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The relationship between nightmares, depression and suicide
Stockholm University, Faculty of Science, Department of Mathematics.
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Number of Authors: 62021 (English)In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 77, p. 1-6Article in journal (Refereed) Published
Abstract [en]

Objective: Previous studies investigating the association between nightmares and suicide have yielded different results. We aimed to investigate whether nightmares, directly or indirectly, influence the incidence of suicide.

Methods: We used a prospective cohort study, based on 40,902 participants with a mean follow-up duration of 19.0 years. Cox proportional hazards models with attained age as time-scale were fitted to estimate hazard ratios (HR) of suicide with 95% confidence intervals (CI) as a function of the presence or absence of depression and nightmares. Mediation analysis was used to asses to what extent the relationship between nightmares and the incidence rate of suicide could be mediated by depression.

Results: No association was observed between nightmares and the incidence of suicide among participants without depression. Compared with non-depressed participants without nightmares, the incidence of suicide among participants with a diagnosis of depression was similar among those with and without nightmares (HR 12.3, 95% CI 5.55-27.2 versus HR 13.2, 95% CI 7.25-24.1). The mediation analysis revealed no significant effects of nightmares on suicide incidence. However, the incidence of depression during follow-up was higher among those who suffered from nightmares than among those who did not (p < 0.001).

Conclusions: Our findings indicate that nightmares have no influence on the incidence rate of suicide, but may reflect pre-existing depression. This is supported by a recent discovery of a strong genetic correlation of nightmares with depressive disorders, with no evidence that nightmares would predispose to psychiatric illness or psychological problems. Interventions targeting both depression and nightmares, when these conditions co-occur, may provide additional therapeutic benefit.

Place, publisher, year, edition, pages
2021. Vol. 77, p. 1-6
Keywords [en]
Nightmares, Depression, Suicide, Prospective cohort study, Mediation analysis
National Category
Public Health, Global Health, Social Medicine and Epidemiology Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:su:diva-191929DOI: 10.1016/j.sleep.2020.11.018ISI: 000618554500001PubMedID: 33285395OAI: oai:DiVA.org:su-191929DiVA, id: diva2:1542136
Available from: 2021-04-06 Created: 2021-04-06 Last updated: 2022-02-25Bibliographically approved

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Hössjer, OlaÅkerstedt, Torbjörn

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