0140 Nightmares are Associated with Increased Suicidality in Young Adulthood: A Population-based Cohort Study

Abstract

Abstract Introduction Childhood nightmares have a second increase in incidence in young adulthood, which has been attributed to trauma and psychopathology. As suicide rates are high in young adults and have been associated with nightmares, more research is needed regarding this relationship in this age range. This study aimed to examine the association of nightmares, independent of sleep disturbances, insufficient sleep or trauma-history, with suicidality in young adulthood. Methods The Penn State Child Cohort is a random, population-based sample of 700 children (5-12 years at baseline) studied in the sleep laboratory who returned for follow-up visits during adolescence and young adulthood. For the current study, 258 young adults (25.1±2.7 years old, 53.9% female, 24.8% racial/ethnic minority) completed their follow-up visit 15.9±2.0 years later. Nightmares were ascertained by self-report. The presence of suicidality was ascertained from responses on items querying suicidal ideation and/or attempts via clinically-relevant sources (i.e., MINI structured interview, Child Behavior Checklist Adult Self-Report, and Depression Anxiety and Stress Scale). General linear and logistic regression models adjusted for important covariates. Results Subjects reporting nightmares (n=109) had a significantly higher rate of suicidality (29%) than those absent of nightmares (14%; p=0.002), after adjusting for sex, age, sleep disturbances, sleep duration and trauma history. This rate was even higher (46%) in those reporting moderate-to-severe nightmares (n=24; p< 0.01). The odds of suicidality associated with nightmares were 2.3-fold (95%CI=1.1-4.7), after adjusting for sex, age, sleep disturbances, sleep duration and trauma history (p=0.023); a risk that increased to 6.1-fold (95%CI=2.0-18.6) in those reporting moderate-to-severe nightmares (p=0.001). Conclusion These findings further strengthen previous research that has established nightmares’ significant relationship to increased suicidality, even when controlling for other important risk factors such as sleep disturbances and trauma history. Furthermore, as these results come from a random, population-based sample, it also demonstrates the generalizability of the association between nightmares and suicide. As the search for effective prevention strategies for suicide continues, it will be important to assess for the presence and severity of nightmares in those who express suicidal ideation, especially given the treatable nature of nightmares. Support (if any) National Institutes of Health (R01HL136587, R01MH118308, UL1TR000127)