Innovative care: Tackling insomnia in Veterans with TBI

Dr. Darlene Makulski and team utilize groundbreaking device to improve Veterans’ lives at Houston VA

At the Michael E. DeBakey VA Medical Center (MEDVAMC) in Houston, a team of dedicated health care professionals is making remarkable strides in the treatment of Veterans with traumatic brain injuries (TBI). Among them is Dr. Darlene Makulski, director of the Houston VA’s TBI Polytrauma Program. With a deep commitment to enhancing the lives of her patients, Makulski is using a groundbreaking new sleep device to combat a common and debilitating condition in TBI patients: insomnia.

The impact of insomnia on Veterans

Makulski has long observed that many of her Veteran patients with severe TBIs suffer from chronic insomnia, which exacerbates their TBI symptoms, including memory issues, mood disturbances and a decline in their overall well-being. Insomnia not only affects the Veterans, but it also has a profound impact on their caregivers, who often struggle with sleepless nights and the resulting stress.

Determined to find a solution that didn’t involve medication, Makulski began researching and came across the Modius Sleep device, a groundbreaking vestibular nerve stimulator designed to treat chronic insomnia. Eager to explore its potential in Veterans with traumatic brain injuries, she reached out to the manufacturer and began introducing the device to her patients last year. The results have been extraordinary.

A life-changing experience

One of them is Navy Veteran Trent Stahl. In 2013, during basic training, Stahl suffered cardiac arrest and a severe anoxic brain injury, leaving him with significant challenges. By the time he arrived at MEDVAMC for care in 2020, his condition had taken a toll not only on him but also on his mother and primary caregiver, Traci Stahl.

Traci, also a Navy Veteran, was desperate for a solution. Trent’s insomnia was severe—he would go to bed at 9 p.m. but wake up every 15 minutes for hours, requiring her assistance throughout the night. When Makulski suggested trying the Modius Sleep device, both Traci and Trent were hopeful.

Positive results

Since using the device, Trent has not only begun sleeping through the night, but he has also shown significant improvements in his cognitive functioning and overall demeanor. He’s more engaged with his surroundings, talkative, focused and, most importantly, happy. For Traci, the device has been a game changer, allowing her to finally get a full night’s sleep and see her son improve in ways she thought might never be possible.

“We couldn’t be happier with the care Trent has received at MEDVAMC,” Traci said. “Dr. Makulski has been a godsend. Her dedication to finding innovative solutions and being with us every step of the way has made all the difference.”

The Modius Sleep device is an FDA-cleared, drug-free tool that employs electrical vestibular nerve stimulation to target brain regions responsible for sleep regulation. It consists of a battery-powered device that goes on like a headband and delivers low-level electrical impulses through self-adhesive electrode pads placed behind the ears. Users can adjust the intensity of the stimulation to their comfort, and the device is easily rechargeable via micro-USB cable. Using the device for just 30 minutes a day can have a marked impact on insomnia.

“Seeing the positive changes in my Veteran patients and the resulting impact it has on their caregivers has been incredibly rewarding,” Makulski said. “As a mother myself, I know how hard it can be to relax when your son or daughter is uncomfortable. When both the Veteran and the caregiver can sleep through the night, the changes in their lives are truly profound.”

A focus on exceptional care

Makulski said she receives immense satisfaction in her work at VA, where she can focus on helping Veterans like Trent without the constraints of insurance limitations that often hinder access to such technologies in the private sector. Alongside her colleague, Dr. Stephanie Sneed, director of the MEDVAMC’s Rehabilitation and Extended Care Line, she is determined to offer consistent, exceptional care for Veterans with brain injuries, driven by a strong commitment to improving their quality of life and helping them be the best version of themselves.

“Seeing the positive changes in my Veteran patients is what it’s all about,” Makulski said. “It is truly a joy to care for them.”

“Industrial strength” Veterans

Sneed, who has worked at MEDVAMC for 20 years, also feels a special connection to her patients and says she often describes Veterans as “industrial strength.”

“As a group, I find my Veteran patients to be incredibly determined, resilient, and willing to work hard and do everything they can to recover,” she said. “I’m in awe of their accomplishments and feel fortunate to be able to play a small role in giving them the help they need and deserve.”

After years of caring for her son, Traci Stahl has now become a passionate advocate in the TBI and caregiver communities, actively participating in groups to spread the word about the Modius Sleep device and sharing her positive experiences at VA.

“I believe this is a device that can help countless other TBI patients and their families, and I want everyone to know about it,” she said.

The innovative work of Makulski and the team at MEDVAMC, coupled with the powerful Modius Sleep device, is not just changing lives; it’s restoring hope for Veterans and their caregivers, one restful night at a time.