A soldier finds relief

Veteran Robert Guithues suffers from relentless PTSD-driven nightmares. 20-years of service with active duty in Afghanistan can do that to a guy.

“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. 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.”

But Guithues says everything changed when he discovered NightWare. NightWare is a digital therapeutic system that works in conjunction with Apple Watch and iPhone to disrupt nightmares related to post-traumatic stress disorder. Available by prescription only, it’s also the first and only digital therapeutic developed specifically to treat nightmares that is cleared by the FDA.

How Apple Watch’s NightWare works

NightWare uses information from the Apple Watch heart rate sensor, accelerometer, and gyroscope to detect a nightmare and then disrupt it through haptic feedback (vibration), generating gentle pulses on the wrist that gradually increase until the user is roused from the nightmare, but not from sleep.

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.

Brian Robertson is a sleep medicine doctor who spent 25 years in the Army, says:

“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. 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.”

Does NightWare work?

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.

On the second night of using the system, Guithues slept for nine hours — something that hadn’t happened for him in more than a decade. He credits NightWare with healing his mind, helping to reduce the number of medications he’s taking by half, and saving his life.

“Some of the most horrific sights I’ve ever seen kept playing over and over, but when I started using NightWare, they stopped. In the morning, the device will tell me it’s intervened 25 or 30 times through the night, and I never woke up once. It’s to the point where I don’t remember any of the old nightmares.”

Currently, NightWare is prescribed to 400 patients in the US, 98 percent of whom are active-duty military or veterans. A new study in the peer-reviewed Journal of Clinical Sleep Medicine shows that participants who used NightWare at least 50 percent of the time had significantly better self-reported sleep quality compared to participants not using NightWare.

“The results of our first published clinical trial demonstrate NightWare’s efficacy, and Apple technology is a critical part of that. NightWare benefits from so many of the singular features of the Apple ecosystem — the hardware and design of Apple Watch, the quality control standards, the ease of software integration and deployment — it all comes together to create a system that is changing lives.”

Help for veterans suffering from PTSD

Guithues believes NightWare could help so many other service members, especially because it’s not a drug and it won’t affect their deployment status.

“I would encourage any veteran out there who is wrestling with nightmares to give NightWare a try because there really is hope. To me, this system is like the man in the foxhole next to me,” says Guithues. “I tell all the soldiers I know who are going through this, ‘Listen, NightWare has got your six. You don’t have to worry about it — it’s taken over the fight. You can rest now.’”

The downside to Apple’s NightWare

The downside to Apple’s NightWare tech is in the fine print.

“NightWare is a Class II medical device that delivers the NightWare therapy through a dedicated closed-system specially provisioned Apple Watch and iPhone. In this configuration, iPhone and Apple Watch functionality is limited to running the NightWare app.”

Yikes.