Non-Pharmacological Management of Insomnia Through Electrical Vestibular Stimulation (VeNS)

Insomnia is a pathology characterized by the difficulty in initiating and maintaining sleep. It is a very prevalent disease affecting 10–15% of the population and is associated with significant impairment to normal daytime functioning, mood, and cognitive function. Insomnia can be experienced independently or comorbidly with other metabolic and psychiatric indications such as anxiety and depression — in a bidirectional relationship where one pathology contributes to severity and onset of the other. This review details the current understanding of insomnia pathology and its connection to the vestibular system in addition to current studies focusing on safety and efficacy of VeNS as a therapeutic measure.

Pathophysiology of insomnia is not fully clear but there is evidence it involves numerous neurobiological abnormalities such as disorder of hyperarousal, or increased somatic, cognitive, and cortical activation. Due to the complex and eclectic nature of the pathophysiology, it warrants deeper consideration of non-pharmacological options. Vestibular system is a complex set of structures and neuronal pathways involved in modulation of visuomotor, balance, and equilibrium but also sleep. The distinct neuronal vestibular projections are processed by the brainstem before proceeding to other ‘downstream’ autonomic nuclei of the brain, hypothalamus, and broader cortical regions of the brain. Electric vestibular stimulation (VeNS) has been shown to be an effective and safe method of treating insomnia but also associated comorbidities like anxiety and depression effectively targeting the bidirectional relationship.

Electric vestibular stimulation (VeNS) has been proposed as a novel, safe, and effective way of treating insomnia.