A randomized sham-controlled clinical trial of a novel wearable intervention for trauma-related nightmares in military veterans.
Nicholas D Davenport, J Kent Werner
Journal of Clinical Sleep Medicine February 1, 2023 DOI: 10.5664/jcsm.10338 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized sham-controlled clinical trial Peer reviewed |
|---|---|
| Sample size | 65 |
| Population | Veterans with impaired sleep secondary to trauma-related nightmares |
| Duration | 30-day trial |
| Topics | PTSD Dreaming |
| Keywords | Humans Dreams Stress disorders, post-traumatic Quality of life Veterans Nightmares Sleep quality |
| Registration | NCT04040387 |
| Key findings | Both Active and Sham groups improved significantly on all measures over 30 days, with no individual between-group comparison reaching statistical significance. A post-hoc analysis excluding low-frequency users found significantly better perceived sleep quality with the Active device than Sham, which the authors present as preliminary evidence of benefit, particularly in compliant users. |
Abstract
Study
Objectives: Persistent nightmares are common among individuals exposed to trauma and are especially prevalent among veterans. While behavioral and pharmacological interventions are available, they have demonstrated limited efficacy. Innovations in wearable technology provide a potential avenue to match or exceed these existing treatments by directly targeting nightmare physiology.
Methods: We conducted a randomized, sham-controlled study to determine the efficacy of a novel wearable device-based application in 65 veterans with impaired sleep secondary to trauma-related nightmares. Changes in measures of sleep quality, posttraumatic stress disorder/depression symptoms, and quality of life across the 30-day trial were compared between the Active and Sham systems.
Results: Both groups demonstrated statistically significant within-person improvement on all measures. While the Active system was generally associated with stronger magnitude of improvement, none of the comparisons of individual measures across conditions reached statistical significance. However, a post-hoc analysis excluding participants with low frequency of usage demonstrated significantly better improvement in perceived sleep quality with the Active device than Sham.
Conclusions: Overall, these results provide preliminary evidence that a wearable device may improve self-reported sleep quality for veterans reporting frequent trauma-related nightmares, especially in compliant users. Clinical
Trial Registration: Registry: ClinicalTrials.gov; Name: Traumatic Nightmares Treated by NightWare (To Arouse Not Awaken) (TNT/NW); URL: https://www.clinicaltrials.gov/ct2/show/NCT04040387; Identifier: NCT04040387. Citation: Davenport ND, Werner JK. A randomized sham-controlled clinical trial of a novel wearable intervention for trauma-related nightmares in military veterans. J Clin Sleep Med. 2023;19(2):361-369.
Comparable studies
Other randomized controlled trials on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Efficacy of a Cognitive‐Behavioral Treatment for Insomnia and Nightmares in Afghanistan and Iraq Veterans With PTSD Combat veterans of Operation Enduring Freedom and/or Operation Iraqi Freedom (mean age... | 2013 | Randomized controlled trial | n = 40 |
| Lucid Dreaming Treatment for Nightmares: A Pilot Study Chronic nightmare sufferers | 2006 | Randomized controlled trial | n = 23 |
| Testing the involvement of the prefrontal cortex in lucid dreaming: A tDCS study Participants spending three consecutive nights in a sleep laboratory | 2013 | Randomized controlled trial | n = 19 |
| Pre-sleep treatment with galantamine stimulates lucid dreaming: A double-blind, placebo-controlled, crossover study Adults with high dream recall and an interest in lucid dreaming | 2018 | Randomized crossover trial | n = 121 |
| Studies with lucid dreaming as add-on therapy to Gestalt therapy Adults with nightmares (ICD-10: F51.5) at least twice a week | 2015 | Randomized controlled trial | n = 32 |
Citations in the library
Cited by 4
- Psychometric Properties of the Nightmare Distress Questionnaire in Veterans with Posttraumatic Nightmares Behavioral Sleep Medicine September 12, 2026
- Real-world reduction in nightmare frequency and distress among San Francisco first responders treated with a prescription wearable device: a 60-day open-label pilot Frontiers in Sleep September 9, 2026
- Status of Imagery Rehearsal Therapy and Other Interventions for Nightmare Treatment in PTSD. Current Psychiatry Reports November 1, 2025
- Nightmare Disorder. Sleep Medicine Clinics March 1, 2024
Cites 8
- Imagery Rescripting and Imaginal Exposure in Nightmare Disorder Compared to Positive Imagery: A Randomized Controlled Trial. Psychotherapy and Psychosomatics 2021
- Comparative efficacy of imagery rehearsal therapy and prazosin in the treatment of trauma-related nightmares in adults: A meta-analysis of randomized controlled trials. Sleep Medicine Reviews April 1, 2020
- Nightmares do result in psychophysiological arousal: A multimeasure ambulatory assessment study. Psychophysiology July 1, 2019
- Management of Post-Traumatic Nightmares: a Review of Pharmacologic and Nonpharmacologic Treatments Since 2013. Current Psychiatry Reports October 11, 2018
- Position Paper for the Treatment of Nightmare Disorder in Adults: An American Academy of Sleep Medicine Position Paper. Journal of Clinical Sleep Medicine June 15, 2018
and 3 more in the library