Sleep disturbance linked to early death

The Link Between Nightmares and Premature Death

New research has uncovered a surprising connection between nightmares and premature death, as well as accelerated biological ageing. This study, led by the UK Dementia Research Institute and Imperial College London, examined data from 2,429 children aged between eight and ten years old, and 183,012 adults ranging in age from 26 to 86. The findings were presented at the European Academy of Neurology (EAN) Congress 2025 and have sparked significant interest in the medical community.

Understanding the Study

Adult participants in the study self-reported their nightmare frequency at the beginning of the research, with follow-up assessments conducted over up to 19 years. For the younger group, parents provided information on their children's nightmare frequency at the start of the study. Researchers measured biological ageing in children through telomere length, which serves as a marker for cellular ageing. In adults, biological ageing was assessed using both telomere length and advanced epigenetic clocks, which track the rate of whole-body ageing.

The results showed that adults who experienced weekly nightmares were more than three times more likely to die prematurely before the age of 70 compared to those who rarely or never had nightmares. Both children and adults who frequently experienced nightmares also exhibited signs of accelerated biological ageing, accounting for roughly 40% of the increased risk of premature death.

A Stronger Predictor Than Traditional Risk Factors

Interestingly, the study found that experiencing weekly nightmares is a more significant predictor of premature mortality than established risk factors such as smoking, obesity, a poor diet, and low physical activity. Dr Abidemi Otaiku, the lead author of the study, explained that the sleeping brain cannot distinguish dreams from reality. This means that nightmares can trigger the fight-or-flight response, leading to symptoms like sweating, gasping for breath, and a racing heart.

"The stress reaction caused by nightmares can be even more intense than anything we experience while awake," Dr Otaiku said. "Nightmares lead to prolonged elevations of cortisol, a stress hormone closely linked to faster cellular ageing."

For individuals who frequently experience nightmares, this chronic stress may significantly impact the ageing process. Additionally, nightmares disrupt sleep quality and duration, impairing the body’s essential overnight cellular restoration and repair. The combined effects of chronic stress and disrupted sleep likely contribute to the accelerated ageing of our cells and bodies.

A Universal Impact Across Demographics

The study found a consistent link between regular nightmares and accelerated ageing across various demographics, including age, gender, ethnicity, and mental health status. This suggests that frequent nightmares may be more than just a bad dream; they are associated with quicker cellular ageing and a higher risk of mortality when occurring monthly compared to individuals who seldom face them.

Prevention and Treatment Options

Dr Otaiku emphasized that nightmares can be prevented and treated. Simple measures such as avoiding scary films, maintaining good sleep hygiene, managing stress, and seeking treatment for anxiety or depression can be effective. For those whose nightmares significantly disrupt their quality of life, consulting a sleep specialist may be beneficial. Effective psychological treatments, such as image rehearsal therapy, can be practiced at home.

"Given how common and modifiable nightmares are, they should be taken far more seriously as a public health concern," Dr Otaiku added. "If further studies confirm the causal impact of nightmares on ageing and brain health, then preventing and treating them could become one of the simplest, most cost-effective strategies to slow ageing at a population level."

Broader Implications for Health

This concept isn't new; a 2022 study published in eClinicalMedicine indicated that distressing dreams were associated with a heightened risk of developing dementia. More frequent upsetting dreams were significantly linked to an increased risk of cognitive deterioration in middle-aged adults, as well as a greater likelihood of all-cause dementia in the elderly.

The researchers behind the study stated that distressing dreams predict cognitive decline and all-cause dementia in middle-aged and older adults without cognitive impairment or Parkinson's disease—especially among men. These findings may help identify individuals at risk of dementia and facilitate early prevention strategies.