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Nightmare Frequency and Nightmare Distress in Poor Sleepers: A Cross-Sectional Study.

Michael Schredl

Journal of Sleep Research August 21, 2025 DOI: 10.1111/jsr.70187 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Cross-sectional study Peer reviewed
Sample size 654
Population Adults with mild to moderate sleep problems (509 women, 144 men, 1 non-binary; mean age 41.19 ± 12.95 years)
Topics Dreaming
Keywords Humans Cross-sectional studies Stress, psychological Dreams Adult Middle aged Female Surveys and questionnaires Sleep wake disorders Sleep quality Nightmares Nightmare distress Subclinical insomnia
Key findings Nightmare frequency was elevated compared with previously published representative-sample findings (large effect size), and waking-life stress partially moderated the link between poor sleep quality and nightmare frequency. Gender and waking-life stress contributed significantly to nightmare distress after controlling for nightmare frequency. The authors argue that sleep problems and nightmares are closely linked and that adding insomnia or nightmare treatment modules may benefit affected patients.

Abstract

Having nightmares can contribute to poor sleep quality, and having sleep problems can be accompanied by increased nightmare frequency. The etiological models of insomnia and nightmare disorder also show some parallels. The present cross-sectional study included 654 participants (509 women, 144 men, 1 non-binary) with mild to moderate sleep problems (mean age: 41.19 ± 12.95 years). As expected, nightmare frequency was elevated compared to previously published findings of a representative sample (large effect size). Moreover, waking-life stress level moderated-at least partially-the relationship between poor sleep quality and nightmare frequency. Like previous studies, gender and waking-life stress contributed significantly to nightmare distress-after controlling for the effect of nightmare frequency on nightmare distress. Overall, the present study emphasises the close link between sleep problems and nightmares. Based on previous studies, it seems very beneficial to offer nightmare sufferers additional modules of cognitive-behavioural therapy for insomnia and similarly offer patients with insomnia disorder who also reported elevated nightmare distress a nightmare treatment module like Imagery Rehearsal Therapy.

Comparable studies

Other cross-sectional and survey studies on dreaming, most cited first.

Study Year Design Participants
Insomnia Symptoms, Nightmares, and Suicidal Ideation in a College Student Sample Undergraduate students at a large, public university in the southeastern United States 2011 Observational cross-sectional survey n = 583
Prevalence and Correlates of Frequent Nightmares: A Community-Based 2-Phase Study Middle-aged Hong Kong Chinese adults from the community, mean age 40.9 years (SD 5.5,... 2010 Cross-sectional survey with subsequent clinical evaluation (two-phase design) n = 8,558
Factors of home dream recall: a structural equation model Adults (general population sample) 2003 Cross-sectional survey with structural equation modeling n = 444
The Phenomenology of Lucid Dreaming: An Online Survey Respondents to an online survey about lucid dreams 2014 Online survey n = 684
Frequency of Lucid Dreaming in a Representative German Sample Representative sample of German adults 2011 Cross-sectional survey n = 919

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