Veterans find relief from nightmares with NightWare and Apple Watch

Every night for more than a decade, Robert Guithues dreaded closing his eyes and falling asleep. That’s because when he did, he was transported back to the burning oil fields outside of Baghdad, or to a forward operating base in the mountains of Afghanistan, where his unit was attacked for 278 days out of its yearlong mission there.

“Your mind and your psyche are not meant to take some of the stuff that you run across when you’re deployed and fighting a war,” says Guithues, who retired as a first sergeant in the Army in 2012 after serving for more than 20 years. “As time went on, my nightmares became more vivid and physical — thrashing around, calling out names and commands. And if there was thunder or lightning outside, I wouldn’t go to bed until the sun came up. At my worst point after I got back from Afghanistan, I didn’t sleep for three months.”

NightWare is a digital therapeutic system that works in conjunction with Apple Watch and iPhone to disrupt nightmares related to post-traumatic stress disorder.1 Available by prescription only, it’s also the first and only digital therapeutic developed specifically to treat nightmares that is cleared by the FDA.2 NightWare uses information from the Apple Watch heart rate sensor, accelerometer, and gyroscope to detect a nightmare and then disrupt it through haptic feedback, generating gentle pulses on the wrist that gradually increase until the user is roused from the nightmare, but not from sleep.

Every night at bedtime, Robert Guithues launches NightWare on his Apple Watch.

The prototype was created by Tyler Skluzacek in 2015, when he was studying computer science at Macalester College in Minnesota. His father had developed PTSD during his two-decade military career, and Skluzacek wanted to see if technology could provide a solution. The concept was based on the way a service dog gently nudges its owner to help stop a nightmare.

Not long after he created the prototype, Skluzacek met Grady Hannah, who is now NightWare’s CEO. Hannah has spent the last seven years bringing NightWare to market, and credits Apple’s ecosystem as crucial to that process.
“We had to get an independent security audit and submit it for FDA clearance,” says Hannah. “And because NightWare runs on iPhone and Apple Watch, I think the quality and security of those products were key factors in getting that clearance. It’s important to us that NightWare is functioning optimally for so many people who have given so much of themselves.”

Brian Robertson is a sleep medicine doctor who spent 25 years in the Army, retiring as a colonel. Before he became NightWare’s chief medical officer, one of his last postings was running the sleep disorder clinic at Walter Reed National Military Medical Center.

Through the thousands of soldiers he’s treated over the course of his career, Robertson has seen firsthand the devastating consequences of PTSD. Eighty percent of PTSD patients suffer from nightmares, sleep disturbances increase the risk of suicide, and the suicide rate for US veterans is 52 percent higher than for nonveterans.

To launch NightWare, the user presses the start button on Apple Watch, which draws on information from the heart rate sensor, accelerometer, and gyroscope to detect a nightmare. When the user wakes up in the morning, they simply press stop to end the program.

“Before NightWare, we didn’t really have any great solution for nightmares, and that’s a huge problem because for so many active-duty and retired service members, they are debilitating,” says Robertson. “There is a medication that a lot of them are on called Prazosin, which is actually a blood pressure drug, but it doesn’t work for many patients, has a lot of side effects, and also decreases your athletic performance. And in the military, athletic performance is very, very important.”

Robert Guithues knew Prazosin well — after he returned from Afghanistan, it was one of the 30 pills he was taking daily to help with the injuries he sustained while deployed, including PTSD and nightmares. But sleep was still elusive, and he knew there had to be a better solution than the drugs, which he feared were doing more harm to his body than good.

In 2018, he discovered an article about NightWare and asked his doctor if he could write a prescription for a kit that included Apple Watch and iPhone. When the devices arrived, they were already programmed with NightWare and ready to use.
 

“I would encourage any veteran out there who is wrestling with nightmares to give NightWare a try because there really is hope.”

Sue Baker, Semper Fi & America’s Fund caseworker