Why does hypervigilance follow first responders home?
Police officers, firefighters, paramedics and dispatchers are trained to stay alert. That training keeps communities safe, and it can also follow them home long after the shift ends.
On duty, scanning for danger is part of the job. When the body repeats that response call after call, everyday moments can start to feel like threats too.
MedlinePlus lists being easily startled, feeling tense or on edge and having difficulty sleeping among the arousal symptoms of PTSD. Off duty, it can look like sitting facing the door or reacting hard to a sudden noise.
How do shift work and repeated calls affect sleep?
Long shifts, overtime and rotating schedules make steady sleep hard to protect. A NIOSH scoping review of public safety workers found sleep, fatigue and psychosocial stress among the main outcomes studied in relation to working hours.
When the nervous system stays on high alert, falling asleep is harder still. Your body may be braced for the next call, even on a day off.
How might a stellate ganglion block calm the stress response?
The stellate ganglion is a cluster of nerves in the neck that is part of the fight-or-flight response. A stellate ganglion block places a local anesthetic beside it, designed to quiet those signals for a time.
A randomized trial published in JAMA Psychiatry in 2020 found that active-duty service members who received two right-side blocks improved more on PTSD symptoms than those who received a sham injection. The follow-up was short, and the VA's patient guide still calls the evidence not conclusive.
First responders meet repeated trauma on the job, the kind of indirect exposure the PTSD criteria name for medics and first responders.
What do the two days look like on a shift schedule?
Day one starts with a consultation and nervous system evaluation, done by Dr. Michael Meighen. He reviews your symptoms, history, medications and stress patterns before anything else.
If the protocol fits, he places the block on the right side that day and on the left side the next day, each under real-time ultrasound. After each injection you rest for 30 to 45 minutes while the team monitors you.
Afterward you are able to drive yourself home, and if that is a concern, the staff arrange a ride. Plan for two consecutive days, and see the two-day schedule in detail before you pick them.
Who might be a candidate?
It may be worth an evaluation if you live with constant alertness, broken sleep or other signs of PTSD. Every candidate starts with that evaluation, and the protocol is not right for everyone.
Some people should not have it, including anyone who takes a blood thinner or has an infection where the injection goes. Others include people who have reacted to a local anesthetic, are pregnant or have a heart or lung condition, such as a very slow heartbeat or severe lung disease. Using a stellate ganglion block for PTSD is off-label.
What can support you afterward?
The weeks after the two days are a good time to protect sleep when your schedule allows, stay active and keep regular meals.
Keep any counseling or peer support you already use. Reboot Vitality does not provide talk therapy, and the protocol is meant to sit beside that support. Depending on your evaluation, BrainTap sessions from the first of the four phases of care may be part of the plan.
Common questions
Is DSGB only for veterans?
No. Police officers, firefighters, EMS crews, dispatchers and other high-stress professionals can be evaluated too. Whether it fits depends on your evaluation, not your profession.
Do I need a PTSD diagnosis to be evaluated?
No. You can come in with symptoms such as hypervigilance, poor sleep or morning anxiety. Dr. Meighen reviews your history and symptoms at your consultation and nervous system evaluation.
How much time off will I need?
Plan around two consecutive days, one injection each day, each followed by 30 to 45 minutes of monitoring. Talk through your shift schedule with the team before you book.
Will it help my sleep?
No result is promised. Sleep is one of the things Dr. Meighen asks about at your evaluation, and it is worth keeping a simple sleep log before and after to share with him.