The Presence of Nightmares Associated With Increased Risk of Suicidality


The results of the study presented during SLEEP 2023 show the rate of suicidality was 46% in individuals who reported moderate-to-severe nightmares.

The Presence of Nightmares Associated With Increased Risk of Suicidality

Credit: Andrea Piacquadio / Pexels

Research into nightmares can be crucial as investigators are now reporting that individuals who suffer from nightmares, which are highly treatable, are at an increased risk of suicidality.1

In research presented during the SLEEP 2023 Annual Conference in Indianapolis, a team led by Raegan Atha, Penn State College of Medicine, examined the association of nightmares, independent of sleep disturbances, insufficient sleep, or trauma-history, with suicidality in young adulthood.


Patients who experience childhood nightmares often have a second increase in incidence during young adulthood, which is linked to trauma and psychopathology.

In addition, suicide rates are high in young adults and often associated with nightmares. However, more research in needed to study this relationship in this specific age range.

In the Penn State Child Cohort, the investigators looked at a random, population-based sample of 700 pediatric patients aged 5-12 years at baseline. Each participant was initially examined in a sleep laboratory and returned for follow-up visits during adolescence and young adulthood.

The New Study

The new subanalysis is a look at 257 young adult patients as part of the Penn State Child Cohort who completed follow-up visits 15.9±2.0 years later.

Each participant self-reported nightmares and the presence of suicidality was identified through responses on items querying suicidal ideation and/or attempts through clinically-relative sources, including MINI structured interview, Child Behavior Checklist Adult Self-Report, and Depression Anxiety and Stress Scale.

Finally, they adjusted for important covariates using general linear and logistic regression models.

The results show the 109 participants reporting nightmares had a significantly higher rate of suicidality (29%) compared to participants without nightmares (14%; P = 0.002), after the investigators adjusted for sex, age, sleep disturbances, sleep duration, and trauma history.

The rate was actually higher, hitting 46%, for individuals reporting moderate-to-severe nightmares (n = 24; P <0.01) and the odds of suicidality associated with nightmares was 2.3-fold (95% confidence interval [CI], 1.1-4.7), after adjusting for sex, age, sleep disturbances, sleep duration, and trauma history (P = 0.023). This risk increased to 6.1-fold (95% CI, 2.0-18.6) in individuals reporting moderate-to-severe nightmares (P = 0.001).

“These findings further strengthen previous research that has established nightmares’ significant relationship to increased suicidality, even when controlling for other important risk factors such as sleep disturbances and trauma history,” the authors wrote. “Furthermore, as these results come from a random, population-based sample, it also demonstrates the generalizability of the association between nightmares and suicide.”

Future Research

However, there remains a need for further research on effective prevention strategies for suicide. This means the ability to properly assess for the presence and severity of nightmares in patients who express suicidal ideation is crucial, especially because nightmares can often be treatable.


Raegan Atha and others, 0140 Nightmares are Associated with Increased Suicidality in Young Adulthood: A Population-based Cohort Study, Sleep, Volume 46, Issue Supplement_1, May 2023, Page A63,

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