Disturbing dreams, nightmares, and psychological distress are predictors of poor sleep quality.

Objective: Up to 40% of adults report poor sleep quality, yet research investigating the role of nightmares on sleep quality is limited. This study aimed to characterise the prevalence of disturbing dreams and nightmares and their relationship to poor sleep quality.

Method: 439 adults (310 females, Mage=44.9 years) completed an online survey investigating sleep, dreams, nightmares, and mental health. Validated questionnaires were administered, including the Pittsburgh Sleep Quality Index (PSQI), Disturbing Dreams and Nightmares Severity Index (DDNSI), and Depression Anxiety Stress Scale (DASS-21). Two linear regression models, adjusted for age and sex, examined the variance explained in PSQI scores by the DDNSI and DASS-21.

Results: 22% of participants met the criteria for a potential nightmare disorder. Participants with a sleep or mental health disorder were more likely to report a nightmare disorder than participants without either condition. Disturbing dreams and nightmares significantly predicted PSQI scores (β = 0.294, p < 0.001), accounting for 8.7% of the variance. This effect remained significant even after including psychological distress in the analysis (β =.051, p=.004), with the combined influence of disturbing dreams, nightmares and psychological distress explaining 22% of the variance.

Conclusion: Disturbing dreams and nightmares contribute to poor sleep quality, even after accounting for psychological distress. Our results show that a substantial proportion of adults (22%) may experience nightmares severe enough to meet the criteria for a potential nightmare disorder, putting them at risk of poorer sleep quality. Greater attention must be paid to disturbing dreams and nightmares when assessing sleep quality.