SHAW AIR FORCE BASE, S.C. -- “When was the last time you were actually happy?”
For some patients, this question is not so easy to answer, says Maj. David Provaznik, 20th Medical Group Mental Health medical director.
Stress, depression, anxiety; all are factors that can affect one’s mood negatively. But Provaznik and his staff are looking to treat one in particular:
Nightmares.
“Nightmare disorder is basically recurring dreams that are distressing in nature, usually involving safety to yourself or someone else, that cause you such distress they wake you up at night,” said Provaznik. “These interruptions impair your day-to-day function because now you’re chronically fatigued.”
Nightmares and post-traumatic stress disorder often go hand-in-hand, with lived traumas providing fuel for the fire of distressing dreams. Pilots of both manned and remotely piloted aircraft, and service members in combat roles, are more at risk for PTSD and nightmares related to the things they’ve experienced.
They also have the most restrictions when it comes to treatment.
“Pilots can only take certain medications, especially psychiatric ones,” said Provaznik. “There are only about 5 psychiatric medications that are approved, and the approval process for each member can take up to a year, during which they are unable to fly. Even if I give them a medication that is approved by the Air Force for pilots, they have to have six months of stability once the medication has reached its correct dose, and then we have to put up a waiver to get them back in the air. That’s for RPAs, that’s for controllers, that’s for anybody who has flight status.”
With that in mind, Provaznik kept searching for a way to help his patients without potentially costing them their career - and that’s how he discovered a new device. Once the device finished its trials and received Food and Drug Administration approval, he decided to put it to the test. Reaching out to the company, he began what would soon be a revolution in how military mental health providers approach this kind of treatment.
The concept is simple: a watch that you wear to bed, which runs an app that monitors your heart rate and body movements while you sleep. When it detects patterns of a nightmare, it delivers a series of short, rapid vibrations to interrupt the nightmare without waking you.
Sounds too good to be true? Provaznik’s patients thought so, too - until they tested it for themselves.
“They’re skeptical. They have no hope. They’re so used to being let down,” said Provaznik. “But then the next time I see them, it has consistently been: ‘I don’t know what I’d do without this.’”
In light of its successes, word of this new device spread as patients spoke about it with their friends, family, even coworkers.
“Nobody was ashamed to tell other people that they wore this device to stop nightmares,” said Provaznik. “They don’t do that about their meds that frequently. They don’t do that about their therapy that frequently. But there was no stigma against wearing a watch.”
Word of the device didn’t stop at the gates of the installation, either. As the message spread, Provaznik received multiple calls from friends of patients and providers alike asking how to get a device of their own.
“In my mind I'm asking, ‘how in the heck is this supposed to help me, how is this not going to wake me up?’” said Senior Master Sgt. Nikki Pogue, 20th Operational Medical Readiness Squadron senior enlisted leader. “Because of the device, I was able to get rest. After nearly two decades, I was finally able to sleep through the night.”
Pogue is one of more than 1,300 patients who have found success with the device, not only at Shaw but across the Department of Defense - some of whom have been searching for an answer for decades or more.
“It’s amazing how used to being miserable you can get,” said Provaznik. “It is amazing how that level of depression and anxiety you’ve had for so long just becomes so ingrained you don’t even think of other ways it can be. And then to start having that lifted through therapy, through medication, through whatever - the world comes back.
“People don’t come and see me because I’m super fun. They don’t go to therapy and talk about their problems because it’s great. They do it because they said, ‘I’m tired of feeling this way.’”
If you’re suffering from nightmares, if you feel like you could benefit from a device like this, reach out to your Mental Health provider.
“It’s never too late to come in,” said Provaznik. “I hear that all the time from people who’ve been in 20 years: ‘I wish I’d have done this sooner’. Sure, I wish you’d have done it sooner too, but I’m glad you’re here now. You’ve got a lot of living left to do. Let’s not lament on what could have been, let’s look towards the future.”