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Evaluating the Relationship Between Emotion Regulation, Mood and Distressing Dreams Using Daily Sleep Diary Reports in Trauma Survivors

Nadia Malek, Anthony Santistevan, Leslie Yack, Miles Kovnick, Shane Pracar, Emily Berg, Thomas J. Metzler, Steven H. Woodward, Thomas C. Neylan, Anne Richards

Journal of Sleep Research April 3, 2025 DOI: 10.1111/jsr.70054 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Observational cohort Peer reviewed
Sample size 103
Population Trauma-exposed veterans and civilians
Duration 3 weeks of follow-up
Topics Dreaming
Keywords Distressing Mood Evening Clinical psychology Dream Population Mental health Experience sampling method Psychological intervention Psychotherapist
Citations 2
Key findings Poor mood before bed increases the risk of distressing dreams, which then worsen next-day mood, creating a bidirectional cycle; better emotion regulation is associated with fewer distressing dreams and better mood.

Abstract

Posttraumatic stress disorder (PTSD) is a debilitating psychiatric condition that affects approximately 6% of the US population, with even higher rates among veterans. Sleep disturbances (e.g., distressing dreams) are among the most reported symptoms in individuals with PTSD. Distressing dreams (sometimes referred to as nightmares) have been associated with significant negative mental health outcomes, such as suicide. Therefore, understanding factors that contribute to or mitigate the risk of experiencing distressing dreams is critical for improving mental health in people with PTSD. The current study uses data on twice daily mood ratings from a mobile phone application across 3 weeks of follow-up to assess the bidirectional relationship between mood and distressing dreams. Additionally, we investigate how emotion regulation difficulties contribute to the incidence of distressing dreams and to their impact on overall mood. Participants were veterans (N = 90) and civilians (N = 13) enrolled as part of a larger study of distressing dream physiology in trauma-exposed individuals. Our results suggest that among individuals with poor mood before bed, the risk of having at least one distressing dream increases, resulting in poor mood the following morning. This negative mood state carried over into the evening on the next day, thereby further increasing the risk of having another distressing dream. Adjusting for sex, age and PTSD severity, we find that individuals with better emotion regulation have a lower incidence of distressing dreams and better mood on average. Future research on novel interventions targeting emotion regulation, mood and/or sleep disturbances is warranted.

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

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Dreaming PTSD