Advisor(s)

William Tyler

Committee Member(s)

Kristine Lokken
Mark Bolding
Matthew MacAluso
Nicole Bentley

Document Type

Dissertation

Date of Award

1-27-2026

Degree Name

Doctor of Philosophy (PhD)

School

School of Engineering

Department

Engineering

Abstract

Breast cancer remains the most frequently diagnosed cancer among women worldwide, with over 2.3 million new cases annually. While advances in treatment have improved survival, many women continue to suffer from persistent insomnia, fatigue, anxiety, depression, and cognitive dysfunction that collectively impair quality of life and recovery. These interrelated symptoms share common biological underpinnings, including autonomic dysregulation, vagal withdrawal, and chronic inflammation. Transcutaneous auricular vagus nerve stimulation (taVNS) is a non-invasive, bioelectronic therapy that modulates afferent vagal pathways via auricular branches of the vagus and trigeminal nerves. By engaging central autonomic and neuroimmune circuits, including the nucleus tractus solitarius and locus coeruleus, taVNS may normalize arousal regulation, reduce inflammation, and promote restorative sleep. This pilot study investigates the feasibility, tolerability, and preliminary efficacy of nightly, at- home taVNS for improving sleep and related symptoms in women with breast cancer. Chapter 2 investigates the application of taVNS for improving sleep and associated symptom clusters in women with breast cancer, highlighting its potential as a safe and effective intervention for mitigating insomnia and fatigue. Chapter 3 advances this work by examining a subset of participants to evaluate the effects of taVNS on inflammatory biomarkers and autonomic regulation. Collectively, Chapter 4 of this dissertation delineates and explores the role of non-invasive vagus nerve stimulation in alleviating psychophysiological symptom burden through modulation of the underlying mechanisms, including autonomic dysregulation, inflammatory activity, and arousal imbalance in breast cancer. Findings from this study aim to establish preliminary evidence for taVNS as a safe, accessible, and mechanistically grounded intervention to address sleep disturbance and psychophysiological symptom burden in breast cancer, paving the way for larger- scale investigations and translational applications in oncology supportive care.

Keywords

breast cancer;insomnia;non-invasive neuromodulation;transcutaneous auricular vagus nerve stimulation;Vagus nerve stimulation

ProQuest Publication Number

32284363

ISBN

9798273380950

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