PTSD nightmares among veterans linked to suicide attempts

WASHINGTON: A recent study found that nightmares linked to a specific traumatic event in veterans are significantly associated with suicide reattempts.

Researchers analyzed data from more than 3,200 veterans with a documented suicide attempt and diagnosis of one of three types of nightmares: idiopathic nightmares of unknown origin; trauma-related nightmares with a diagnosis of post-traumatic stress disorder; or complex nightmares, accompanied by diagnoses of PTSD and a sleep-related breathing disorder.

Of the three nightmare types, only trauma-related nightmares were positively associated with suicide reattempts.

"One possible explanation for these findings may be the influence of the actual dream content," said principal investigator Todd Bishop, who has a doctorate in clinical psychology and is a researcher and health science specialist at the VA Center of Excellence for Suicide Prevention.

"Previous research depicts trauma-related nightmares as having content that is very similar to the original trauma, whereas complex nightmares can have varying types of dream content, often times not directly related to the trauma. Thus, it is possible that the dream content of the nightmare is a driving factor for the observed differences."

Researchers also found that complex nightmares and trauma-related nightmares were significantly associated with mental health care utilization. Investigators believe this could help providers refine their treatments for veterans experiencing nightmares.

"Complex nightmares and trauma-related nightmares have been traditionally treated as the same phenomenon; however, if they are in fact different, they may need to be treated with different interventions," explained Bishop.

He added, "For example, some of the most common treatments for nightmares related to PTSD are prazosin and rescripting psychotherapies such as exposure, relaxation, and rescripting therapy. In contrast, if complex nightmares are more closely related to sleep-disordered breathing than PTSD, then treatment approaches designed to target trauma-related nightmares may be less effective."