Frequent nightmares triple the risk of early death and accelerates ageing

A major study is the first to show that nightmares independently predict faster biological ageing and earlier death.

The paper, which was presented at the European Academy of Neurology (EAN) Congress 2025, is the first study to show that nightmares independently predict faster biological ageing and earlier mortality – even after accounting for other health issues.

The study showed that adults reporting weekly nightmares were more than three times as likely to die prematurely (before age 70) compared to those who rarely or never experienced nightmares. Children and adults with more frequent nightmares also exhibited faster biological ageing, which accounted for approximately 40% of the heightened mortality risk.

Notably, weekly nightmares were found to be a stronger predictor of premature death than other established risk factors such as smoking, obesity, poor diet, and low physical activity.

"...nightmares often wake us up sweating, gasping for breath, and with our hearts pounding – because our fight-or-flight response has been triggered. This stress reaction can be even more intense than anything we experience while awake." Dr Abidemi Otaiku Department of Brain Sciences

“Our sleeping brains cannot distinguish dreams from reality”, said Dr Otaiku, lead author and Clinical Research Fellow within the UK Dementia Research Institute at Imperial. “That’s why nightmares often wake us up sweating, gasping for breath, and with our hearts pounding – because our fight-or-flight response has been triggered. This stress reaction can be even more intense than anything we experience while awake.”

Nightmare frequency in adults was self-reported at the start of the study, with participants followed for up to 19 years. For children, nightmare frequency was reported by their parents at the beginning of the study. Biological ageing in children was assessed by measuring the length of their telomeres – small DNA sequences that serve as indicators of cellular ageing. Biological ageing in adults was assessed using telomere length as well as advanced epigenetic clocks, which are molecular markers that measure the speed of whole-body ageing.

How nightmares age us

Dr Otaiku explains, “Nightmares lead to prolonged elevations of cortisol, a stress hormone closely linked to faster cellular ageing. For those who frequently experience nightmares, this cumulative stress may significantly impact the ageing process. Additionally, nightmares disrupt both sleep quality and duration, impairing the body’s essential overnight cellular restoration and repair. The combined effects of chronic stress and disrupted sleep likely contribute to the accelerated ageing of our cells and bodies.”

The association between frequent nightmares and accelerated ageing remained consistent across all ages, sexes, ethnicities, and mental health statuses, indicating a universal effect. Even monthly nightmares were linked to faster ageing and increased mortality compared to rare or no nightmares, emphasising the importance of reducing nightmare frequency across the population. 

 “The good news is that nightmares can be prevented and treated”, said Dr Otaiku. “Simple measures like avoiding scary movies, maintaining good sleep hygiene, managing stress, and seeking treatment for anxiety or depression can be effective.” 

 “Those experiencing frequent nightmares that disrupt their quality of life may benefit from seeing a sleep specialist. Effective psychological treatments, such as image rehearsal therapy, can be practiced at home. Recent research also suggests that therapies like CBT-I, which reduce nightmares, may significantly slow the ageing process”, he added. 

Reflecting on the broader public health significance of these findings, Dr Otaiku stated, “Given how common and modifiable nightmares are, they should be taken far more seriously as a public health concern.”  

“If further studies confirm the causal impact of nightmares on ageing and brain health, then preventing and treating them could become one of the simplest, most cost-effective strategies to slow ageing at a population level. This would not only improve individual well-being but also help achieve the United Nations Sustainable Development Goal of reducing premature death worldwide and promoting health for all.” 

This article was adapted from press materials provided Science Media Centre.