The relationships between insomnia, nightmares, and dreams: A systematic review
J.P. Delage, Jeannie Côté, William-Girard Journault, Alexandre Lemyre, Célyne Bastien
Sleep Medicine Reviews April 16, 2024 DOI: 10.1016/j.smrv.2024.101931 (opens in new tab) via OpenAlex
Summary
AI-generated from the abstractInsomnia and nightmares frequently co-occur and worsen each other. This systematic review of 67 studies found consistent positive links between insomnia and nightmares across diverse groups—people with insomnia or nightmares, general populations, students, children, older adults, military personnel, and veterans—even during the COVID-19 pandemic. People with insomnia also report more negative dream content and emotions than controls. Some interventions, like Imagery Rehearsal Therapy, may reduce both conditions. The authors propose a model where insomnia increases nightmare likelihood, and nightmares then cause sleep loss and nonrestorative sleep.
Study at a glance
| Characteristics | Systematic review Peer reviewed |
|---|---|
| Population | Individuals without a concomitant psychopathology, including those with insomnia or nightmares, general population, students, children, older adults, military personnel and veterans |
| Intervention | Imagery Rehearsal Therapy |
| Topics | Dreaming |
| Keywords | Insomnia Psycinfo Context archaeology Psychopathology |
| Citations | 22 |
| Key finding | Insomnia and nightmares are positively related and may be mutually aggravating across diverse populations, with insomnia also linked to more negative dream content. |
Abstract
Insomnia and nightmares are both prevalent and debilitating sleep difficulties. The present systematic review aims to document the relationships between insomnia and nightmares in individuals without a concomitant psychopathology. The relationships between insomnia and dreams are also addressed. PsycINFO and Medline were searched for papers published in English or French from 1970 to March 2023. Sixty-seven articles were included for review. Most results support positive relationships between insomnia variables and nightmare variables in individuals with insomnia, individuals with nightmares, the general population, students, children and older adults, and military personnel and veterans. These positive relationships were also apparent in the context of the COVID-19 pandemic. Some psychological interventions, such as Imagery Rehearsal Therapy, might be effective in alleviating both nightmares and insomnia symptoms. Regarding the relationships between insomnia and dreams, compared with controls, the dreams of individuals with insomnia are characterized by more negative contents and affects. The results show that insomnia and nightmares are connected and may be mutually aggravating. A model is proposed to explain how insomnia might increase the likelihood of experiencing nightmares, and how nightmares can in turn lead to sleep loss and nonrestorative sleep.