No. Most people feel a mild tingling, and many feel almost nothing. The intensity is adjustable across 15 levels using the joystick. The included Comfort Care paste further reduces skin sensation. Most users settle on a level well below the discomfort threshold.

Vagus Nerve Stimulation FAQs - Common tVNS Questions Answered

Questions and honest answers

Common questions about vagus nerve stimulation, our devices, and how to get better results

Can I use tVNS if I have an arrhythmia or other heart condition?

Ask your cardiologist first. The vagus nerve directly influences heart rate and rhythm (that connection is part of how tVNS works), so if you have an arrhythmia such as atrial fibrillation, bradycardia, or tachycardia, or any other diagnosed heart condition, get individual advice from the doctor who knows your heart before using any vagus nerve stimulation device.

Do not use tVNS at all if you have a pacemaker, implanted defibrillator (ICD), or any other electronic medical implant. And if you ever notice palpitations or a change in your heart rhythm while using tVNS, stop and speak to your doctor.

If your cardiologist has questions, our support team is happy to provide clinical documentation and research references. Our devices are consumer wellness products and are not intended to diagnose, treat, cure, or prevent any disease, including heart rhythm disorders.

What if it doesn't work for me?

Is there a subscription?

Who should NOT use this device?

Is this a medical device?

Why does Buddy cost more than Boost?

Because it does more of what matters. Buddy is current-controlled: EverSteady checks your skin's impedance 50,000 times a second and adjusts every pulse, so the dose you set is the dose that reaches the nerve. Boost is voltage-controlled, so its output drifts as your skin changes.

Buddy also has its own battery (4+ hours) and EverCharge wireless charging, so it can charge during a session. It has a screen and joystick, loads Vagal Tones over Bluetooth, takes over-the-air firmware updates, uses titanium electrodes, and carries a two-year warranty. Used nightly, it works out at under $1 a day over the first year, and it is HSA/FSA eligible.

Boost is a good way to find out what stimulation feels like. Buddy is the device most owners choose to keep using.

How quickly will I notice a difference?

Does it hurt?

What is Vagal Buddy?

Buddy is our second-generation handheld vagus nerve stimulator, and the device most of our customers choose. It clips to the tragus of your ear and delivers gentle, current-controlled micro-pulses to the auricular branch of the vagus nerve, which helps your body shift into its rest-and-recover mode.

Sessions take 15 minutes and Buddy stops on its own. It holds three Tones at a time and connects over Bluetooth to the companion app (Vagal Tones on iOS, Vagally Better on Android) for more. It charges wirelessly, including during a session. See Buddy.

Can subjects use the device at home for longitudinal studies?

Yes. The Research Edition supports at-home use with pre-programmed protocols. Finite-use mode allows you to limit the number of sessions per device, ensuring protocol compliance. Subjects clip to the ear, press start, and the device delivers the exact parameters you configured. Session data syncs when the device reconnects via the companion app (called Vagal Tones on iOS and Vagally Better on Android).

What data formats does the session logging export?

Can I get IRB or ethics board documentation for my study proposal?

Yes. We provide comprehensive documentation packages for ethics board and IRB submissions, including device specifications, safety certifications (IEC 60601-1, CE, FCC), stimulation parameter ranges, and published safety data. Contact [email protected] with your protocol details and we will prepare the documentation for your specific submission requirements.

How does the sham mode work for double-blind studies?

Sham mode delivers an initial ramp-up of stimulation so the subject feels a brief sensation, then stops delivering therapeutic current while maintaining the appearance of active stimulation on the device display. This approach avoids the common workaround of placing electrodes on the earlobe (which subjects may notice). Both the subject and the administrator can be blinded, enabling true double-blind study designs.

Does it hurt? What do subjects report about the sensation?

Most subjects report a mild tingling sensation at the ear. The intensity is fully adjustable from 0 to 4mA in 0.1mA increments, so researchers can titrate to each subject's comfort threshold. The included Comfort Care conductive paste further reduces skin sensation. In sham mode, subjects feel an initial ramp-up sensation that then ceases, making it difficult to distinguish from active stimulation.

What is the Research Edition and how does it differ from the standard Vagal Buddy?

The Research Edition is a firmware upgrade for the Vagal Buddy (tVNS Stimulator) that unlocks advanced capabilities for clinicians and researchers. These include sham mode for double-blind studies, expanded parameter ranges (0.1-100 Hz frequency, 0-4 mA amplitude, 15-1000 us phase duration), four waveform modes (symmetric, alternating, asymmetric, monophasic), session data logging, protocol automation, finite-use mode for study management, a Chrome Control Surface for browser-based device control, and MCP integration for AI-powered device control via Claude. If you already own a Vagal Buddy with firmware 5.2 or above, you can upgrade to the Research Edition via the Digital Upgrade for $299. Starting from scratch, the full research setup is a Vagal Buddy ($349) plus the Digital Upgrade ($299).

Where exactly do I place Vagal Oh! on my ear?

Vagal Oh! clips onto the tragus area of your ear, the small flap of cartilage at the front of the ear canal. This is where a branch of the vagus nerve is accessible from outside the body. A small amount of Comfort Care conductive paste is applied to the electrodes before use to ensure a good connection. Most people find the right placement within their first couple of sessions. If you have smaller ears, the included silicone ear hook helps keep the device stable and in the optimal position. Detailed placement guidance is available in the app and on our instructions page.

Are there any subscriptions or ongoing costs with Vagal Oh!?

No, there are no subscriptions or ongoing fees. Vagal Oh! is a one-time purchase and works fully out of the box with the free companion app (called Vagal Tones on iOS and Vagally Better on Android). The device comes pre-loaded with a standard stimulation protocol. If you wish to explore additional protocols (called Tones), these are available separately through the Vagal store and via the Tone Portal, but they are entirely optional. You will eventually need replacement conductive paste, which is available at a low cost from our shop.

What is the return policy and warranty for Vagal Oh!?

We are confident you will love Vagal Oh!, but if for any reason it is not right for you, our 45-night sleep trial means you can return it for a full refund. Simply contact our support team within 45 days of delivery to arrange the return. We also offer a 2-year warranty covering manufacturing defects. Vagal Oh! is HSA and FSA eligible in the US, so you may be able to purchase it using pre-tax health funds.

What comes in the box with Vagal Oh!?

In the box you will receive the Vagal Oh! device, a medical-grade silicone ear hook for extra stability during active use, a USB charging cable, and a tube of Comfort Care conductive paste. The ear hook is optional (many users find the device stays in place without it), but it is included for those with smaller ears or who plan to use it during exercise. You do not need to buy any additional accessories to get started.