Sleep
April 8, 2026
Julia Maruani, Pierre A Geoffroy
2 citations
Nightmares are strongly linked to depression and suicide risk, yet they are rarely assessed or treated in clinical practice. Up to 90% of people with major depressive episodes experience nightmares, which are among the strongest predictors of suicide attempts. Dream alterations often precede suicidal crises. Imagery rehearsal therapy (IRT), a first-line treatment for nightmare disorder, reduces nightmare frequency and emotional distress, and may also improve depressive and suicidal symptoms by reducing emotional burden, improving sleep quality, and decreasing anxiety. The authors argue that nightmares should be considered a core, modifiable risk factor for suicide and that systematic assessment and treatment of nightmares could be a valuable suicide prevention strategy.
Brain and Behavior
February 28, 2025
Léa Dobler, Océane Richard, Emmanuelle Clerici et al.
2 citations
Women with premenstrual syndrome (PMS) may experience more frequent nightmares during the premenstrual phase of their menstrual cycle. In a case series of seven women who kept daily dream diaries and tracked PMS symptoms over one menstrual cycle, nightmare frequency increased premenstrually, though no formal statistical comparison was made between those with and without PMS. A therapy called imagery rehearsal therapy (IRT), conducted weekly for one month, significantly reduced nightmare severity overall, but this effect was not significant in the PMS subgroup. These findings suggest a link between PMS and nightmares that warrants further investigation in larger studies.
Sleep
May 29, 2026
Julia Maruani, Pierre A Geoffroy
Nightmares, especially in people with posttraumatic stress disorder, are linked to an increased risk of suicide. Imagery rehearsal therapy and the medication prazosin are two nightmare-focused interventions that may reduce suicide risk, but the mechanisms are not yet fully understood. The authors clarify how these treatments work—imagery rehearsal therapy by changing nightmare content and reducing distress, and prazosin by blocking adrenaline effects to lessen nightmare intensity—and propose that improving nightmare frequency and severity could lower suicidal ideation and behavior. They call for more research to directly test this connection.
Journal of Sleep Research
August 21, 2025
Dieter Riemann, Christoph Nissen, Pierre A Geoffroy et al.
Science fiction frequently uses sleep and dreams to probe questions about consciousness, reality, and technology. This article identifies recurring Sci-Fi themes such as hypno-pedagogics, space hibernation, brain-machine interfaces, electrostimulation, genetic engineering, and the effects of substances on sleep and dreams. The authors compare these fictional concepts with current sleep science to assess their future feasibility. They also examine whether Sci-Fi has inspired real sleep research or merely mirrors existing scientific topics with added fiction.
L'Encephale
June 1, 2026
Pierre A Geoffroy, Sammy Saadi, Sibylle Mauries et al.
Hyperonirism, or 'epic dreaming,' is an emerging clinical phenomenon marked by excessive, vivid, and continuous dream activity that disrupts sleep and causes daytime fatigue. Four patients at sleep and psychiatry centers described dream activity that was frequent, intrusive, and mentally exhausting, yet distinct from nightmares because the content was not necessarily negative. Comprehensive evaluations, including polysomnography and actigraphy, found largely normal objective sleep measures, highlighting a disconnect between subjective experience and standard tests. Psychiatric conditions like depression or anxiety were common but insufficient to explain the hyperonirism. This case series supports recognizing hyperonirism disorder as a distinct condition at the intersection of sleep medicine and psychiatry, with proposed diagnostic criteria covering both nocturnal and daytime symptoms.
International journal of clinical and health psychology : IJCHP
January 1, 2026
Julia Maruani, Nathan Martins, Emmanuelle Clerici et al.
Imagery rehearsal therapy (IRT) is associated with greater reductions in nightmare severity, depressive symptoms, anxiety, and suicidal ideation compared to sleep education therapy in adults with both major depressive episodes and nightmare disorder. In a non-randomized controlled study of 53 adults, those receiving four weekly group-based IRT sessions showed significantly larger improvements across nightmare frequency, emotional and diurnal impacts, and nocturnal disturbances than those who received a single sleep education session followed by a waitlist. IRT was also linked to decreased depressive and anxiety symptoms and reduced suicidal ideation. Treatment-resistant depression predicted greater emotional improvement from nightmares, while higher nightmare frequency predicted less benefit. The findings suggest IRT should be integrated into treatment plans for this high-risk population.
Journal of Sleep Research
May 1, 2024
Pierre A Geoffroy, Émilie Stern, Julia Maruani et al.
A new multidimensional scale, the Nightmare Severity Index (NSI), was tested in 102 patients, mostly women (64%) and outpatients (76%) with mood disorders (depression 31%, bipolar disorder 41%) and frequent PTSD comorbidity (44%). The NSI assesses nightmare frequency, emotional impact, diurnal impact, and nocturnal impact. The questionnaire showed good internal consistency (Cronbach's alpha >0.7) and was well suited for factor analysis. Higher NSI scores corresponded to individuals meeting DSM-5/ICSD-3 criteria for nightmare disorder. The NSI appears to be a promising tool for clinical assessment of nightmare severity.