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Related Experiment Video

Updated: Nov 27, 2025

Author Spotlight: Unveiling the Connection Between Sleep Disorders and Cognitive Symptoms in Depression
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The relationship between nightmares, depression and suicide.

Anna Karin Hedström1, Rino Bellocco2, Ola Hössjer3

  • 1Department of Clinical Neuroscience and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

Sleep Medicine
|December 7, 2020
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Summary

Nightmares do not directly increase suicide risk. However, nightmares may indicate underlying depression, which is strongly linked to suicide incidence. Targeting both conditions may offer therapeutic benefits.

Keywords:
DepressionMediation analysisNightmaresProspective cohort studySuicide

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Area of Science:

  • Psychiatry and Mental Health
  • Epidemiology
  • Sleep Medicine

Background:

  • Previous research on the link between nightmares and suicide has produced conflicting results.
  • Understanding the relationship between nightmares, depression, and suicide is crucial for public health.
  • Nightmares may serve as a potential indicator for underlying mental health conditions.

Purpose of the Study:

  • To investigate the direct and indirect influence of nightmares on suicide incidence.
  • To examine the mediating role of depression in the relationship between nightmares and suicide.
  • To clarify the association between nightmares and suicide in individuals with and without depression.

Main Methods:

  • A prospective cohort study involving 40,902 participants with a mean follow-up of 19.0 years.
  • Cox proportional hazards models were used to analyze the risk of suicide.
  • Mediation analysis assessed the extent to which depression mediates the link between nightmares and suicide.

Main Results:

  • No significant association was found between nightmares and suicide incidence in participants without depression.
  • In participants with depression, the suicide incidence was similar regardless of nightmare presence.
  • Nightmare sufferers had a higher incidence of depression during follow-up, suggesting nightmares may reflect pre-existing depression.

Conclusions:

  • Nightmares do not appear to directly influence suicide rates.
  • Nightmares may be an indicator of pre-existing depression, which is a significant risk factor for suicide.
  • Combined interventions for depression and nightmares may enhance therapeutic outcomes for individuals experiencing both conditions.