiar mode of administration, are proven safer, and pose significantly lower financial barriers to entry.

Here’s what we recommend in place of vagus nerve stimulation in the following areas of health:

As for other health concerns, like chronic headaches and epilepsy, we recommend speaking with a doctor to explore prescription options. Medications like sumatriptan can help prevent the escalation of a cluster headache, and anticonvulsants can help manage epileptic seizures.