Chronic pain patients experience more frequent nightmares, greater nightmare distress, more pain dreams, and more distress from life events than healthy controls. They also report more negative and aggressive dream content and physical sensations in dreams. These findings confirm a continuity between waking-life pain and dream experiences, with distress from critical life events contributing to negative dream affect and pain perception.
People who have nightmares in which they are the aggressor may be more aggressive in waking life, supporting the continuity hypothesis that dreams reflect waking experiences. In contrast, nightmares where the dreamer reacts aggressively in self-defense may compensate for suppressed aggression in waking life. The study used the Buss and Perry Aggression Questionnaire to measure waking-life aggression. Results showed that dreamers who initiated aggression in their nightmares were more aggressive in waking life than those whose aggression was reactive to threats from other dream characters. This suggests two subtypes of aggressor nightmares: those reflecting continuity of waking aggression and those compensating for it.