You’ve probably heard that it is the longest nerve in the body, named vagus—not because it’s lazy, but because it wanders through the body like a vagabond.
It is part of the autonomic nervous system, which regulates the body’s involuntary functions. It’s easy to understand: this ANS is divided into two parts—one is the sympathetic nervous system (SNS), which prepares you for action, and the other is the parasympathetic nervous system (PNS), which acts as the off switch, and the vagus nerve is part of this.
It is the “great highway” that connects the brainstem with almost all essential organs, helping the body switch to rest mode—relaxation, recovery, regulation of heart rate, and breathing.
Since about 80% of its fibers are sensory, we can say the vagus nerve acts like a psychologist: the organs “tell” it how they are, and it reports that to the brain, with “the impact this has on our mind, our thoughts, and perhaps even our feelings” (Dr. Kevin Tracey).
How does vagus nerve dysregulation affect the respiratory system?
To understand this, we first have to consider the type of dysregulation or dysfunction that could affect the vagus nerve—whether it comes from hyperactivation of the sympathetic nervous system, or from a hyperresponse of the vagus itself.
When the response is due to vagal hyperactivation, we will have several approaches to consider:
Inflammatory processes: since the intestinal microbiome communicates with the brain through the vagus nerve, this brain–gut pathway is key. As neuroscientist John Cryan says: “What happens in the vagus doesn’t just stay in the vagus.”
Later, this can affect the respiratory microbiota, making it more fragile and sensitive to possible colonization by pathogens, leading to inflammation and hypersecretion.
Irritative or compressive processes: adhesions or tissue compressions along the path of the vagus nerve.
This leads to an increase in bronchoconstriction (natural to the smooth muscles of the respiratory system), with a rise in hypersecretion by mucous cells.
Processes of insufficient maturation of the central nervous system: where the Hering–Breuer reflex and its modulation must work in perfect interrelation with the phrenic nerve.
In preterm newborns, this may cause an increase in apneas and hypoxia.
3 Keys to Successful Respiratory Treatment
Since in newborns the inspiratory maneuvers that promote air entry in conventional pediatric respiratory physiotherapy can only be performed through instrumental physiotherapy, it is valuable for professionals to have additional tools—especially as demand in this highly vulnerable age group is growing in the pursuit of excellent quality care.
Understand whether the vagus nerve dysfunction is due to an increase or a deficit of activity.
Understand the interrelation of the respiratory system with other systems—and therefore with other types of professionals.
Have manual therapy tools to regulate the action of the vagus nerve—releasing it and increasing its mobility to restore its function, and therefore respiratory function.
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