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Randomized Controlled Trial
. 2025 Dec;27(1):236-248.
doi: 10.1080/19585969.2025.2526547. Epub 2025 Jul 11.

Efficacy of electrical vestibular stimulation (VeNS) on adults with insomnia: A double-blind, randomized, sham-controlled trial

Teris Cheung  1   2 , Joyce Yuen Ting Lam  1   2 , Kwan Hin Fong  1 , Calvin Pak-Wing Cheng  3 , Yu-Tao Xiang  4 , Tim Man Ho Li  5
Affiliations
Randomized Controlled Trial

Efficacy of electrical vestibular stimulation (VeNS) on adults with insomnia: A double-blind, randomized, sham-controlled trial

Teris Cheung et al. Dialogues Clin Neurosci. 2025 Dec.

Abstract

Introduction: Insomnia, a widespread sleep disorder, affects a significant portion of the global population. This study is the first in Asia to evaluate the efficacy of electrical vestibular stimulation (VeNS) as a treatment for insomnia in Hong Kong adults, addressing a gap in non-pharmacological interventions.

Methods: A double-blind, randomized, sham-controlled trial was conducted with 101 adults exhibiting insomnia symptoms. Participants were randomized into active VeNS or sham groups (1:1 ratio) and underwent twenty 30-minute VeNS sessions over four weeks. Psychological outcomes, including insomnia severity, sleep quality, and quality of life were assessed at baseline (T1), post-intervention (T2). Follow-up assessments were conducted at one- (T3) and three-month (T4) to evaluate the sustainability of VeNS effects.

Results: Of 83 participants (40 VeNS and 43 sham-VeNS), the VeNS group showed significant reductions in insomnia severity at T2 (p = 0.03, d = -0.47) and T4 (p = 0.02, d = -0.32), alongside improved quality of life (i.e., role-physical) at T2.

Conclusion: VeNS is a novel, non-invasive and safe neuromodulation device that may serve as an adjunct treatment for primary insomnia. The present findings provide a foundation for future multisite comparison studies to further evaluate VeNS efficacy.

Trial registration: ClinicalTrials.gov Identifier: NCT04452981.

Keywords: Vestibular stimulation; brain stimulation; efficacy; insomnia; randomised clinical trial.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
The mechanism of vestibular stimulation in modulating sleep. Note. In blue: Vestibular stimulation inhibits both the HPA axis and the sympathetic-adreno-medullary (SAM) axis, thereby decreasing stress (Sailesh and Mukkadan 2013a), and excites sleep-inducing areas such as the nucleus tractus solitarius (NTS) (Davis et al. ; Sailesh and Mukkadan 2013b) and the serotonergic dorsal raphe nucleus (Horowitz et al. 2005). In green: The activation of neurons in the midbrain periaqueductal gray matter excites neurons in the rostral medulla and increases serotonin release. Activation of serotonin receptors causes the secretion of growth hormone-releasing hormone (GHRH) (Conway et al. 1990), which promotes rapid eye movement (REM) and non-REM sleep in humans (Kerkhofs et al. 1993), thereby helping to modulate sleep (Snowball et al. 1997).
Figure 2.
Figure 2.
CONSORT flow diagram of subject recruitment and data collection at each time point. VeNS = Electrical Vestibular Stimulation; ISI = Insomnia Severity Index; PSQI = Pittsburgh Sleep Quality Index; SF-36 = 36-Item Short Form Health Survey
Figure 3.
Figure 3.
(A) The Modius Sleep device (Neurovalens®) as intended to be worn, with electrode pads over the mastoid processes. Identical appearance for Modius Sleep and sham devices. (B) The user interface of the study app (Vestal, Neurovalens®).
See this image and copyright information in PMC

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