Exploring the mediation of distress and depressive symptoms in the relationship between nightmares and suicidal ideation in adults
Jonatan Baños-Chaparro, Tomás Caycho‐Rodríguez, Diego Valencia-Pecho, Esteban Sarmiento-Suarez, Dulce Bernabel-Tarazona, Gabriela Rivera-Álvarez
Medicina Clínica y Social October 20, 2026 DOI: 10.52379/mcs.v10.775 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional study Peer reviewed |
|---|---|
| Sample size | 507 |
| Population | Peruvian adults from the general population (66.7% women) |
| Topics | Dreaming |
| Key findings | Nightmares were associated with suicidal ideation indirectly through psychological distress (β = 0.170) and depressive symptoms (β = 0.234), with a combined indirect effect of β = 0.404. The direct effect was not significant (β = 0.057), and the total effect was significant (β = 0.460), consistent with an indirect-only mediation pattern. The authors note the cross-sectional design precludes causal inference. |
Abstract
Introduction: Nightmares constitute a frequent parasomnia in adults in the general population and have been consistently associated with various indicators of psychological distress. Evidence suggests a significant relationship between nightmares and suicidal ideation; however, the psychological mechanisms underlying this association have not yet been fully clarified.
Objective: To analyse the mediating role of psychological distress and depressive symptoms in the relationship between nightmares and suicidal ideation in adults in the general population. Methodology: A total of 507 Peruvian adults (66.7% women) participated in the study and completed a sociodemographic questionnaire and psychological assessment instruments. Structural equation modelling was used to conduct the mediation analysis.
Results: Nightmares showed significant indirect associations with suicidal ideation through psychological distress (? = 0.170, p = 0.007) and depressive symptoms (? = 0.234, p = 0.002). The combined indirect effect was statistically significant (? = 0.404, p < 0.001), whereas the direct effect of nightmares on suicidal ideation was not significant (? = 0.057, p = 0.515). The total effect was statistically significant (? = 0.460, p < 0.001), supporting an indirect-only mediation pattern.
Conclusions: The association between nightmares and suicidal ideation in adults is statistically accounted for by indirect pathways involving psychological distress and depressive symptoms, consistent with an indirect-only mediation pattern. Given the cross-sectional design, these findings should be interpreted as statistical associations rather than evidence of causal mechanisms.
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 |