NightWare and Cardiovascular Health in Veterans With PTSD

Inclusion Criteria

• Diagnosis of Post-traumatic stress disorder (PTSD) via American Psychiatric Association PTSD diagnostic criteria in the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
• Self-report having repetitive nightmares contributing to disrupted sleep
• Resting blood pressure (BP, \<160/100 millimeters of mercury (mmHg)
• Fasted glucose \<126 milligrams per deciliter (mg/dL)
• Poor overall sleep quality as indicated by a Pittsburgh Sleep Quality Index (PSQI) score 6 or higher
• Epworth Sleepiness Scale (ESS): Question #8 score above "0" will prompt an additional question: Do you drive ("get behind the wheel") when you are drowsy? The answer must be "No" to be enrolled in the study due to safety concerns
• Wireless Internet and two power outlets in sleeping location
• Willingness not to use any other application which collects heart rate data on the phone and watch that is used for NightWare

Exclusion Criteria

• Unstable medical condition (e.g., uncontrolled hypertension or active Cardiovascular disease (CVD) or cancer)
• Active infection (note, anyone with an active infection would become eligible once the infection has ended)
• Thyroid dysfunction, defined as an ultrasensitive thyroid stimulating hormone (TSH)\<0.5 or >5.0 milliunits per liter (mU/L); volunteers with abnormal thyroid stimulating hormone (TSH) values will be re-considered for participation in the study after follow-up evaluation by the Primary Care Provider (PCP) with initiation or adjustment of thyroid hormone replacement; or other problems that would interfere with participation in the study
• Use of insulin or sulfonylureas
• Pregnancy or currently breast feeding
• Current history (past 3 months) of substance (excluding marijuana) or alcohol abuse per the SCID-5. Adults with past substance or alcohol use disorders will be allowed to participate
• Participants will be excluded if they report elevated acute risk for suicidal self-directed violence warranting immediate hospitalization (e.g., suicidal ideation with intent, evaluated by the Columbia-Suicide Severity Rating Scale [C-SSRS])
• Shift workers (due to circadian rhythm disruption)
• Diagnosis of active disorder of arousal from non-rapid eye movement sleep, rapid eye movement sleep behavior disorder, or narcolepsy;
• Nocturia that causes awakening from sleep
• Known sleep walking or acting out dreams (contraindication to NightWare (NW) use)
• Diagnosis or suspicion of dementia
• Seizure disorder
• Participants experiencing severe cognitive impairment or current psychiatric symptoms of such severity that would preclude participation (e.g., active psychosis, imminently suicidal)