Brain and Body

There’s a Significant Link Between Nightmares and Suicidal Behavior, Research Finds

March 17, 2016 | Kelly Tatera

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Nightmares could be an important treatment target to reduce suicide risk.

Obviously nightmares aren’t a particularly enjoyable experience, but scientists have discovered an especially disturbing reality about the horrific dreams — they’re significantly linked to a risk of suicidal behavior.

Suicidal thoughts, plans, or attempts occurred in 62 percent of study participants who experienced nightmares, according to the research results. On the contrary, only 20 percent of the participant who didn’t experience nightmares showed these suicidal behaviors.

The researchers collected data for the study from 91 participants who had experienced traumatic events, 51 of whom met the criteria for a PTSD diagnosis. An additional 24 participants had previously been diagnosed with post-traumatic stress disorder (PTSD).

Nightmares can be particularly problematic for people suffering from PTSD because the unpleasant dreams trigger negative cognitive thoughts like defeat, hopelessness, and feeling trapped. According to the researchers, these thoughts reinforce suicidal behaviors.

Further, the brain pathways between nightmares and suicidal thoughts and behaviors appear to function independently of insomnia and depression.

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"PTSD increases the risk of suicidal thoughts and behavior, and our study shows that nightmares, a hallmark symptom of PTSD, may be an important treatment target to reduce suicide risk," principal investigator Donna L. Littlewood, doctorate researcher in medical and human sciences at The University of Manchester, said in a press statement.

Nightmares were measured by adding up the frequency of the dreams and intensity ratings of relevant items on the clinician-administered PTSD scale. Additionally, participants completed questionnaires on their suicidal behaviors and feelings of hopelessness, defeat, and entrapment. The analysis was conducted both with and without the participants who had comorbid depression.

"This study emphasizes the importance of specifically assessing and targeting nightmares within those individuals experiencing PTSD. In addition, monitoring and targeting levels of negative cognitive appraisals such as defeat, entrapment, and hopelessness, may reduce suicidal thoughts and behaviors,” said Littlewood.

According to the American Academy of Sleep Medicine, nightmares are typically vivid, realistic, and disturbing, and make an individual feel as though his or her survival or security is threatened. When repeated nightmares cause stress or interfere with an individual’s ability to socialize or have a job, experts say he or she likely has a nightmare disorder.

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Up to 80 percent of PTSD patients experience nightmares within three months of the trauma, and these stress-caused nightmares can persist throughout life.

The study authors suggest that future research should attempt to identify the additional brain pathways that found the relationship between nightmares and suicide.

Although there’s more research to be done on the neuroscience behind the link between nightmares and suicide, researchers are already working on innovative ways to help PTSD patients get a healthier, nightmare-free sleep cycle.

A recent study showed that PTSD symptoms dropped about 30 percent when patients slept with an electric patch that uses trigeminal nerve stimulation (TNS) to adjust the brain’s electrical wiring. The study participants reported that their nightmares were gone and that it was the first time in years they’d been able to sleep through the night, so the hope for a treatment is indeed promising.

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