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physiological factor. 37–40 The upregulation of the stomatognathic 8. Koffel E, Khawaja IS, Germain A. Sleep disturbances in post-
system in PTSD could provide insight into this treatment gap. traumatic stress disorder: updated review and implications for
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The device used in this series, with its well-established safety 00485713-20160125-01
profile, compact size, durability, and cost-effectiveness, pres- 9. Miles SR, Dillon KH, Jacoby VM, et al. Changes in anger and
ents a promising first-line diagnostic and therapeutic option for aggression after treatment for PTSD in active duty military. J Clin
PTSD or PTSD/TBI-related DNB and sleep disturbances, partic- Psychol. 2020;76(3):493–507. doi:10.1002/jclp.22878
ularly in combat settings. 20–22 Unlike pharmacological agents, it 10. Reist C, Petiwala I, Latimer J, et al. Collaborative mental health
requires no titration to effect and has no long-term side effects. care: a narrative review. Medicine (Baltimore). 2022;101(52):
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Large-scale clinical trials are needed to refine its medical ap- 11. Miller KE, Brownlow JA, Gehrman PR. Sleep in PTSD: treatment
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12. Zapata-Soria M, Cabrera-Martos I, López-López L, et al. Clinical
Conclusion characteristics and rehabilitation strategies for the stomatognathic
This case series in an SOF population is the first to propose that system disturbances in patients with stroke: a systematic review.
an intraoral neuroprosthesis can effectively resolve PTSD-as- Int J Environ Res Public Health. 2022;20(1):657. doi:10.3390/
ijerph20010657
sociated disorders, like DNB. The device’s safety, durability, 13. Knibbe W, Lobbezoo F, Voorendonk EM, Visscher CM, de Jongh
and compact size make it well-suited for deployment as a first- A. Prevalence of painful temporomandibular disorders, awake
line treatment and diagnostic tool for PTSD and PTSD/TBI- bruxism and sleep bruxism among patients with severe post-trau-
related DNB. To improve mission readiness, frontline medics matic stress disorder. J Oral Rehabil. 2022;49:1031–1040. doi:
could use it to address both DNB and sleep disturbances, with 10.1111/joor.13367
diagnostic protocols involving non-invasive methods, such as 14. Weber FC, Wetter TC. The many faces of sleep disorders in post-
traumatic stress disorder: an update on clinical features and treatment.
a questionnaire and palpation of targeted muscle groups. Neuropsychobiology. 2022;81(2):85–97. doi:10.1159/000517329
15. Harris AL, Carmona NE, Moss TG, Carney CE. Testing the con-
Acknowledgments tiguity of the sleep and fatigue relationship: a daily diary study.
The authors wish to thank the office staff who assisted in of- Sleep. 2021;44(5):zsaa252. doi:10.1093/sleep/zsaa252
fice administration and patient care. 16. Lindberg MA, Sloley SS, Ivins BJ, Marion DW, Moy Martin EM.
Military TBI-What civilian primary care providers should know.
J Family Med Prim Care. 2021;10(12):4391–4397. doi:10.4103/
Author Contributions jfmpc.jfmpc_98_21
Both authors were involved in the study idea, coordinating the 17. Frueh BC, Madan A, Fowler JC, et al. “Operator syndrome”:
methodological logistics, edits of the manuscript, development a unique constellation of medical and behavioral health-care
of the treatment frameworks, identification of external stake- needs of military special operation forces. Int J Psychiatry Med.
holders, and review/approval of the final manuscript. 2020;55(4):281–295. doi:10.1177/0091217420906659
18. Ivory RA, Graber JS, Frueh BC, Cady H. Operator syndrome: nurs-
Disclaimer ing care and considerations for military Special Operators. Nurs-
ing. 2024;54(8):25–31. doi:10.1097/NSG.0000000000000001
The authors are solely responsible for the content of this article, 19. Moana-Filho EJ, Nixdorf DR, Bereiter DA, John MT, Harel N.
which does not necessarily reflect the views of their affiliated Evaluation of a magnetic resonance-compatible dentoalveolar tac-
institutions. tile stimulus device. BMC Neurosci. 2010;11:142. doi:10.1186/
1471-2202-11-142
Disclosures 20. Moeller DR. Evaluation of a removable intraoral soft stabiliza-
The authors have nothing to disclose. tion splint for the reduction of headaches and nightmares in mili-
tary PTSD patients: a large case series. J Spec Oper Med. 2013;13
(1):49–54.
Funding 21. Moeller DR, Duffey JM, Goolsby AM, Gallimore JT. Use of a re-
No funding was received for this work. movable mandibular neuroprosthesis for the reduction of post-
traumatic stress disorder (PTSD) and mild traumatic brain injury/
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