Study Links Nightmares with Anxiety, Insomnia in Heart Patients

Frequent nightmares were not associated with heart medications and sleep-disordered breathing, but were linked with depression, anxiety, and insomnia.

Patients with a heart condition who have weekly nightmares are 5 times more likely to feel depressed or anxious and are even more likely to struggle sleeping compared to patients without frequent nightmares, according to a new study published in the European Journal of Cardiovascular Nursing.

Earlier studies have found that frequent nightmares are associated with sleep and psychological disorders in the general population, but this was the first study to investigate this relationship in patients with heart diseases, according to the authors. They also examined whether hart medications were connected with nightmares.

“Health professionals should ask patients if they experience bad dreams as a warning sign for depression, anxiety, or trouble sleeping,” said study author Takashi Kohno, MD, PhD, in a press release. “Psychological disorders and insomnia are linked with the development and progression of heart disease and upsetting dreams could be a clue that patients need extra prevention efforts.”

The study included 1233 patients admitted to Keio University Hospital with various heart diseases. Participants had an average age of 64 years and 25% were women. Nightmares, sleep, and psychological characteristics were assessed with self-reported questionnaires and sleep-disordered breathing was measured using overnight pulse oximetry.

Nearly 15% of participants had at least 1 nightmare per month and 3.6% had at least 1 nightmare per week, which was defined as frequent nightmares. Women were more likely to have frequent unpleasant dreams compared to men. In total, 45.9% of patients reported insomnia, 18.5% had depression, 16.9% had anxiety, and 28% had sleep-disordered breathing.

“Our study shows strong associations between depression, anxiety, insomnia, and bad dreams in patients with heart disease,” Kohno said in the press release. “As this was an observational study, it cannot determine the cause-effect relationship, but it may be bidirectional. In other words, depression, anxiety, and insomnia.”

Frequent nightmares were not associated with heart medications and sleep-disordered breathing, but were linked with depression, anxiety, and insomnia, according to the press release. Patients with weekly bad dreams were 5 times more likely to be depressed, 5 times more likely to be anxious, and 7 times more likely to have insomnia.

“The prevalence of nightmares and frequent nightmares in the general population, reported by other groups, is similar to the experience of heart patients in our study,” Kohno said. “We showed that in people with heart disease, women are more likely than men to have persistent bad dreams—this also mirrors findings in the general public. The strong associations among frequent nightmares, insomnia, and psychological disorders we observed reflects prior research in health people, suggesting that these relationships could be universal regardless of the presence of heart diseases.”


Nightmares linked with anxiety and insomnia in heart patients [news release]. European Society of Cardiology; December 17, 2020. Accessed January 19, 2021.