Rates and correlates of nightmares and insomnia in active duty military service members pre- and postdeployment.
Kristi E. Pruiksma, Daniel J. Taylor, Claire A Lavalley, Joanne L. Davis, Douglas E Williamson, Kevin M Kelly, Douglas M Maurer, Elisa V Borah, Antoinette Brundige, Stacey Young-McCaughan, Brett T Litz, Rene L Olvera, Keith A Young, Alan L Peterson
Psychological trauma : theory, research, practice and policy September 28, 2026 DOI: 10.1037/tra0002244 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 3,952 |
| Population | U.S. Army personnel assessed before and after combat deployment |
| Measures | PTSD Checklist-Military Version distressing dreams item (Item 2), Insomnia Severity Index |
| Topics | Dreaming |
| Key findings | Nightmares and insomnia, alone and combined, were associated with mental health problems in U.S. Army personnel. Predeployment, 12% had nightmares only, 9% insomnia only, and 11% both; the combined group showed greater anxiety than other groups. Postdeployment, new-onset and chronic nightmare or insomnia trajectories were generally related to higher PTSD, anger, and anxiety symptoms than remitted or absent trajectories. |
Abstract
This study aimed to determine the rates, chronicity, and correlates of nightmares and insomnia, alone and in combination, in U.S. Army personnel at predeployment and postdeployment. Service members were assessed prior to (N = 3,952) and following (N = 1,762) a combat deployment between 2010 and 2016. Participants were categorized predeployment into nightmare and insomnia groups using the PTSD Checklist-Military Version distressing dreams item (Item 2 score ≥ 3) and the Insomnia Severity Index (total score ≥ 15). Postdeployment, participants were further classified into 16 groups reflecting the combination of nightmare and insomnia trajectories. Predeployment, 12% of participants were in the nightmares only group, 9% were in the insomnia only group, and 11% were in the both nightmares and insomnia group. Predeployment, the nightmares only group was older, had more deployments, and had greater mental health symptoms than the neither group. The insomnia only group had more deployments and greater mental health symptoms than the neither group. The both nightmares and insomnia group was more likely to identify as Native American, be older, have more prior deployments, and have greater anxiety symptoms than all other groups. Postdeployment, the new-onset trajectory, chronic nightmare trajectory, and chronic insomnia trajectory were generally related to higher posttraumatic stress disorder, anger, and anxiety symptoms compared with the remitted, no nightmares, and no insomnia trajectories. Nightmares and insomnia, singularly and comorbid, are associated with mental health problems. Transdiagnostic treatments that target both conditions may be an efficient means to ameliorate sleep problems and minimize effects on mental health. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
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 |