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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

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