People with insomnia, especially those who developed it during the pandemic, reported more negative and vivid dream changes than good sleepers. In a global survey of 2240 participants followed over 12 months, 45% reported dream changes at baseline. Those with new-onset insomnia were most likely to report dream changes (55%), compared to those with pre-existing insomnia (45%) or good sleepers (36%). Dream themes included increased activity, vividness, negative emotions, survival, and poor sleep quality. Individuals with insomnia used more anxious and death-related words to describe their dreams. Dream activity decreased by 3-month follow-up. Dream changes were linked to worse mental health over time, especially for those with insomnia.
Fear of death (death anxiety) is linked to disrupted sleep, but little research has examined its connection to insomnia and nightmares. In an online survey of 515 adults (70% female, 89% in Australia), higher death anxiety was associated with more severe insomnia. Attachment style did not significantly influence this relationship. Nightmare severity acted as a mediator, meaning death anxiety may contribute to insomnia partly through increasing nightmares. The findings suggest that addressing death anxiety could be a useful target for insomnia interventions.
About 22% of adults may have a nightmare disorder severe enough to affect sleep quality. In a survey of 439 adults, disturbing dreams and nightmares predicted poor sleep quality even after accounting for psychological distress like depression and anxiety. Together, nightmares and psychological distress explained 22% of the variation in sleep quality scores. The findings suggest that nightmares independently contribute to poor sleep, not just as a symptom of distress, and should be assessed when evaluating sleep problems.