Adults who frequently experience nightmares may age more quickly and face a significantly higher risk of premature mortality, according to new research presented at the European Academy of Neurology Congress 2025.
Investigators followed 4,196 adults aged 26 to 74 years for up to 18 years using data from four large population-based studies. They examined whether frequent nightmares were associated with premature mortality—defined as death prior to age 75 years—and accelerated biological aging.
Over the follow-up period, 227 participants died prematurely. Individuals who reported weekly nightmares at the start of the study were nearly three times more likely to die early compared with those who didn't report nightmares. This association remained statistically significant after adjusting for other potential risk factors.
To assess biological aging, the investigators used three validated epigenetic clocks: DunedinPACE, GrimAge, and PhenoAge. These tools estimate biological aging based on DNA methylation patterns. The participants with frequent nightmares showed faster aging across all three measures compared with those without nightmares.
Accelerated biological aging explained 39% of the relationship between nightmares and premature mortality, suggesting that epigenetic aging may partially mediate this risk.
While nightmares have long been associated with psychiatric conditions and sleep disorders, the findings indicated they may also reflect broader physiological health risks. Although the investigators didn't identify causes of mortality, their research pointed to a potential connection between sleep disturbances and long-term physical health outcomes.
Nightmare frequency was self-reported only once at baseline, limiting insight into changes over time. The investigators acknowledged that some participants may have misreported their sleep patterns. Nonetheless, the large sample size, long-term follow-up, and use of biological aging metrics strengthened the findings.
The investigators emphasized the need for further investigation to determine whether treating nightmares could reduce mortality risk or slow biological aging.
The study highlighted the critical need for clinicians to consider frequent nightmares in adults not only as a mental health issue but also as a possible marker of underlying health risk. The results of the study also underscored the value of combining subjective symptom reporting with objective biological data in assessing long-term outcomes.
The authors reported no conflicts of interest.