A new study has illuminated a possible pathway by which recurring nightmares may lead to the development of suicidal tendencies. Though previous research had identified a positive correlation between nightmares and a propensity for suicidal thoughts, the intermediary psychological processes linking these two phenomena has remained murky.

According to recent studies, people who experience regular nightmares are 2.61 times more likely to become suicidal than those who do not regularly suffer from disturbing dreams. Several theories have been put forward as to why this may be the case, many of which are based on the so-called Cry of Pain model for suicidality.

This notion involves a pathway toward suicide that begins with a sense of “defeat” following traumatic life events, leading to feelings of “entrapment” when one cannot escape their despair or rectify their situation, and culminating in “hopelessness.”

Adopting this model, researchers from the University of Manchester and Oxford University sought to investigate how recurrent nightmares could activate the Cry of Pain pathway, thereby identifying a link between nightmares and suicidal tendencies.

Their investigation, which appears in the Journal of Clinical Sleep Medicine, involved 91 individuals diagnosed with post-traumatic stress disorder (PTSD). According to some estimates, around 90 percent of those who develop this condition experience regular nightmares in the acute phase following trauma.

The researchers used a series of scientifically approved psychological questionnaires in order to measure the frequency and intensity of nightmares, as well as the extent of participants’ suicidal tendencies. Further questionnaires evaluated overall feelings of defeat, entrapment, and hopelessness.

^{The Cry of Pain pathway begins with a sense of defeat, before progressing to entrapment and hopelessness. Africa Studio/Shutterstock}

Results confirmed a strong link between nightmares and suicidality, with 62 percent of those who had experienced nightmares in the month preceding the study having suicidal thoughts, compared with just 20 percent of those who had not had nightmares during this period.

Furthermore, ratings for feelings of defeat, entrapment, and hopelessness were higher in participants who had experienced nightmares and suicidal thoughts than those who had not. This would appear to validate the multi-step, indirect pathway linking nightmares to suicidality, mediated by these three stages.

Exactly how nightmares activate the Cry of Pain pathway is not clear, although the study authors propose several possibilities. For instance, people who re-live traumatic events in their nightmares may experience an acute sense of defeat associated with being subjected to certain unpleasant experiences. Alternatively, the continual recurrence of nightmares may generate feelings of defeat rooted in an inability to cope or control one’s dreams.

Based on these findings, the researchers recommend that clinicians monitor PTSD sufferers closely for signs of recurring nightmares, while also basing interventions around treating feelings of defeat, entrapment and hopelessness.

Accordingly, they are currently recruiting participants for a new study investigating the effect of sleep on psychological wellbeing, while also assessing the possibility of using cognitive behavioral therapy to improve mental health by bringing about changes in the quality of sleep. People suffering from insomnia and other sleep disorders can take part in the study by visiting this website.