NightWare is an Apple Watch app that helps treat nightmares stemming from disorders like PTSD. It works by monitoring smartwatch motion and heart rate data to detect bad dreams and interrupts them without waking the user up with a vibration. The app is supposed to be used only with a prescription and that’s a good thing, observers say. “The downside to this approach is that it doesn’t do anything about the adrenaline response, so I’d be concerned about the adrenaline disrupting sleep even after the app wakes the user,” Dr. Aaron Weiner, a clinical psychologist who specializes in trauma, said in an email interview. “It may also decrease the chance that the individual decides to attend therapy, which ultimately would be the most effective way to permanently address PTSD symptoms.”
Don’t Use Without Rx
The app’s maker says that the software isn’t meant to replace therapy but is meant to be part of an overall treatment strategy that includes medication. The company also warns against using NightWare if you “act out” during sleep. NightWare learns the wearer’s sleep pattern after just a few days of wearing the watch each night, the company says. Users wear the watch only while sleeping and recharge it during the day. A 30-day randomized study of 70 patients showed better sleep quality with NightWare than in a control group, the FDA said in a statement. “Sleep is an essential part of a person’s daily routine,” said Carlos Peña, director of the Office of Neurological and Physical Medicine Devices in the FDA’s Center for Devices and Radiological Health. “However, certain adults who have a nightmare disorder or who experience nightmares from PTSD are not able to get the rest they need. Today’s authorization offers a new, low-risk treatment option that uses digital technology in an effort to provide temporary relief from sleep disturbance related to nightmares.” One potential problem with NightWare is that even though it’s designed not to wake users up when they are having a nightmare, the buzzing alert could knock them out of REM sleep, “which could otherwise be restorative, but fewer nightmares would be so incredibly helpful for folks,” Weiner said.
Filling a Void
The app could fill a treatment void, Weiner pointed out, as current options are limited. Psychiatrists prescribe a drug named prazosin to reduce adrenaline production, “as PTSD nightmares come from the traumatic memory coming up in a dream and then triggering adrenaline release,” he said. Another approach is to desensitize patients to the traumatic memory through therapy, thereby stopping the fight or flight adrenaline-fueled response, he said. PTSD and sleep problems are a major problem, experts say. One study found the lifetime prevalence of PTSD among adult Americans to be 6.8 percent. Apps should not be used as a replacement for therapy, psychologist Nikki Winchester said in an email interview. “In most cases, people should seek treatment from a licensed therapist,” she added. “However, apps can be useful tools for providing coping skills for symptoms that are easily accessible.” NightWare is the only app that’s FDA-approved for PTSD and nightmares but it’s among a growing number of apps aimed at improving sleep. There’s Sleep Cycle, for example, which claims that it “tracks and analyzes your sleep, waking you up at the most perfect time, feeling rested.” Another option is Pillow Automatic Sleep Tracker that uses “advanced algorithms that monitor your movements and heart rate to wake you up at the lightest possible sleep stage.” Or you could try Sleep Tracker ++ which “takes advantage of the motion and health monitoring capabilities of your Apple Watch to measure both the duration and quality of your sleep.” Getting a good night’s sleep is important for everyone as it provides both physical and psychological benefits. For those with PTSD, sleep is a particular challenge and NightWare could be a valuable tool to help them cope.
