Nightmare Severity and Sleep Disturbance Among Young Adults Reporting Trauma Exposure in Lahore
Shomesa Urooj, Madiha Masood, Saira Majid
Scholar Insight Journal September 30, 2026 DOI: 10.68024/21yesg03 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional observational study Longitudinal Peer reviewed |
|---|---|
| Sample size | 209 |
| Population | Young adults aged 18–29 years recruited through educational networks in Lahore, Pakistan |
| Measures | Life Events Checklist for DSM 5, Nightmare Severity Index, PTSD Checklist for DSM 5, Sleep Condition Indicator |
| Topics | Dreaming |
| Key findings | Nightmare severity was positively associated with adjusted posttraumatic symptoms and with sleep disturbance, and posttraumatic symptoms were positively associated with sleep disturbance. The authors report a positive indirect association between nightmare severity and sleep disturbance through posttraumatic symptoms, alongside a remaining direct association, but state that the cross-sectional design does not establish temporal or causal mediation. |
Abstract
Nightmare severity and sleep disturbance may co-occur with broader posttraumatic symptoms, but overlapping questionnaire content complicates their interpretation. This study examined concurrent direct and indirect associations among these constructs in 209 young adults aged 18–29 years recruited through educational networks in Lahore, Pakistan. Participants completed the Life Events Checklist for DSM 5, Nightmare Severity Index, PTSD Checklist for DSM 5, and eight item Sleep Condition Indicator. The symptom score used in the primary model excluded the disturbing dreams and sleep difficulty items, and the sleep score was reversed so that higher values indicated greater disturbance. Nightmare severity correlated positively with adjusted posttraumatic symptoms (r = .675) and sleep disturbance (r = .369); adjusted symptoms also correlated with sleep disturbance (r = .377; all p < .001). PROCESS Model 4 with 5,000 bootstrap resamples yielded a positive indirect association, B = 0.196, 95% bootstrap CI [0.042, 0.359], alongside a remaining direct association, B = 0.262, p = .015. The final model explained 16.6% of sleep disturbance variance. These findings support assessing nightmare burden, broader symptoms, and sleep difficulties together, while recognising residual measurement overlap and self-report limitations. Because all variables were measured simultaneously, the results do not establish temporal or causal mediation. Longitudinal replication with verified trauma exposure and complementary sleep measures is warranted.
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 |