Nightmares and cardiometabolic diseases in an adult population-based sample.
Keyuan Liu, Geoffroy Solelhac, Nicola Andrea Marchi, Raphaël Heinzer, Pedro Marques-Vidal
Journal of Psychosomatic Research May 14, 2026 DOI: 10.1016/j.jpsychores.2026.112867 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 4,223 |
| Population | General population of Lausanne, Switzerland (CoLaus|PsyCoLaus study) |
| Duration | Three follow-ups (first, second, and third) |
| Topics | Dreaming |
| Keywords | Autonomic arousals index Cardiometabolic diseases Ecological momentary assessment Nightmares Salivary cortisol |
| Key findings | Frequent nightmares are associated with higher prevalence of hypertension and diabetes, with a multivariable-adjusted odds ratio for hypertension of 2.53 in the second follow-up. |
Abstract
Nightmares can trigger stress responses and lead to insufficient or poor-quality sleep, which are associated with cardiometabolic diseases (CMD) and their risk factors. However, research on the association and underlying mechanisms between nightmares and CMD in the general population remains limited. Data from three follow-ups of the CoLaus|PsyCoLaus study (Lausanne, Switzerland). Frequent nightmares were assessed through questionnaires, with additional ecological momentary assessment (EMA) in the second and third follow-ups. Salivary cortisol levels (as a biomarker of stress), and polysomnographic data including the pulse wave amplitude drops index (PWAD) were also analysed. Data from 4223, 2850 and 2009 participants from the first, second, and third follow-ups was analysed. Prevalence of frequent nightmares was 11.7%, 8.1% and 7.7% in the first, second, and third follow-ups, respectively. Across three follow-ups, the frequent nightmares group tended to present with higher body mass index and higher prevalence of hypertension and diabetes than the no-nightmare group. EMA data confirmed these findings: multivariable-adjusted odds ratio and (95% CI) for hypertension 2.53 (1.32-4.85) and 1.78 (0.92-3.41) in the second and third follow-ups, respectively. Polysomnography data showed that the frequent nightmares group had a significantly lower PWAD: multivariable adjusted mean ± SE 46.31 ± 1.34 vs. 52.02 ± 0.49. Salivary cortisol levels did not differ between the frequent nightmares and the no-nightmare groups. Frequent nightmares show a significant association with CMD, although this association should be confirmed. The underlying mechanisms are not fully explained by dysregulation of the hypothalamic-pituitary-adrenalaxis or autonomic nervous system alone.
Comparable studies
Other observational and cohort studies on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Lucid Dreaming: a State of Consciousness with Features of Both Waking and Non-Lucid Dreaming Student volunteers trained to become lucid and signal lucidity with horizontal eye... | 2009 | Observational study | n = 6 |
| Nightmare Prevalence, Nightmare Distress, and Self-Reported Psychological Disturbance Young adults with a mean age of 20 years | 2002 | Prospective observational study | n = 116 |
| Long-term effects of extreme situational stress on sleep and dreaming Survivors of traumatic events who complained of sleep disturbances, compared with... | 1987 | Case-control study | n = 11 |
| The relationship of nightmare frequency and nightmare distress to well‐being Adults who reported dreams | 2004 | Observational cohort | n = 147 |
| Dreaming in NREM Sleep: A High-Density EEG Study of Slow Waves and Spindles Healthy human subjects | 2018 | Observational cohort | n = 14 |
Citations in the library
Cites 3
- Prevalence and Correlates of Frequent Nightmares: A Community-Based 2-Phase Study Sleep June 1, 2010
- Sleep breathing at the intersection of nightmares and cardiovascular risk Sleep July 12, 2023
- Nightmares do result in psychophysiological arousal: A multimeasure ambulatory assessment study. Psychophysiology July 1, 2019