Psychiatry and psychology

Polyvagal theory explains what you see every day: patients in chronic hypervigilance or in collapse. The autonomic nervous system (ANS) is the biological substrate of trauma, stress and the behaviours you observe in practice. HRV predicts antidepressant response and is a biomarker of emotional resilience — yet it remains largely unmeasured in clinical protocols.

Non-invasive neuromodulation with NESA XSIGNAL® supports regulation of the vagal and sympathetic circuits underlying mental health, providing the stable physiological foundation on which your pharmacological and psychotherapeutic approach performs better. It does not replace your approach: it enhances it.

Treatment

Non-invasive neuromodulation with NESA XSIGNAL® acts directly on the autonomic nervous system, supporting processes that influence pain, tone, inflammation, microcirculation and sleep quality.

By targeting autonomic regulation, it may help reduce hyperreactivity, improve physiological variability and promote more efficient recovery between sessions.

It integrates as a supportive component within the treatment plan, without interfering with other interventions, and can be tailored to the patient’s profile: symptoms, sleep, pain, stress levels and load tolerance.

Functional objectives

Better sleep and more restorative rest.

Improved sympathetic/parasympathetic balance.

More efficient recovery between sessions.

Greater adherence to, and progression within, the treatment plan.

Applications

Common Clinical Presentations

Anxiety, hyperactivation and difficulty switching off.

Stress, irritability and mood dysregulation.

Sleep disorders.

Cognitive fatigue and low energy.

Autonomic dysregulation (sympathetic/parasympathetic imbalance).

Elevated physiological stress / hyperarousal.

As Support for Recovery Processes

Sleep disorders.

Fatigue and reduced recovery capacity.

Sleep disorders.

Support for microcirculation and tissue perfusion.

Benefits

Improved sleep and recovery.

Reduced hyperreactivity and enhanced stress regulation.

Complementary, non-invasive and drug-free support.

Individualised protocols tailored to symptoms and autonomic profile.

Modulate the root. Enhance your treatment

Neuroanatomy of the autonomic nervous system associated with your clinical specialty

IMG-012_Insula y corteza cingulada anterior

Introducing NESA XSIGNAL®

NESA XSIGNAL® is a non-invasive neuromodulation system that applies very low-intensity microcurrents through electrodes, with protocols oriented towards regulation of the autonomic nervous system. It is designed to integrate into clinical practice as part of the multimodal approach.

In Psychiatry and Psychology, the protocols act specifically on the vagal and sympathetic circuits underlying hypervigilance, anxiety, depression and dissociation.

Testimonials

“Non-invasive neuromodulation is consolidating itself as an effective tool to reduce the intensity of symptoms in chronic patients, which translates into a significant improvement in their quality of life.”

“With NESA I achieved a radical change: anxiety, muscle pain disappeared and now I sleep deeply, without stress.”

“Thanks to NESA technology, I have managed to make patients who would normally need medication able to avoid it, as well as facilitating that other patients stop medication by improving their anxiety and sleep problems.”

“Before, I didn’t sleep well, I had trouble falling asleep and spent sleepless nights. After a few sessions with NESA, I recovered rest without needing medication.”

“Now I sleep deeply, something I missed. The irritability disappeared and I feel much calmer. After stabilizing my nervous system, I felt like another person.”

“Thanks to NESA we have seen a phenomenal change at home and in everything. For me, NESA is better than a pill.”

“With NESA®, I felt a deep tranquility from the first sessions. Little by little, the nighttime anguish has decreased and I hope to soon stop sleep medication.”

“NESA is an innovative technology that breaks paradigms and offers real solutions to patients without previous response. It has been very well accepted and is here to stay.”

“NESA complements EMDR by regulating the autonomic nervous system, reducing anxiety and stress in patients with complex trauma, and improving sleep, well-being and emotional adaptation.”

“NESA balances the nervous system non-invasively during sleep, improving its quality. A technology with great potential, presented at an inspiring congress.”

“We use NESA to improve sleep and reduce physiological symptoms in patients with anxiety and agoraphobia, enhancing their recovery and emotional well-being.”

“NESA neuromodulation improves anxiety, depression and physical pain without side effects. In a few sessions, mental, physical and cognitive advances are noticed.”

“From psychology, this new tool, apart from impacting the autonomic and central nervous system, will beneficially affect the quality of life of patients.”

“NESA addresses many pathologies and symptoms that sometimes are not fully treated. It is a non-invasive technology that I consider a good way to cover those needs.”

“We are excited to incorporate NESA in Costa Rica to work with different healthcare professionals, using this technology to transform the quality of life of our patients.”

“As a pilot, I cannot take sleeping medication. My neurologist recommended NESA and since then I sleep better, I’m calmer and my attention level has improved a lot.”

I live with a lot of stress due to my business and I suffered from insomnia, anxiety and tachycardia. With NESA®, I returned to sleeping, I feel calmer, rested and able to face the day without overwhelm. It has been a before and after.

“Since we introduced neuromodulation with NESA, we have seen absolute success, with the disappearance of the discomfort and pain that limited people. This has allowed my patients to go further in their treatments.”

“When using NESA, I have noticed greater rest and internal stability that helps me better manage hectic life, even without having specific sleep problems.”

“For me, the most beautiful thing about my work is being able to help people in difficult moments… being able to accompany them and have them gradually begin to see the light.”

“Before having NESA, when there was a patient who did not respond well to traditional physiotherapy because the origin of the problem was untreatable with my hands, I would pass them to consultation with Susana for combined therapy. Now, with the combination of NESA, it has changed quite a bit our way of approaching these cases.”

“I observed that by putting NESA first and then having therapy, patients came differently than if I didn’t treat them with NESA.”

“When I learned about NESA, the truth is that I was very happy to be able to close a circle to give a much more comprehensive treatment and that the effect on the person was at all levels: mental, emotional and physiological.”

“At the clinic we plan to incorporate, starting in September, a specific sleep unit with NESA technology because we are seeing that there is a lot of demand and that there are many people who need it.”

“After motherhood, the NESA conductors helped me to recover deep sleep and to get up rested and full of energy. I continue the treatment in moments of stress and tiredness, which allows me to rest and sleep well again. Even if I wake up, I manage to fall back asleep easily thanks to NESA.”

“I have greatly improved in sleep quality. I have been for 14-16 months waking up much calmer, more relaxed, without the aggressiveness I noticed before and this, of course, represents for me a quality of life that I was losing”

After the fifth session with NESA, I sleep super well. What’s more, the first days I finished the session, it was a curious thing because at eight hours of sleep I wanted to continue sleeping.

“NESA non-invasive neuromodulation is a revolutionary technology that regulates the autonomic nervous system comfortably, improving pathologies such as bruxism and promoting treatment adherence at all ages.”

“We tried with three patients with sleep problems and the results with 10 sessions were impressive.”

“Thanks to neuromodulation with NESA, I started sleeping better. Before, I suffered from insomnia, but now my sleep is much deeper and more restorative.”

“NESA regulates the autonomic nervous system and improves sleep, anxiety and cognitive decline, marking a paradigm shift in these disorders.”

“She told me: ‘I don’t know whether I’ve lost fat or not; what I do know is that I didn’t think about the bathroom once during the whole holiday, and for me that is a gift.'”

When specific work on the autonomic nervous system is incorporated, the effect is often systemic: reduced physiological “noise”, more consistent recovery and improved adaptive capacity. In psychiatry and psychology, this may translate into:

Supporting autonomic balance may expand the patient’s adaptive capacity, allowing local interventions such as manual therapy, exercise or procedures to be better tolerated and more consistent over time.

Key Evidence (3 papers):

Ramesh A, et al. (2023) Heart rate variability in psychiatric disorders: a review of literature. PMID: 37881808

Sgoifo A, et al. (2015) Autonomic dysfunction and heart rate variability in depression. PMID: 26004818

Goffi F, et al. (2025) Heart rate variability in major depressive disorder: a systematic review and meta-analysis. PMID: 40595479

Persistent pain is associated with both autonomic dysregulation and altered central processing. Supporting autonomic regulation may help reduce hypervigilance and complement pain management strategies.

Key Evidence (3 papers):

Rampazo ÉP, et al. (2023) Heart rate variability in adults with chronic musculoskeletal pain: a systematic review. PMID: 37661339

Adlan AM, et al. (2014) Autonomic function and rheumatoid arthritis: a systematic review. PMID: 25151910

Barkhudaryan A, et al. (2025) Autonomic dysfunction after stroke: an overview of recent advances. PMID: 40131648

Sleep is a key modulator of pain, inflammation and tissue repair. Supporting autonomic stability may help promote more restorative sleep patterns and more consistent recovery.

Key Evidence (3 papers):

Frandsen MN, et al. (2022) Preoperative heart rate variability as a predictor of perioperative outcomes: a systematic review without meta-analysis Journal of Clinical Monitoring and Computing. PMID: 35092527 DOI: 10.1007/s10877-022-00819-z

Cameron S, et al. (2024) Mind and skin: exploring the links between stress and dermatological disease. PMID: 37469218

Michalek-Zrabkowska M, et al. (2021) Cardiovascular implications of sleep bruxism: a systematic review. PMID: 34064229

The autonomic nervous system regulates vascular tone and perfusion. Improved regulation may support peripheral comfort, effort tolerance and recovery processes, particularly in patients with coldness, heaviness or reduced perfusion.

Key Evidence (3 papers):

Lee JY, et al. (2011) Heart rate variability in men with erectile dysfunction. PMID: 21811698

Goernig M, et al. (2008) Peripheral arterial disease alters heart rate variability. PMID: 18684283

Bachmann SB, et al. (2019) A distinct role of the autonomic nervous system in modulating the function of lymphatic vessels under physiological and tumor-draining conditions Cell Reports

Integrating non-invasive neuromodulation as a supportive approach may help address the regulatory component without replacing the primary treatment. The aim is additive: greater stability, improved recovery and better adherence.

Key Evidence (3 papers):

Yeom JW, et al. (2025) Transcutaneous auricular vagus nerve stimulation improves sleep quality in chronic insomnia disorder: a double-blind, randomized, sham-controlled trial Sleep Medicine. PMID: 40398066 DOI: 10.1016/j.sleep.2025.106579

Alomari MS, et al. (2022) Non-inferior and more feasible transcutaneous tibial nerve stimulation in treating overactive bladder: a systematic review and meta-analysis International Journal of Urology. PMID: 35711082 DOI: 10.1111/iju.14961

Ylikoski J, et al. (2020) Stress and tinnitus: transcutaneous auricular vagal nerve stimulation and neuroplasticity

Resources

Training courses

Our training work at NESA Academic is aimed at professionals who want to integrate non-invasive neuromodulation and autonomic nervous system regulation into rehabilitation, physiotherapy and reconditioning. The content combines physiology, application criteria by specialty, safety and session design, so that integration is practical and consistent in the clinical setting.

Testimonials

Real cases and experiences from clinics and teams that integrate NESA XSIGNAL® into rehabilitation, physiotherapy and reconditioning. What comes up repeatedly: better rest, reduced reactivity during high-load periods and more sustained treatments over time. We also share clinical meetings where protocols, learnings and case discussions are presented.

News

Articles, bibliography and downloadable materials to go deeper into non-invasive neuromodulation, autonomic nervous system, heart rate variability, vasomotor control and neurovascular health applied to rehabilitation, physiotherapy and reconditioning. A living library to keep clinical criteria up to date and provide context for each indication.