Nightmares and early death: reading the headlines carefully

In the summer of 2025 a striking claim travelled widely: people who have nightmares every week are three times as likely to die before 70. If you have nightmares often, that is not an easy thing to read, least of all at 3 a.m. So we went back to the sources.

Where the claim comes from

Dr Abidemi Otaiku of the UK Dementia Research Institute and Imperial College London presented the work at the European Academy of Neurology Congress in Helsinki in June 2025. According to the congress press release, the team drew on six long-term population cohorts: 183,012 adults aged 26 to 86 and 2,429 children aged 8 to 10. Adults reported how often they had nightmares at the start; for the children, parents did. Adults were followed for up to 19 years.^[1]

• Adults with weekly nightmares were more than three times as likely to die before 70 as those who rarely or never had them.
• Children and adults with frequent nightmares showed faster biological ageing, measured with telomere length and, in adults, epigenetic clocks (chemical marks on DNA that change with age).^[2]
• Faster ageing accounted for about 40% of the extra risk.
• The team also reported that weekly nightmares predicted early death more strongly than smoking, obesity, poor diet or low physical activity, and that the link held across ages, sexes, ethnicities and mental health.^{[1, 2]}

Why the numbers don’t quite line up

A report on the congress abstract itself describes a narrower analysis: 4,196 adults aged 26 to 74 from four cohorts, with early death defined as before 75. There, weekly nightmares went with a hazard ratio of 2.73 for early death, and ageing explained about 39% of the link.^[3] The two descriptions may reflect different stages of one project. That is the point: until a full paper is published, nobody outside the team can check the methods or the numbers. As far as we can find, the work has not yet appeared in a peer-reviewed journal.

What the study cannot show

• Cause. This is observational research. It shows that nightmares and early death travel together, not that one causes the other. Dr Otaiku himself said further studies are needed to confirm a causal link.^[2]
• Everything else that comes with nightmares. Frequent nightmares often arrive alongside depression, anxiety, PTSD, poor sleep, other sleep disorders or illness, all of which affect health. Statistical adjustment helps, but it cannot account for what was never measured.
• A single snapshot. Nightmares were asked about once, at the start, often many years before the outcome.
• Absolute risk. “Three times” is a relative figure. On its own it says nothing about how likely early death is for any one person, and the press materials gave no absolute numbers.
• The smoking comparison. Which factor predicts best in one dataset is not the same as which is more harmful.

A pattern seen before

Dr Otaiku has reported related findings in peer-reviewed work. In a 2022 study of three US cohorts, middle-aged adults with weekly distressing dreams had about four times the odds of faster cognitive decline, and older adults about twice the odds of a dementia diagnosis; the links were statistically significant only in men.^[4] These too are associations. The author suggested that distressing dreams might help identify people at risk early; the study could not show that they cause the decline.

What this means for you

• Nightmares are treatable. Imagery rehearsal is the approach sleep medicine recommends for nightmare disorder.^[5] Here is how it works.
• Whether treatment changes long-term health is unknown. The report on the abstract notes that more research is needed to find out whether treating nightmares slows biological ageing.^[3]
• Weekly, distressing nightmares are worth raising with a doctor. Not because of a headline, but because they can come with treatable problems, such as low mood or another sleep disorder, and because better nights are worth having. Please don’t start, stop or change any medicine on your own; talk to your doctor or pharmacist.

If reading this has left you wide awake, a few minutes of slow, long exhales can help. And if you want to know how we weigh studies like this one, we explain how we label evidence.