FREQUENT nightmares are linked to accelerated biological ageing and a threefold increase in the risk of premature death, according to new research presented at EAN 2025 by Dr Abidemi Otaiku of the UK Dementia Research Institute.
Nightmares have long been associated with neurodegenerative diseases, but their broader impact on health and ageing has remained unclear. This study is the first to demonstrate that nightmares are not only distressing but may also be a significant, independent predictor of faster biological ageing and earlier mortality in the general population.
The study analysed data from 4,196 adults aged 26 to 74, drawn from four large population-based cohort studies, with a total follow-up of 18 years. Nightmare frequency was self-reported at baseline, and premature mortality was defined as death before age 75. The study used Cox regression to examine the association between nightmare frequency and premature death, while biological ageing rates were measured using a composite of three epigenetic clocks (DunedinPACE, GrimAge, PhenoAge). During the follow-up period, 227 premature deaths occurred. Adults who reported weekly nightmares at baseline had a more than threefold increased risk of dying before 75 compared to those with no nightmares (adjusted hazard ratio 2.73; p<0.001). Furthermore, individuals with frequent nightmares exhibited significantly faster rates of biological ageing (p<0.001). Mediation analysis revealed that accelerated biological ageing explained approximately 39% of the relationship between nightmares and premature mortality, suggesting that the stress and sleep disruption caused by nightmares may directly impact cellular ageing processes.
These findings highlight the importance of recognising and addressing nightmares as a modifiable risk factor for accelerated ageing and early death. For clinical practice, this suggests that patients presenting with frequent nightmares should be screened for underlying sleep disorders, stress, and mental health issues, and offered appropriate interventions such as cognitive behavioural therapy for insomnia or image rehearsal therapy. Given that nightmares are both common and treatable, targeted interventions could not only improve sleep quality and mental well-being but may also contribute to healthier ageing and reduced mortality risk. Further research is needed to confirm whether treating nightmares can slow biological ageing and extend lifespan, but the evidence already supports a proactive approach to nightmare management in routine healthcare.
Reference
Otaiku A. Nightmares accelerate biological aging and predict premature mortality in humans. Abstract OPR-111. EAN Congress, 21-24 June, 2025.
