title: Use of a Removable Mandibular Neuroprosthesis for the Reduction of Posttraumatic Stress Disorder (PTSD) and Mild Traumatic Brain Injury/PTSD/Associated Nightmares, Headaches, and Sleep Disturbances.
abstract: BACKGROUND
  Posttraumatic stress disorder (PTSD) has been associated with nighttime headaches (HAs), nightmares (NMs), and difficulty falling or staying asleep (sleep disturbances [SD]). The authors of the current study evaluated the correlative elements of using a removable mandibular neuroprosthesis (RMN) and the reduction of these symptoms in participants diagnosed with PTSD or mild traumatic brain injury (mTBI)/PTSD. The RMN device is a form of specialized dental splint that has a potential to reduce the painful stimuli of bruxing and potential upregulation of threat response systems that may occur during sleep.
  
  
  METHODS
  A sample of 32 individuals was selected through random assignment from a volunteer base of 200 volunteers for examination by self-report according to an A-B-A-B design. The sample included 25 men and 7 women between the ages of 21 and 65; 21 had military experience and 11 were civilians. Participants were asked to rate the frequency and intensity of their HAs, NMs, and SD during each phase. Their responses were scored using a custom survey (equivalent forms reliability) that provides ratio-scaled results for symptom frequency and intensity. The original number of participants was 35 with three participants dropping out before the conclusion of the study.
  
  
  RESULTS
  Survey scores for PTSD-related sleep symptoms were relatively high at baseline (x̄=0.52) and significantly lower in the first experimental phase (x̄=0.20). Scores in the second experimental phase were likewise lower (x̄=0.38). Significant reductions in symptoms were reported across all three dimensions.
  
  
  CONCLUSIONS
  All participants reported some improvement in symptoms while using the device. No participants reported worsening of any symptoms as a result of using the RMN. Participants commonly reported that improvements in symptoms were immediate and did not diminish over time. Data indicate that there is a negative correlation between the use of an RMN and the reduction of HAs, NMs, and SD in persons diagnosed with PTSD or mTBI/PTSD.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Moeller
authors.forename: John M
authors.initials: JM
authors.lastname: Duffey
authors.forename: Angela M
authors.initials: AM
authors.lastname: Goolsby
authors.forename: Jesse T
authors.initials: JT
authors.lastname: Gallimore
mesh_terms: D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications*; D004325:Dreams; D005260:Female; D006261:Headache / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D009064:Mouth Protectors; D011446:Prospective Studies; D020186:Sleep Bruxism / Q000150:complications / Q000628:therapy*; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000628:therapy*; D013313:Stress Disorders, Post-Traumatic / Q000150:complications*; D055815:Young Adult