1057 Trauma-Related Sleep Processes and Mental Health: The Roles of Dream Self-Efficacy and Nightmare Distress
Victoria West Staples, Westley Youngren, Emma Angle, Adam Horowitz, Michelle Carr, Karen R Konkoly, Guillermo Bernal, Robert Stickgold
SLEEPJ May 1, 2026 DOI: 10.1093/sleep/zsag091.1056 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional analysis of baseline data from a larger study Peer reviewed |
|---|---|
| Sample size | 30 |
| Population | Trauma-exposed adults |
| Topics | Dreaming |
| Key findings | Lower dream self-efficacy and heightened nightmare distress independently predicted PTSD symptom severity and suicidal thoughts, while only lower dream self-efficacy predicted insomnia severity. |
Abstract
Both heightened nightmare (NM) distress, intense negative emotional reactions to nightmares, and low dream self-efficacy (DSE; the perceived ability to manage or influence dream experiences), are understudied contributors to posttraumatic functioning. Individuals with lower DSE shows increased suicide risk in trauma survivors and may increase emotional disturbances during sleep, while NM distress is strongly linked to daytime impairment and suicide risk. Despite these associations, the unique and combined contributions of DSE and NM distress to PTSD symptoms, insomnia, and suicidal thoughts remain unclear. This study examined whether DSE and NM distress independently predicted these clinically relevant outcomes in a trauma-exposed sample. As part of a larger study on Targeted Dream Incubation (TDI), which involves providing auditory cues (e.g., “think of a tree”) as individuals fall asleep to shape dream content, N = 30 completed an in-person survey battery. Surveys assessing DSE, NM distress, PTSD symptoms, insomnia, and suicidal thoughts were completed at baseline (pre-TDI/nap. For the present study, three multiple linear regressions were conducted to evaluate whether DSE and NM distress significantly predicted PTSD symptoms, insomnia severity, and suicidal thoughts. Both DSE (b = .41) and NM distress (b = 1.83) were significant predictors of PTSD symptoms (p < .001). For insomnia, DSE emerged as the only significant predictor (b = .18, p < .05). For thoughts related to suicide, both DSE (b = .31) and NM distress (b = 1.48) were significant predictors (p < .05). Findings indicate that trauma-related dreaming, specifically lower DSE and heightened NM distress, are associated with PTSD symptom severity, suggesting that both confidence in managing dreams and the distress experienced from nightmares independently contribute to posttraumatic outcomes. Reduced DSE alone predicted insomnia severity, highlighting that confidence in dream management may influence broader sleep disturbances beyond nightmare distress. For suicidal thoughts, both lower DSE and higher NM distress were significant predictors, emphasizing the relevance of trauma-related dream variables to suicide risk. These results highlight the importance of assessing DSE and NM distress in trauma-exposed individuals; however, future research should extend these findings to inform clinical utility. N/A
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 |