Bad Dreams and Nightmares Preceding Suicidal Behaviors

Area of Science:

• Psychiatry
• Sleep Medicine
• Psychology

Background:

• Nightmares and altered dreams are increasingly recognized as potential indicators of psychological distress.
• Suicidal behaviors represent a significant public health concern, necessitating improved methods for early identification and intervention.

Purpose of the Study:

• To investigate the temporal relationship and progression of dream content alterations (bad dreams, nightmares, suicidal scenarios) preceding a suicidal crisis.
• To differentiate the characteristics of individuals experiencing altered dreams before a suicidal crisis compared to those without.

Main Methods:

• A naturalistic study involving individuals hospitalized for suicidal crisis (thoughts and attempts) between January and May 2021.
• Data collection included assessment of dream content, sociodemographic factors, family history of insomnia, depressive symptoms (MADRS), insomnia severity (ISI), sleep quality (PSQI), and sleepiness (ESS).

Main Results:

• 80% of patients reported altered dreams (AD) before their suicidal crisis, with specific subtypes appearing sequentially: bad dreams (111 days prior), nightmares (87.3 days prior), and suicidal scenarios (45.2 days prior).
• The AD group showed a higher prevalence of family history of insomnia compared to the no altered dreams (ND) group.
• High rates of depressive symptoms, insomnia, poor sleep quality, and sleepiness were observed across the patient cohort.

Conclusions:

• Alterations in dream content, including bad dreams, nightmares, and suicidal ideation within dreams, appear to be significant prodromal signs of suicidal crises.
• The chronological progression of these dream alterations offers a potential window for early detection and intervention in individuals at risk for suicide.
• Assessing dream content and sleep disturbances may enhance the identification of individuals experiencing suicidal ideation.