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New research suggests that nightmares in middle-aged adults may significantly increase the risk of developing dementia later in life. However, this connection remains a subject of debate among experts.
Key Findings
A study presented at the 2024 Congress of the European Academy of Neurology (EAN) found that middle-aged adults who experienced weekly distressing dreams had a fourfold increased risk of developing dementia compared to those without nightmares. Dr. Abidemi Otaiku from Imperial College London, the lead investigator, suggests that distressing dreams could either be a causal risk factor for dementia or an early symptom of it.
“We found that after controlling for genetic factors, the association between distressing dreams and both cognitive decline and dementia remained robust,” Otaiku stated. The study analyzed genetic data from participants, including blood tests, saliva samples, and family history, and found no significant relationship between nightmare frequency and genetic factors.
Previous Research
Earlier findings by Otaiku and colleagues indicated that middle-aged adults with frequent nightmares were four times more likely to experience cognitive decline over the following decade. Older adults with nightmares had a twofold increased risk of all-cause dementia. The current study builds on this by examining the genetic influence on these associations.
Expert Skepticism
Despite the robust findings, some experts remain cautious. Dr. Sebastiaan Engelborghs, a professor of neurology and co-chair of the EAN Scientific Panel on Dementia and Cognitive Disorders, suggests that the link between nightmares and dementia might be explained by rapid eye movement (REM) sleep behavior disorder. This disorder, characterized by distressing dreams, can precede dementia by many years.
“It is well-known that REM sleep behavior disorder may precede dementia. One of the key symptoms of REM sleep behavior disorder are nightmares,” Engelborghs noted. He emphasized that without sleep exams to rule out REM sleep behavior disorder, the study’s findings might be premature.
Future Directions
Dr. Otaiku highlighted the importance of identifying individuals at an early stage before they develop dementia symptoms, as early detection could allow for preventive strategies and disease-modifying treatments. He suggested future studies to explore whether treating distressing dreams could help slow cognitive decline or prevent dementia.
Engelborghs agreed that patients with REM sleep behavior disorder could benefit from specific treatments for their symptoms but noted that such treatments do not necessarily reduce dementia risk. “Disordered sleep is often the first, early manifestation of neurodegeneration that is the cause of future dementia,” he explained.
Conclusion
The study sheds light on the potential link between nightmares and dementia risk, highlighting the need for further research to understand this relationship better. While the findings suggest that nightmares could be an early indicator of dementia, experts emphasize the importance of comprehensive sleep evaluations to rule out other underlying disorders.
