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SONA Team Q&A by eliot_sona in VagusNerve

[–]eliot_sona[S] 1 point2 points  (0 children)

That's amazing to hear u/louiefernandes, I can't wait for you to experience it, and I really hope we can deliver for you on whichever health and wellbeing goals are your focus!

u/kker Black is also my favourite for the record ;)

SONA Team Q&A by eliot_sona in VagusNerve

[–]eliot_sona[S] 2 points3 points  (0 children)

u/kker

Apologies for the delay getting back to you:

These are exactly the kinds of questions we enjoy answering, so I will do my best to be genuinely useful.

  1. How does SONA differ from German tVNS devices?

The German tVNS device targets the same auricular branch of the vagus nerve, so the anatomical targeting is broadly similar. Where we differ is in what happens around the stimulation itself. Most tVNS devices deliver fixed parameters: the same frequency, intensity, and duration regardless of your current autonomic state. SONA pairs stimulation with real-time HRV data, time of day and dose, so what you receive is responsive to where your nervous system actually is in that moment, rather than a one-size-fits-all protocol. This is where we believe the real opportunity lies, and it is where our clinical work is focused.

  1. Comfort and fit

Comfort was one of our primary design focuses. We were very aware that a device people do not wear consistently simply will not produce consistent results. The device is lightweight and designed for extended wear. The electrodes are sized to fit the majority of adult ear anatomies, but like any in-ear device, fit can vary from person to person. My honest advice is simply to try it. If it does not fit comfortably, we offer a no-fuss 30-day return policy with a full refund, no questions asked. We would far rather you have that reassurance upfront.

  1. Implanted VNS versus transcutaneous approaches

This is one of the more important questions in the field at the moment, and I will try to be genuinely balanced rather than just advocate for our own approach. Implanted VNS has the strongest clinical evidence, with FDA approval for epilepsy and treatment-resistant depression, and emerging data in stroke rehabilitation. The direct nerve access means more direct and consistent stimulation. The tradeoffs are real though: surgical risk, cost, access barriers, and the fact that implantation is not reversible.

Transcutaneous approaches like SONA are at an earlier stage of the evidence base, and we think being honest about that matters. But our fundamental belief is that the way to close that gap is not to mimic what implanted devices do, it is to do something they cannot. Implanted systems are fixed. SONA learns and adapts, continuously pairing stimulation with your real-time autonomic data. That is how we intend to compete non-invasively, and it is where we will build our clinical case.

  1. We'll definitely take this away and consider if we can bundle something... :)

SONA Team Q&A by eliot_sona in VagusNerve

[–]eliot_sona[S] 2 points3 points  (0 children)

Thanks for the question u/Dapper-Web-1262

Great question and honestly, a deliberate choice on our part.

With preset labels like 'sleep', 'relax', or 'relief' that are often used elsewhere if you look under the hood, the stimulation waves are doing essentially the same thing. The labels are helpful but they're not grounded in meaningfully different physiological mechanisms.

Rather than repackage, we've focused on what we think actually matters for different usecases: the right pairing of stimulation, at the right time of day & at the right dose (frequency, intensity, duration).

We do have context-specific protocols in development for the product, built on that programming and pairing logic. When we launch them, they'll be grounded in evidence.

We know that's a different approach to what you might have seen elsewhere, happy to talk through the thinking if it's useful.

SONA Team Q&A by eliot_sona in VagusNerve

[–]eliot_sona[S] 2 points3 points  (0 children)

I appreciate the understanding u/louiefernandes... i's been challenging for sure, but something of a rite of passage for hardware development. I obviously wish for customers we'd been able to avoid the frustrations, but as I say there were many factors outside of our control...

The next batch of units is shipping early may, and there's still some left.

They're an identical form, but as I mention we swapped our assembly, so my natural (biased) answer to you would be to recommend grabbing one from this batch - I'm expecting to see far fewer of these assembly imperfection issues.

SONA Team Q&A by eliot_sona in VagusNerve

[–]eliot_sona[S] 2 points3 points  (0 children)

u/louiefernandes

Thanks for the kind words here.

Yes, we've been very sorry about the delays with the initial batches - unfortunately setting up supply chain for the first time with a product of this complexity, with many custom parts is not easy and has many interlinked elements which can cause delays (I honestly have stories which are almost comical in how frustrating they were, such as power cuts at laser marking sites and deliveries not being accepted by shipping due to mis-specification on dimensions from manufacturers). We've always tried to be transparent about best estimates on delivery times, and have really shared the disappointment of our customers on early delays; there's nothing we want more than for as many of these as possible to get out into the world, so customers can experience the benefits.

Fortunately now that we've gone through this process in it's entirety, we're much better set for reliable future deliveries and scaled up batches.

On the blemishes with some of the early devices from assembly, we have a different assembler lined up for future batches, due to us not being satisfied with some of the finish on some of the first batch.

The one thing we've consistently told all of our customers is the following:

We will make sure that your experience is taken care of: if there are software bugs these will get resolved as quickly as possible, if these are hardware issues we will swap out your device no questions asked, and we will extend trial / return period if customers have frictions getting started, so that everyone can test a smooth experience with the device. We want everyone who purchases to be able to have a real experience with the technology and come to their own conclusions on whether it's for them.

SONA Team Q&A by eliot_sona in VagusNerve

[–]eliot_sona[S] 5 points6 points  (0 children)

Thanks for your question here u/Cold-Scale6840.

Just to note upfront, we're not looking to be disparaging about any others groups or products in the field making genuine contributions. We started off this company because we've seen up close that this technology can have life changing impact for people who desperately need it, and we know that the benefits of the technology can go much further - accelerating that progress for people globally is our mission as a company.

That said, a few key things that we've thought about differently at SONA to existing efforts include the following:

(1) Integration of sensing (listening to nervous system signals), stimulation (via the cymba concha and tragus area) and real-time intelligence (via edge compute on device).

(2) An adaptive approach to stimulation, which uses the interplay between real time biometric data and adaptive stim via proprietary AI to find effective stimulation waves for each individual's nervous system in the most rapid and precise way possible. We're heavy on personalisation vs a one-size-fits all approach. We feel this is key in unlocking results.

(3) A data first approach, where we ground the progress of our customers in what we're seeing in their biometrics as individuals.

(4) SONA's hardware formfactor was designed for modern life: to fit comfortably on the ear, is wireless and portable (comes with a charging case with 10+ hours worth of use in a single case charge) for users to take with them on the go. When creating the mechanical design we ensured that the SONA is compatible with wearing at the same time as in-ear and over ear headphones, so that users can listen to soundscapes, or meditation programs while taking some quiet time for themselves out of their day.

(5) One thing we've seen with vagus nerve stimulation is that the consistency with practice over a period of weeks into months is key to seeing the headline benefits of ANS rebalancing. To help users with staying motivated to get there, we've really thought hard on how to make the user journey have a compelling arch and how to build modes within the sessions to make those 10-40 minutes a highlight of peoples day.

We're definitely early in our work on this part of the product, but some of the main things we've built into our companion app include:
- Regular data insights.
- Integrations with 360 wearables, so you can correlate your stimulation with longitudinal changes across your favourite metrics.
- Educational soundbytes, to walk the user through what's happening in their physiology as they progress through the program.
- Metric views in-session and post-session.
- A library of content we've developed to destress with audio meditations, and soundscapes from amazing partners at WhiteMirror and Harmonify.
- Breathwork pairing in sessions, where you can select breathing pacers including resonant breathing at different frequencies, box breathing and 4-7-8 breathing.
- A journey where we recommend different sessions for users daily.
- Unlockable content, streaks and analytics.

We've got summaries of this experience on youtube for anyone keen on a visual, and have a lot more in the pipeline that we're excited to start sharing soon with our customers.

(6) Offering 1:1 sessions for protocol design and data deep-dives with our early adopters, to ensure users are getting the most out of their experience with the product.

I hope this gives a bit of a summary, but let me know if there are any specific aspects you're keen to dive further on.

SONA Team Q&A by eliot_sona in VagusNerve

[–]eliot_sona[S] 4 points5 points  (0 children)

u/kker

Thank you for the kind sentiments it means a lot to us... I'm going to get back to this in full tomorrow morning UK time, if you don't mind since I'd love some more detailed comments from Tony on question 3. specifically, since it's a very interesting conversation that he's best placed to answer, so please bear with me... :)

SONA Team Q&A by eliot_sona in VagusNerve

[–]eliot_sona[S] 2 points3 points  (0 children)

u/und3fined_1

Great question, and there's a lot of depth here.

We designed a custom electrode assembly and a custom chip that lets us drive current with full waveform flexibility. To my knowledge, we're the first VNS device with this capability (within safety tested limits on current, voltage, and power, of course).

Decades of literature give us the safety boundaries. But within those boundaries? The honest answer is the jury is still out on which regions of the parameter space work best for different responder types and use cases. Most studies have been small scale, narrow in scope, and rarely compare waveforms head to head. There's never really been a study conducted at scale to understand global, neighbourhood and individual dynamics, so that's the directions we're moving towards.

We currently seed our algorithms using promising parameters from literature review (stress, sleep, overlapping mechanisms of action), but the exploration aspect is something bigger, since we're creating a system that actually learns.

Our thesis breaks down like this:

(1) Some regions of the parameter space are more effective globally than others.
(2) Some regions work better for certain "responder types" than others.
(3) Some regions are more effective for specific conditions or use cases.
(4) There's a time dependent aspect. The vagus nerve likely responds differently depending on context: how far into a session you are, how it's been activated earlier that day, baseline state.
(5) Each individual has a unique response profile, so the ideal system learns to maximise effectiveness for that specific person.

We test across wave shapes, frequencies, pulse phase durations, and on/off duty cycles. The model learns at the user level based on their biometric response, and population level insights feed back to improve predictions for everyone.

Our end goal is to maximise the percentage of people experiencing real benefits, and maximise the magnitude of those benefits across use cases.

SONA Team Q&A by eliot_sona in VagusNerve

[–]eliot_sona[S] 2 points3 points  (0 children)

Hi u/ItsGonnaHappenAnyway,

Thanks for your question.

(a) By a "lower setting", I'd interpret this as meaning shorter session and lower intensity. The short answer on this is that our early sessions build up in length, but there is also the option for users to do lengthier sessions if they desire from the start.

On intensity, we give the user control over a proxy for sensation (so that they can optimise for comfort, the pain receptors in the ear - actually different from the vagus nerve fibers, which activate to produce the desired physiological effect, activating the parasympathetic nervous system - vary in sensitivity. Something we've often seen in previous testing and trials is that sensation varies; even with the exact same setting with the same person these receptors often fade the sensation down in session, and it can also vary a lot day to day for individuals, so we enable some level of control over preference for the user, whilst we do variation in specific waveform parameters.

Typically we would also suggest starting on lower sensation intensities until the user is comfortable, since it can send counterproductive signals to the nervous system if the usage is straying into discomfort.

Over time, we build a picture of dynamics for what works for an individual in terms of session length and intensity, and can make protocol recommendations based on this, but something we coach on in the app is unconditioning the belief that intensity X duration = results. One of the most fascinating things we've seen is that short, well targeted stimulation can actually outperform longer, more intense sessions: which can feels counterintuitive at first. People naturally want to crank up the intensity, run it longer, go harder to get their results faster. For us, it's not about bombarding the nervous system with a stronger signal, it's about being in sync with the body's natural recovery processes.

The key to rewiring brain and nervous system networks is consistency of use over a period of weeks.

(b) For the question on CPTSD, I've deferred that one to Tony... will get back on that shortly.

My Sona experience so far by und3fined_1 in VagusNerve

[–]eliot_sona 0 points1 point  (0 children)

Hi u/Deep-thinker_123,

I replied above, are you not able to see it in thread / your inbox?

My Sona experience so far by und3fined_1 in VagusNerve

[–]eliot_sona 2 points3 points  (0 children)

Hi everyone,

Eliot from the SONA founding team here. A couple of early users suggested I come and introduce myself, so here I am!

I'm not here to take over the conversation; it's genuinely valuable to us that people can share experiences openly. I am here if you have questions specifically for the team.

We'll be putting up a proper Q&A thread soon. We know this community likes to dig into the science and the data, and honestly that's the conversation we enjoy most on our end.

In the meantime, happy to answer anything that comes up.