Abstract

Abstract Introduction Nightmares are a common problem affecting 2-8% of the general population with the prevalence of comorbid nightmares in those with post-traumatic stress disorder (PTSD) being significantly higher at 72%. The negative sequelae of nightmares are myriad including impaired quality of life, sleep deprivation, insomnia, daytime sleepiness, fatigue, and suicidal ideation. This study investigated a novel approach for the treatment of nightmare disorder in military veterans. Methods All participants in this study were veterans receiving care at the Minneapolis Veterans Affairs Health Care System (VAHCS), diagnosed with PTSD, and had self-reported nightmares. At the baseline assessment, eligible participants were given a digital smartwatch preloaded with an application designed to arouse but not awaken the user out of the nightmare. Paired t-test analysis was used to compare the participants’ baseline and follow-up responses. Results A significant decrease in participant Pittsburgh Sleep Quality Index (PSQI) scores (13.6 to 7.4, p < 0.001), PTSD Checklist for DSM-5 (PCL-5) scores (45.8 to 25.1, p < 0.0025) and Patient Health Questionnaire (PHQ-9) scores (12.2 to 6.1, p < 0.002) was observed over the sixty day trial. All 9 participants experienced a decrease in the Epworth Sleepiness Scale (ESS) upon completion of the trial, with an average decrease of -2.5 ± 1.4. Conclusion These results demonstrate that a novel digital therapeutic smartwatch application is effective in improving sleep quality, reducing the burden associated with PTSD symptoms, and lowering depressive symptoms in those with nightmare disorder within an open label study. These results have initiated further investigation into efficacy of digital therapeutic smartwatch applications in nightmare intervention and improved sleep quality. Support NightWare, Inc.

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