The purpose of this study is to learn more about the effectiveness of a prescription wrist-wearable device called NightWare (NW) on improving sleep in Veterans with nightmares related to posttraumatic stress disorder (PTSD). The investigators also want to learn whether it improves cardiovascular health among this population.
Diagnosis of PTSD via American Psychiatric Association PTSD diagnostic criteria in the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Self-report having repetitive nightmares contributing to disrupted sleep;
Age 22 years (rationale is because the device has only been used in adults in 22 years and older);
Resting blood pressure (BP, <160/100 mmHg);
Unstable medical condition (e.g., uncontrolled hypertension or active CVD or cancer);
Active infection (note, anyone with an active infection would become eligible once the infection has ended);
Thyroid dysfunction, defined as an ultrasensitive TSH <0.5 or >5.0 mU/L; volunteers with abnormal TSH values will be re-considered for participation in the study after follow-up evaluation by the PCP with initiation or adjustment of thyroid hormone replacement; or other problems that would interfere with participation in the study;
Use of insulin or sulfonylureas
Parallel
NightWare
DeviceNightware intervention app (enabled) will attempt to detect when an individual is having a nightmare based on a Nightware proprietary algorithm and attempt to disrupt the nightmare without awakening. In the sham comparator group the NightWare app will be disabled and not deliver an intervention.
Change in Pittsburgh Sleep Quality Index
Sleep questionnaire with a scale of 0 to 21 with a higher score indicating a significant sleep disturbance
Change in physiological sleep - total sleep time
Total sleep duration (minutes) calculated through ambulatory electroencephalography.
Change in endothelial function
Brachial artery flow mediated dilation (FMD) using ultrasound
Change in Autonomic function - spontaneous baroreflex sensitivity (BRS)
Cardiovagal baroreflex sensitivity (cBRS) measured using beat-to-beat time series of systolic blood pressures (finger photo-plethysmography) and R-R interval (three-lead electrocardiogram) will be recorded simultaneously at 1,000 Hz.
Change in large elastic artery stiffness
Carotid-femoral pulse wave velocity (PWV)
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