Vagus Nerve and ADHD: A Therapist’s Guide

Brittany Ferri, PhD, OTR/L
Occupational Therapist, Writer
December 19, 2025

While society is beginning to learn more about conditions such as autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD), they still tend to be misunderstood. For instance, it may surprise most people to learn there is a strong connection between ADHD and the vagus nerve.

Attention-deficit/hyperactivity disorder and similar neurodevelopmental conditions can cause restlessness along with difficulty regulating emotions, processing information, and maintaining attention. These symptoms can be trying to manage, so it’s important that people with this condition are aware of treatment options that can help them.

Since the vagus nerve helps regulate many bodily functions, including mood, alertness, and attention, vagus nerve stimulation shows promise in helping some of the challenges associated with ADHD. In this article, we will discuss how vagus nerve function interacts with brain mechanisms as part of ADHD and explain how certain therapies (including SoundSory and other non-invasive methods) that target the vagus nerve can assist with ADHD management.

What is the Vagus Nerve, and How Does It Influence ADHD?

As a critical part of the nervous system, the vagus nerve has a hand in many bodily functions. In order to understand all it does, you must know about the basic structures of the autonomic nervous system.

The autonomic nervous system is composed of two branches: the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). The sympathetic nervous system is responsible for increasing the rate of several bodily functions to help us act during times of stress. If you’ve ever heard the term ‘fight or flight,’ this refers to the work of the SNS – including an increase in heart rate, blood pressure, sweating, and breathing rate, along with a decrease in digestion. The first few vital signs are necessary to help our body jump into action against threats, while the latter (digestion) is viewed as less important during such times.

While this mode serves a distinct purpose in keeping us safe, our bodies are not meant to stay in a ‘fight or flight’ state for very long. In fact, doing so places us at risk of a host of health concerns. Most individuals can fluidly switch between this and a resting state, which is ushered in by the parasympathetic nervous system (with the help of the vagus nerve). The parasympathetic nervous system is known to move vital signs in the other direction – it brings our heart rate, breathing rate, and blood pressure back to a lower level and restarts digestion as well as other background processes that are important to our quality of life.

Everyone should be able to go between these two states in response to their environment and the challenges life brings them. This allows a healthy balance between all bodily functions. However, some individuals (namely those with ADHD and other health conditions) have difficulty switching between these bodily states. When someone has difficulty switching between modes, they are also likely to have low heart rate variability. High heart rate variability is known to be a good indicator of health, as it points toward the body’s resilience and ability to handle stress.

Heart rate variability

Low heart rate variability and vagus nerve dysfunction can lead to symptoms of impulsivity, poor attention, mood swings, restlessness, fidgeting, difficulty recognizing emotions, and more, which are all characteristic of ADHD. In fact, one study found that major changes in heart rate variability (and, secondarily, vagus nerve function) could be a potential source of inattention and varied energy levels in those with ADHD.

Self-regulation and reward

Other research found a connection between self-regulation, reward processing, and the presence of ADHD in young people. Since self-soothing and the ability to process rewards are behavioral and psychological products of the autonomic nervous system, difficulty in these areas is an indicator of low vagus nerve activity. An inability to recognize rewards will impact someone’s motivation and learning, which are common functional concerns for many individuals with ADHD. If someone struggles to regulate themselves, irritability, impulsivity, anxiety, and mood swings are likely to result. Such research proves a close connection between the health of the vagus nerve and ADHD.

Gut-brain axis imbalance

There is also a hidden connection between digestion and mental health as a result of something called the gut-brain axis. This means that natural chemicals (called neurotransmitters) and inflammatory signals travel between the digestive system and the brain, influencing both the breakdown and use of food and our cognition. Evidence shows that the vagus nerve plays a big part in the relationship between the gut and brain. If this relationship is not going smoothly, someone may experience changes in brain function that can lead to ADHD or other conditions.

How Vagus Nerve Stimulation (VNS) Might Help with ADHD Symptoms

A wide range of research demonstrates the relationship between the vagus nerve and ADHD symptoms. There is also evidence proving the effectiveness of vagus nerve stimulation (to strengthen the vagus nerve) and address functional concerns due to ADHD.

One study found that transcutaneous vagus nerve stimulation (tVNS) directly impacted the use of two important neurotransmitters called norepinephrine and GABA in the brain. Up until now, research has shown that individuals with ADHD have less availability of norepinephrine and GABA, which manifests as various cognitive and behavioral symptoms. Therefore, tVNS shows promise in addressing these symptoms.

A larger scale study explored the benefits of transcutaneous vagus nerve stimulation for ADHD compared to other neurological treatments such as transcranial magnetic stimulation. While many studies were small, results did show neurostimulatory benefits, meaning tVNS can potentially assist with the management of ADHD symptoms. However, this study notes that larger studies are needed to definitively prove the impact of this modality.

Other studies explored the specific outcomes associated with vagus nerve stimulation when used with individuals who have ADHD. Results showed potential improvements in social dysfunction, impaired emotion recognition, memory performance, and attention, all of which are known to be impacted by ADHD. In addition, vagus nerve stimulation can assist with managing self-control and impulsivity by improving response inhibition deficits. Lastly, this form of vagus nerve stimulation has been known to activate certain attentional networks in the brain, which can improve focus concerns associated with this condition.

In addition, vagus nerve stimulation improves the function of a brain structure called the microglia as well as managing neuroinflammation levels. Since the microglia plays an important part in balancing nervous system function (including the vagus nerve), this benefits people with ADHD who may have difficulty shifting between nervous system states as we mentioned earlier.

Signs Vagus Nerve Dysfunction May Be Impacting ADHD

There are some telltale signs that vagus nerve dysfunction is having an impact on your child’s ADHD. If this is the case, their nervous system will be in a state of imbalance. This can lead to sensory overload, which occurs when the brain cannot properly or efficiently process all of the sensory information it is receiving, including sight, sound, smell, taste, and touch-based information. 

In addition, children whose ADHD is being affected by vagus nerve dysfunction may experience changes in their sleep patterns, more severe and fluctuating emotions, and greater difficulty managing stress. This can also worsen ADHD symptoms such as impaired concentration and impulsive behaviors.

How to Stimulate the Vagus Nerve for ADHD

While vagus nerve stimulation is traditionally performed through devices and implants, there are many ways that people can harness its power from the comfort of their own home. This can be done through several natural, non-invasive vagus nerve stimulation techniques, each of which can assist in improving symptoms of ADHD. 

Give each of these a try using the steps we outline and decide which work best for you. As you go along, pay attention to how each of these activities can have a place in your daily routine. Do you find that meditation might be a good morning practice to use as you start your day? Or are you more comfortable with using gentle exercise to properly balance your energy levels and focus shortly after waking up? Take notes as you go along so you remember your experience with each.

1. Soundsory for ADHD

SoundSory is a non-invasive device that uses multi-sensory activities (including sound frequencies through music and alerting input through exercise) to stimulate and strengthen the vagus nerve.

The way it works:

1. Watch the SoundSory videos for your 3-4 daily exercises.
2. Put on the SoundSory headphones and start listening to the included music.
3. While you continue listening to the music, do each of the day’s exercises as many times as you can in 25 minutes. You can follow modifications or simply dance to the music if you have difficulty.
4. When done, listen to the music while resting for 5 minutes.
5. Repeat these 30-minute sessions once per day for a total of 5 to 7 days each week. Don’t do more than one session per day.
6. Once you have completed 20 sessions, take a 3-week break.
7. After your 3-week break, begin another 20 sessions in order to complete the program.

How it helps ADHD: SoundSory aims to increase brain activity and emotion regulation, which are both known to help improve ADHD symptoms.

2. Meditation for ADHD

Meditation is the act of calming and centering your body and mind through stillness and quiet.

The way it works:

1. Sit in a comfortable chair with the palms of your hands resting on your legs.
   1. You may choose to lay down instead. If you do this, keep your arms relaxed at your sides or cross them over your chest.
2. Close your eyes (if you are comfortable doing so) and focus on your breathing. Take a deep breath in through your nose and a long, slow breath out through your mouth.
3. Once your focus is in tune with your breathing, keep your attention in the present moment.
   1. If other thoughts enter your mind, you can acknowledge them briefly before promptly letting them pass out of your mind. Think of this process as sitting on your front porch watching cars drive by at their own pace. Allow them to move as they are, but do not let them affect you.
4. Shift your focus to what you hear in the room for a short time.
5. Next move to think about what you smell around you.
6. Now think of what you taste.
7. Lastly, acknowledge what is touching your body.
8. After you finish the last sense, slowly open your eyes and stand.
9. Roll your neck in a circular motion a few times and reflect on your time meditating.

How it helps ADHD: Meditation lowers your heart rate and blood pressure, allowing the body to shift into ‘relaxation’ mode. This can help with sleep (especially for those who have hyperactivity and restlessness due to ADHD), but is also known to make our body feel safe enough to focus on the task at hand. This means meditation is also beneficial for improving attention before work or school.

3. Chewing Gum for ADHD

As simple as finding your favorite flavor, chewing gum is a simple vagus nerve stimulation technique that many people already do without even realizing its benefits!

The way it works: 

1. Place two pieces of gum in your mouth.
2. Chew until they combine to form one large wad.
3. Continue chewing until the gum loses its flavor, at which point you can repeat the steps or stop.

How it helps ADHD: Since the vagus nerve passes by the jaw as it runs down each side of the neck, chewing gum gently massages the vagus nerve by activating the muscles of the face. Increased muscle engagement assists with boosting energy levels – but not so much that you have trouble focusing! Chewing gum is an automatic motion that you can do in the background of anything else, meaning it helps keep your attention where it needs to be.

4. Cold Water Immersion for ADHD

Cold water immersion narrows the blood vessels in the body, which reduces levels of inflammation due to sore muscles or injuries.

The way it works: 

1. Put ice and cold water in a bowl that is large enough for your face. Be sure the bowl is no more than ¾ of the way full so there is room for movement.
2. Close your eyes before dunking your full face (eyes, forehead, and cheeks) in the ice water.
3. Keep your face there for 5-20 seconds based on what is most comfortable for you.
4. Remove your face from the water. Repeat until you complete 5 dunks.

How it helps ADHD: Cold temperature exposure in various forms is excellent for cognitive function. This also applies to going outside with minimal clothing on for brief periods, placing cold compresses on the face and neck, etc. Dunking your face in cold water ‘resets’ the vagus nerve, making it so that our attention, alertness, and mood are back in a good balance with one another.

5. Interval Training for ADHD

Interval training (also known as high intensity interval training, or HIIT) is a style of exercise that has a fast pace, alternating quickly between intense workouts and rest periods. This offers a high degree of variety by including multiple exercises and requiring flexibility to follow a certain order.

The way it works:

1. Make a list of several exercises. It’s best to include a variety – some you know and like, others that are new to you, etc. A few examples include jogging in place, push-ups, crunches, squats, lunges, jumping jacks, and pelvic bridges.
2. Select the first exercise on the list and set a timer for 30 seconds.
3. While keeping a fast pace, do as many repetitions of that exercise as you can until the timer goes off.
4. Set the timer again, this time for 60 seconds. Use this span of time to gently stretch.
5. Choose the next exercise from your list and set the timer for another 30 seconds.
6. Go back to the second step and repeat this sequence until you complete a full workout of your desired length. Start small at around 5 minutes total. As you go along and build endurance, you can exercise for 30 minutes or more.

How it helps ADHD: Interval training encourages mental flexibility by following a set pattern of exercises. Individuals with ADHD respond well to information in ‘chunks,’ or smaller parts, which applies to learning as well as physical task engagement. Exercises such as interval training help build motivation and sense of reward for people with ADHD.

6. Massage for ADHD

Massage involves intentional rubbing of various parts of the body to relieve muscle tension, improve blood flow, alleviate inflammation, and relieve pain. The amount of pressure involved in massage varies based on someone’s preference, but it can produce the same benefits either way.

The way it works:

1. Place the fingertips of each hand behind your ears, so the fingertips of your right hand should be behind your right ear and the same on the left side.
2. Move your fingers in a circular motion to gently rub the muscles here.
3. Do this for 30-40 seconds.
4. Move your hands to the part of your face just in front of your ears, and repeat step 3.
5. Cycle through these steps as many times as feels comfortable.

How it helps ADHD: The vagus nerve runs down the side of each neck, so massaging the muscles in this area also gently stimulates the vagus nerve. Since this involves the vagus nerve closest to the brain, massage improves focus, relaxation, and alertness, which is ideal for people with ADHD who are experiencing stress or having difficulty with attention.

When to Seek Professional Help

While these techniques are all safe and likely to provide benefits for those with ADHD, it is important to recognize when to seek professional advice. If you find that ADHD is causing you a great deal of distress and you have significant difficulty in any of the following areas, it may be best to speak with a healthcare professional:

• Attending school or academic completing coursework
• Performing consistently in the workplace
• Fulfilling social responsibilities, such as maintaining relationships with friends and family or openly communicating with loved ones
• Completing household chores, such as cleaning, grocery shopping, and paying bills
• Practicing good personal safety (responding properly during times of crisis, avoiding dangerous situations)
• Displaying effective driving habits, such as refraining from distracted driving (talking on the phone or texting while driving) and following road rules/signs as posted
• Maintaining a stable mood and managing frustration in a healthy manner

Your doctor will assess your medical history (including medications and other health conditions you may have) and the degree of your symptoms in order to determine the best course of action. They may recommend a wearable vagus nerve stimulation device for more consistent access to this treatment, or they may refer you to a mental health professional for talk therapy and other behavioral strategies. 

Doctors most often use a combination of approaches to address conditions such as ADHD. These are associated with the best outcomes and allow for individualized treatment. If you have any questions or concerns along the way, bring them up with your provider. Advocating for yourself and learning about your condition are both important parts of an ADHD treatment plan.

Frequently Asked Questions

Can vagus nerve stimulation be used alongside ADHD medication?

Yes, the at-home vagus nerve stimulation techniques we’ve described are perfectly safe to use if you are taking ADHD medication(s).

What are the long-term effects of using Soundsory for ADHD?

People who use SoundSory for ADHD can expect improvements in focus, memory, emotion regulation, stress management, and more.

Are there any risks associated with vagus nerve stimulation for ADHD?

No, there are no side effects or risks associated with the natural vagus nerve stimulation techniques for ADHD.

What other strategies can help improve focus?

The 20-minute rule, where you deeply focus on a task for 20 minutes before taking a break, is known to assist with building focus for those with ADHD.

What are the symptoms of an overstimulated vagus nerve?

People with an overstimulated vagus nerve may experience nausea, bloating, digestive issues, rapid heart rate, chronic fatigue, dizziness, anxiety, irritability, and difficulty responding to stress.

References:

1. Steenbergen, L., Maraver, M. J., Actis-Grosso, R., Ricciardelli, P., & Colzato, L. S. (2021). Recognizing emotions in bodies: Vagus nerve stimulation enhances recognition of anger while impairing sadness. Cognitive, Affective & Behavioral neuroscience, 21(6), 1246–1261. https://doi.org/10.3758/s13415-021-00928-3 
2. Takeda, M., Takeda, T., & Shinba, T. (2025). Autonomic characterization in adults with attention deficit hyperactivity disorder assessed by heart rate variability measurement during a three-behavioral state paradigm: A pilot study. PCN reports: Psychiatry and Clinical Neurosciences, 4(3), e70176. https://doi.org/10.1002/pcn5.70176 
3. Tenenbaum, R. B., Musser, E. D., Raiker, J. S., Coles, E. K., Gnagy, E. M., & Pelham, W. E., Jr (2018). Specificity of reward sensitivity and parasympathetic-based regulation among children with attention-deficit/hyperactivity and disruptive behavior disorders. Journal of Abnormal Child Psychology, 46(5), 965–977. https://doi.org/10.1007/s10802-017-0343-0 
4. da Silva, B. S., Grevet, E. H., Silva, L. C. F., Ramos, J. K. N., Rovaris, D. L., & Bau, C. H. D. (2023). An overview on neurobiology and therapeutics of attention-deficit/hyperactivity disorder. Discover Mental Health, 3(1), 2. https://doi.org/10.1007/s44192-022-00030-1 
5. Zaehle, T., & Krauel, K. (2021). Chapter 7 – Transcutaneous vagus nerve stimulation in patients with attention-deficit/hyperactivity disorder: A viable option? Editor(s): Roi Cohen Kadosh, Tino Zaehle, Kerstin Krauel. Progress in Brain Research, Elsevier, Volume 264, pp 171-190. https://doi.org/10.1016/bs.pbr.2021.03.001. 
6. Wong, H.C., & Zaman, R. (2019). Neurostimulation in treating ADHD. Psychiatria Danubina, 31(3), pp 265-275.
7. Zhu, S., Zhang, X., Zhou, M., Kendrick, K.M., & Zhao, W. (2022). Therapeutic applications of transcutaneous auricular vagus nerve stimulation with potential for application in neurodevelopmental or other pediatric disorders. Frontiers in Endocrinology, 13. DOI=10.3389/fendo.2022.1000758
8. Gargus, M., Ben-Azu, B., Landwehr, A., Dunn, J., Errico, J. P., & Tremblay, M. È. (2025). Mechanisms of vagus nerve stimulation for the treatment of neurodevelopmental disorders: a focus on microglia and neuroinflammation. Frontiers in neuroscience, 18, 1527842. https://doi.org/10.3389/fnins.2024.1527842  
9. Zhi, J., Zhang, S., Huang, M., Qin, H., Xu, H., Chang, Q., & Wang, Y. (2024). Transcutaneous auricular vagus nerve stimulation as a potential therapy for attention deficit hyperactivity disorder: modulation of the noradrenergic pathway in the prefrontal lobe. Frontiers in Neuroscience, 18. DOI=10.3389/fnins.2024.1494272

Brittany Ferri, PhD, OTR/L

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My areas of expertise include occupational therapy, rehabilitation medicine, telehealth, and mental health. With nearly 10 years of healthcare experience, I am also qualified to write on topics such as exercise, health insurance, nutrition, orthopedics, geriatric care, pediatric therapy, neurology, and health tech.