Can frequent nightmares be a harbinger of dementia?
Nightmares that occur regularly can be more than just an unpleasant experience—they represent a significant risk factor for cognitive impairment and the development of dementia. A British study led by neurologist Dr. Abidemi Otaiku has brought new insights into the connections between bad dreams and the decline in cognitive functions, including the onset of dementia.
Data from three cohort studies
The research, whose results were published in the journal EClinicalMedicine and presented at last year's European Academy of Neurology (EAN) congress in Helsinki, analyzed data from three cohort studies: Midlife in the United States (MIDUS), Osteoporotic Fractures in Men Study (MrOS), and the Study of Osteoporotic Fractures (SOF).
Data were obtained from 605 middle-aged adults, with an average age of 50 years, who were monitored up to 13 years as part of the MIDUS study. The criterion for assessment was the risk of cognitive function decline.
The second group within the research consisted of 2,600 older adults, with an average age of 83 years, who were monitored for up to 7 years and assessed for the risk of dementia occurrence.
The main criterion was the frequency of nightmares—based on participants' self-reports—and its relationship to cognitive function decline and the diagnosis of dementia.
Risks increase with age
The research results showed that middle-aged adults who experience nightmares at least once a week have a fourfold higher risk of cognitive impairment. Another important finding is that older adults have more than twice the risk of dementia. The analysis additionally showed that this relationship was statistically significant, particularly among men.
How to 'rewrite' dreams
Dr. Otaiku emphasizes that nightmares may be an indicator of changes in the brain that precede the development of neurodegenerative diseases, such as Alzheimer's and Parkinson's disease. They may also be related to genetic predisposition or other risk factors including stress, depression, and sleep disorders.
Given that nightmares can potentially be influenced, Dr. Otaiku recommends that doctors actively ask their patients about their occurrence, especially where other dementia risk factors are present.
Effective interventions may include:
- Cognitive-behavioral therapy (CBT) focused on stress control and improving sleep hygiene.
- Imagery rehearsal techniques: Patients should think about a positive ending to a recurring bad dream (e.g., "the tiger hugs me instead of attacking") and repeatedly visualize this scenario before going to sleep.
- Pharmacotherapy in cases of psychological comorbidities.
Look for patients' bad dreams
The findings of this study provide a new perspective on nightmares not only as a symptom but also as a potential marker for the early identification of individuals at risk of dementia. Doctors should pay attention to these seemingly less significant sleep problems, as they may hold the key to preventing serious neurodegenerative diseases.
Editorial Team, Medscope.pro
Sources:
- Otaiku A. I. Distressing dreams, cognitive decline, and risk of dementia: A prospective study of three population-based cohorts. EClinicalMedicine 2022; 52: 101640, doi: 10.1016/j.eclinm.2022.101640.
- EAN 2024, Press Pack. Available at: https://www.ean.org/fileadmin/user_upload/ean/congress-2024/Press_2024/EAN_2024_Press_Pack_V2.pdf.
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