At the ANZMES (Association of NZ ME Societies) annual general meeting yesterday, Dr Ros Vallings gave a research update. Dr Vallings is NZ's only physician focused on ME. She talked positively about the presentation of Dr Markku Partinen at this year's Invest in ME C13 conference. I'll cover Dr Vallings' other takeaways from Dr Partinen's presentation elsewhere, but here I want to talk about singing and gargling treatments. The Invest in ME summary of Dr Partinen's talk included the following question and answer: I'm not sure if Dr Vallings has built her treatment recommendation on Dr Partinen's seemingly very lukewarm endorsement of these activities as useful for vagal stimulation (e.g. 'That is possible') or if she only used that as a start point and has done further research. Regardless, Dr Vallings advised that people with ME should sing in the shower or, if we prefer, gargle. My memory of this advice was that the idea that this would result in improved sleep, specifically deep sleep, was presented with quite a lot of certainty. (Ros said that Dr Partinen was suggesting that people with ME do not get enough deep sleep.) I believe that there may be a video of her presentation in due course, so we will be able to check what exactly was said. Now, singing in the shower and gargling seem like fairly harmless activities, and singing at least might even be quite pleasant. But certainly on first hearing, the idea that singing and gargling would be helpful for any ME symptoms via a vagal nerve stimulation mechanism sounded odd to me. I have since googled 'vagal nerve stimulation singing and gargling' and I am amazed at the amount of information about this and the even greater amount of literature about vagal nerve stimulation for a great many bodily complaints. I didn't find anything that I found particularly credible to support the idea that singing in the shower and/or gargling improve ME or sleep or the sleep of people with ME. What do you reckon? Have any of you tried a concerted program of either gargling or shower singing? Presumably even singing outside of the shower might count. So, is there evidence that: 1. the vagus nerves of people with ME are understimulated? 2. that we are not getting enough deep sleep? 3. that singing and gargling do actually stimulate the vagus nerve? (I think there might be some evidence for this.) 4. that stimulating the vagus nerve results in deep sleep? Is Dr Vallings alone in promoting shower singing and gargling as ME treatments operating via a vagus nerve stimulation mechanism or do other ME specialists support this? Any corrections to any of the foregoing will be appreciated.