Nightmares can be an effective muse for horror writers – and a burden for the rest of us. But they also might just be a warning from our bodies, one we commonly overlook.
New research – which Abidemi Otaiku, MD, Clinical Research Fellow at the UK Dementia Research Institute presented at the European Academy of Neurology (EAN) Congress 2025 – suggests they could be a canary in the coal mine of our mortality.
In what he described as the first major study of its kind, Otaiku and his team found that adults who suffer weekly nightmares were more than three times as likely to die before the age of 75. That’s compared to those who rarely or never have to wake up from those bad dreams.
And adults weren’t the only ones. Kids living with frequent nightmares also showed signs of accelerated biological aging. This, the researchers suggested, could imply that the effects of bad dreams could start a lot sooner than we thought.
“Nightmares often wake us up sweating, gasping for breath, and with our hearts pounding — because our fight-or-flight response has been triggered,” Otaiku explained. “This stress reaction can be even more intense than anything we experience while awake.”
Methodology
Researchers have long suspected that nightmares are harbingers of mental health issues and neurodegenerative diseases, but Otaiku’s presentation appears to be the first to show that they might (independently) predict faster biological aging and earlier death. The connection persisted even after the authors accounted for other factors, such as smoking, obesity, poor diet, and physical inactivity.
Otaiku’s team examined data from more than 4,000 adults between the ages of 26 and 74. They pulled the participants from four large, population-based cohort studies. Participants self-reported their nightmare frequency at the start of the study, and the researchers traced their health outcomes for nearly nearly 20 years.
Parents recorded the nightmare frequency for the participants who were minors, while the researchers tracked biological aging measured by telomere length. The researchers assessed adults using both telomere length and advanced epigenetic clocks.
Adults reporting weekly nightmares had a hazard ratio of 2.73 for premature death before age 75. Even less frequent nightmares – at least once a month – showed a link to accelerated aging and a higher mortality risk.
Biological aging, the researchers pointed out, explained about 40% of the relationship between nightmares and early death. This, they added, suggests that the stress and sleep disruption brought on by nightmares speed up the body’s aging processes.
Nightmares Are Common, But Still Ignored
The good news is that nightmares aren’t just common. They’re treatable.
“Simple measures like avoiding scary media, practicing good sleep hygiene, and treating underlying stress or anxiety can make a big difference,” Otaiku noted.
He also highlighted image rehearsal therapy and cognitive behavioral therapy for insomnia (CBT-I) as effective options for patients living with recurring nightmares.
Otaiku concludes with an admonition that everyone – especially policymakers – should take nightmares as a serious public health issue.
“If future studies confirm that treating nightmares can slow biological aging and reduce mortality risk, we might have one of the simplest, most cost-effective strategies to improve population health,” he said. “This could help individuals live longer, healthier lives—and even support global efforts to reduce premature deaths worldwide.”
Nightmares A Red Flag for Suicide, Too?
Otaiku’s presentation echoes earlier research regarding the toll that nightmares take on our bodies. One study, appearing in The Journal of Clinical Psychiatry, singled out a distinct timeline of altered dream content that appears to foreshadow suicidal behavior.
The study, which looked at psychiatric patients who’d been hospitalized for suicidal thoughts or attempts, found that 80% of patients reported dramtic shifts in their dream patterns ahead of tier crisis.
The researchers categorized the dreams into three types:
- Bad dreams — distressing dreams that don’t wake the sleeper.
- Nightmares — disturbing dreams powerful enough to wake the dreamer.
- Suicidal scenarios — dreams that include visions of suicide.
Based on this, the researchers drafted a timeline disturbing enough to induce as many nightmares as it describes:
- First, the bad dreams start to crop up roughly four months before the crisis.
- Next, the nightmares take over about a month later, on average.
- Finally, the suicidal dreams emerged around six weeks before the crisis.
This rapid deterioration appeared consistently across both patients who had suicidal thoughts and those who’d made suicide attempts.
The authors concluded that this research could help identify people at high risk of suicide sooner. Traditional suicide risk assessments often miss early warning signs, they argue, but dreams offer a new window into subconscious distress.
“Dream alterations may offer a simple, accessible way to detect the earliest stirrings of a suicidal crisis – sometimes months before it manifests,” the authors wrote.
Further Reading
Bad Dreams and Nightmares Preceding Suicidal Behaviors