Nightmare Frequency is a Risk Factor for Suicidal Ideation During the COVID-19 Pandemic

Authors

• Courtney J. Bolstad, Mississippi State University
• Brigitte Holzinger, Institute for Consciousness and Dream Research
• Serena Scarpelli, University of Rome
• Luigi De Gennaro, University of Rome
• Juliana Yordanova, The Bulgarian Academy of Sciences
• Silvia Koumanova, The Bulgarian Academy of Sciences
• Sérgio Mota‐Rolim, Universidade Federal do Rio Grande do Norte
• Christian Benedict, Uppsala Universitet
• Bjørn Bjorvatn, Universitetet i Bergen
• Ngan Yin Chan, Chinese University of Hong Kong
• Frances Chung, University Health Network
• Yves Dauvilliers, University of Montpellier
• Colin A. Espie, University of Oxford
• Yuichi Inoue, Tokyo Medical University
• Maria Korman, Ariel University
• Adrijana Koscec Bjelajac, Institut za Medicinska Istrazivanja i Medicinu Rada
• Anne‐Marie Landtblom, Uppsala Universitet
• Kentaro Matsui, National Center of Neurology and Psychiatry
• Ilona Merikanto, University of Helsinki
• Charles M. Morin, Laval University
• Markku Partinen, Terveystalo Healthcare
• Thomas Penzel, Charite – Universitätsmedizin Berlin
• Giuseppe Plazzi, University of Modena and Reggio Emilia
• Cátia Reis, Universidade Católica Portuguesa
• Biserka Ross, Institute for Medical Research and Occupational Health
• Yun Kwok Wing, The Chinese University of Hong Kong
• Michael R. Nadorff, Mississippi State University

ORCID

Bolstad: https://orcid.org/0000-0003-2297-2778; Holzinger: https://orcid.org/0000-0001-5385-4091; Scarpelli: https://orcid.org/0000-0002-9260-7111; De Gennaro: https://orcid.org/0000-0003-3613-6631; Benedict: https://orcid.org/0000-0002-8911-4068; Bjorvatn: https://orcid.org/0000-0001-7051-745X; Chung: https://orcid.org/0000-0001-9576-3606; Dauvilliers: https://orcid.org/0000-0003-0683-6506; Espie: https://orcid.org/0000-0002-1294-8734; Inoue: https://orcid.org/0000-0001-7414-9017; Korman: https://orcid.org/0000-0003-1895-0189; Bjelajac: https://orcid.org/0000-0003-0547-0047; Landtblom: https://orcid.org/0000-0001-9567-470X; Matsui: https://orcid.org/0000-0003-4538-5381; Merikanto: https://orcid.org/0000-0002-1222-6678; Morin: https://orcid.org/0000-0002-8649-8895; Partinen: https://orcid.org/0000-0002-8182-9368; Penzel: https://orcid.org/0000-0002-4304-0112; Plazzi: https://orcid.org/0000-0002-1051-0472; Reis: https://orcid.org/0000-0001-6585-3993; Ross: https://orcid.org/0000-0001-7445-7335; Wing: https://orcid.org/0000-0002-5745-5474

MSU Affiliation

College of Arts and Sciences; Department of Psychology

Creation Date

2026-06-30

Abstract

The association between nightmare frequency (NMF) and suicidal ideation (SI) is well known, yet the impact of the COVID-19 pandemic on this relation is inconsistent. This study aimed to investigate changes in NMF, SI, and their association during the COVID-19 pandemic. Data were collected in 16 countries using a harmonised questionnaire. The sample included 9328 individuals (4848 women; age M[SD] = 46.85 [17.75] years), and 17.60% reported previous COVID-19. Overall, SI was significantly 2% lower during the pandemic vs. before, and this was consistent across genders and ages. Most countries/regions demonstrated decreases in SI during this pandemic, with Austria (−9.57%), Sweden (−6.18%), and Bulgaria (−5.14%) exhibiting significant declines in SI, but Italy (1.45%) and Portugal (2.45%) demonstrated non-significant increases. Suicidal ideation was more common in participants with long-COVID (21.10%) vs. short-COVID (12.40%), though SI did not vary by COVID-19 history. Nightmare frequency increased by 4.50% during the pandemic and was significantly higher in those with previous COVID-19 (14.50% vs. 10.70%), during infection (23.00% vs. 8.10%), and in those with long-COVID (18.00% vs. 8.50%). The relation between NMF and SI was not significantly stronger during the pandemic than prior (rs = 0.18 vs. 0.14; z = 2.80). Frequent nightmares during the pandemic increased the likelihood of reporting SI (OR = 1.57, 95% CI 1.20–2.05), while frequent dream recall during the pandemic served a protective effect (OR = 0.74, 95% CI 0.59–0.94). These findings have important implications for identifying those at risk of suicide and may offer a potential pathway for suicide prevention.

Publication Date

2-17-2024

Publication Title

Journal of Sleep Research

Publisher

Wiley

Rights

© 2024 European Sleep Research Society

Recommended Citation

Bolstad, C. J., Holzinger, B., Scarpelli, S., De Gennaro, L., Yordanova, J., Koumanova, S., Mota‐Rolim, S., Benedict, C., Bjorvatn, B., Chan, N. Y., Chung, F., Dauvilliers, Y., Espie, C. A., Inoue, Y., Korman, M., Koscec Bjelajac, A., Landtblom, A., Matsui, K., Merikanto, I., … Nadorff, M. R. (2024). Nightmare frequency is a risk factor for suicidal ideation during the COVID‐19 pandemic. Journal of Sleep Research, 33(5), e14165. https://doi.org/10.1111/jsr.14165