Frequent nightmares closely associated with suicide risk: Study

China: Teenagers with major depressive disorder (MDD) had more frequent nightmares and were more distressed by their dreams, says an article published in Nature and Science of Sleep Journal.

The major depressive disorder affects over 264 million people globally. Up to one-third of a person's lifespan is spent sleeping, which is a physiological phenomenon thought to be crucial to the functioning of the central nervous system. Due to its profound influence on the growth of critical psychophysiological functions, adequate sleep is crucial for teenagers. One of the most prevalent and specialized sorts of sleep issues, a nightmare is often defined by dysphoric, frightful, or upsetting nightmares that make you extremely irritable and frequently wake you up.

Tian-He Song and colleagues set out to assess the effects of various sleep disruptions and suicide risk in teenage patients with MDD, also to determine the prevalence of nightmares in the clinical population and whether it is higher than in healthy controls. 

Between January 1 and October 31, 2021, 499 outpatients at four sizable mental institutions in China (ages 12- 18) served as the subjects. 499 healthy controls were matched in terms of age and gender simultaneously. All subjects had an examination of their emotional state (depressive and anxiety symptoms), sleep variable (nightmare frequency/distress, insomnia symptoms, and daytime drowsiness), MDD diagnosis, and assessment of their risk of suicide using a completely structured diagnostic clinical interview.

The key findings of this study were:

1. Teenagers with MDD reported having more frequent nightmares (at least once a week) and experiencing more distress from dreams than healthy controls.

2. Approximately one-third of patients (30.7%) reported having frequent dreams, compared to more than half (51.6%) of patients at risk for suicide.

3. Patients who were at a higher risk of suicide performed better on sleep factors, depressive symptoms, and anxiety symptoms.

4. Further logistic regression analysis revealed that the probability of suicide was independently and substantially correlated with female gender, junior class standing, recurring depressive episodes, severe nightmare distress, and severe depressive symptoms.

In conclusion, the current investigation, which covered a sizable clinical population, shows that teenage MDD patients regularly have nightmares. The outcomes of this research also show that nightmare distress is independently linked to a higher probability of suicide. These findings may have significant ramifications for future studies on the mechanics of night suicide and for identifying those who are at risk by inquiring about nightmare suffering.

Reference: 

Song, T.-H., Wang, T.-T., Zhuang, Y.-Y., Zhang, H., Feng, J.-H., Luo, T.-R., Zhou, S.-J., & Chen, J.-X. (2022). Nightmare Distress as a Risk Factor for Suicide Among Adolescents with Major Depressive Disorder. In Nature and Science of Sleep: Vol. Volume 14 (pp. 1687–1697). Informa UK Limited. https://doi.org/10.2147/nss.s362999