08-07-2025
What Your Nightmares May Be Trying to Tell You About Your Health
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New research suggests that there's a link between having regular nightmares and dying early.
People who had weekly nightmares were three times as likely to die early as those who had them less often.
Doctors say there are a few possible reasons for this.
Nearly everyone has a nightmare here and there, but up to 6% of people struggle with frequent nightmares. Not only are those terrifying to experience, but new research suggests having regular nightmares could raise the risk of dying early.
The study, which was presented at the European Academy of Neurology Congress 2025, analyzed data from nearly 2,500 children between the ages of 8 and 10, and 183,012 adults between the ages of 26 and 86. The researchers discovered that adults who said that they had weekly nightmares were more than three times more likely to die prematurely (which they defined as before the age of 70) compared to people who said they never or rarely had nightmares.
The researchers discovered that having weekly nightmares was more strongly linked with premature death than other well-known risk factors like smoking, having obesity, following a poor diet, and being physically inactive.
Meet the experts: W. Christopher Winter, M.D., a neurologist and sleep medicine physician with Charlottesville Neurology and Sleep Medicine and host of the Sleep Unplugged podcast; Thea Gallagher, Psy.D., clinical associate professor at NYU Langone Health and cohost of the Mind in View podcast
If you have regular nightmares, it's understandable to be concerned. Here's what sleep specialists and a psychologist want you to keep in mind.
There are a few reasons why someone may have nightmares. 'It can stem from stress and anxiety, along with depression,' says Thea Gallagher, Psy.D., clinical associate professor at NYU Langone Health and cohost of the Mind in View podcast. 'Sometimes people get nightmares if they have post-traumatic stress disorder (PTSD) or post-traumatic stress symptoms.'
But there are other things that can be behind nightmares, says W. Christopher Winter, M.D., a neurologist and sleep medicine physician with Charlottesville Neurology and Sleep Medicine and host of the Sleep Unplugged podcast. 'While psychological factors probably play a role, there is emerging evidence that it can also relate to neurotransmitter imbalances—think, depression—or increased activity in the amygdala, a part of our brain responsible for emotional processing,' he says.
Nightmares may even be caused by a 'simple sleep disruption of any source,' including sleep apnea, restless leg syndrome, and noisy bedmates, Dr. Winter says. Substance use, eating late, and even certain medications may raise your risk of having nightmares, too, Gallagher says.
The researchers didn't find one definitive reason why nightmares might raise the risk of early death, but there are some theories. One is that having regular nightmares leads to faster biological aging—that accounted for about 40% of the higher-than-usual mortality risk, according to the researchers. The reason for this is likely elevated levels of the stress hormone cortisol, which are usually released in the body when someone has a nightmare, the researchers explained. That speeds up the aging process of cells, raising the risk of early death.
Lack of sleep that can come with nightmares or be the cause of nightmares may also raise the risk of early death, especially if someone is experiencing this often, Dr. Winter says. 'The link between sleep apnea alone and increased dreaming and nightmares is more than enough by itself to explain the findings in this study,' he says. Dr. Winter points out that nightmares may be a 'marker of sleep quality or health quality' in general. Meaning, the nightmares may not cause poor sleep, poor sleep may cause the nightmares.
Gallagher agrees. 'Nightmares may be indicative of underlying mental health and/or medical issues, which we know can put you at risk for premature aging and death,' she says.
Having nightmares may even make people want to sleep less, and lack of sleep raises the risk of early death, Dr. Winter points out. 'There is evidence to support the idea that frequent nightmares often put a significant amount of psychological stress on people—they avoid sleep and engage in other behaviors that put health at risk,' he says.
Because nightmares have so many different potential causes, Dr. Winter says it can be helpful to work with a healthcare provider to try to pinpoint what's behind them.
Some medications, like zolpidem (Ambien) and varenicline (Chantix) are linked to having vivid dreams and nightmares. If you're on one of these and nightmares are a concern, Gallagher says it can be helpful to talk to your prescribing doctor to see if there is another option to consider.
Cognitive therapy may also help, especially if the nightmares seem to be related to trauma. 'We want to process the trauma,' Gallagher says. 'It will find a way to scare you in your sleep if you haven't processed it in the daytime.' That usually involves trying to make meaning of these thoughts and memories to try to make them feel less scary by facing them with the help of a mental health professional, Gallagher says.
Beyond that, Gallagher suggests doing your best to practice good sleep hygiene, including keeping a consistent sleep and wake schedule, limiting the use of stimulants and alcohol before bed, and having a calming bedtime routine.
Again, it's completely normal to have a nightmare here and there. But if these are a regular thing for you and it's disrupting your quality of life, it's time to talk to a healthcare provider about the next steps.
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