Most children will experience a nightmare or two from time to time. While most nightmares amount to nothing more than a random bad dream, persistent childhood nightmares — those that happen repeatedly or for a prolonged period of time — might signal the future development of troubling psychotic behaviors by age 18.

Dr. Andrew Thompson, of the Warwick (England) Medical School’s Division of Mental Health and Wellbeing, led the study exploring links between childhood parasomnias and adolescent psychosis. The medical school is part of the University of Warwick.

Parasomnias are sleep disturbances that include nightmares, night terrors, and sleepwalking. Psychosis is a serious mental disorder characterized by thoughts and emotions so extreme that awareness of external reality is clouded. Some symptoms of psychosis include paranoia, delusions of grandeur, hallucination, uninhibited social interactions, loss of interest in personal hygiene, and an inability to deal effectively with the stresses of everyday living.

Thompson and his colleagues queried the parents of 4,060 children born in the United Kingdom. The parents were asked to report any experiences of parasomnia that occurred when the child was between 2 and 9 years of age. When the child was 12, interviews were conducted to assess the child’s sleep-disturbing events. At 18, the children were screened for symptoms of psychosis.

The research team discovered that, at age 12, 25% of the children had experienced nightmares in the previous six months. At 18, 8% of the children reporting nightmares at age 12 were exhibiting symptoms of psychosis. The children who experienced nightmares proved to be almost twice as likely to develop psychosis as did children of the general population. Children who suffered nightmares were more likely to develop psychosis than did children who experienced night terrors or sleepwalking.

Thompson said his study could indicate the need for parents and healthcare providers to rethink how children experiencing parasomnia, especially nightmares, are dealt with. Most children who experience nightmares and night terrors at an early age will not become psychotic but these sleep disturbances might be noted and long-term behaviors more closely monitored to recognize symptoms and initiate interventions at the earliest possible moment.

Of particular concern would be children with a history of psychosis or other psychiatric disorders in the family and those who have been exposed to traumatic events affecting themselves, their parents or other family members, or their peers. According to Thompson, “Experience of stressful events has also been related to both the development of both nightmares and psychotic symptoms in late childhood and may be important” indicators of deeper underlying distress.


  1. Thompson, Andrew, et al. "Childhood sleep disturbance and risk of psychotic experiences at 18: UK birth cohort." The British Journal of Psychiatry (2015). Web. 1 June 2015.
  2. Algon, Sibel, et al. "Evaluation and Treatment of Children and Adolescents with Psychotic Symptoms." PMC / US National Library of Medicine. US Department of Health and Human Services, 1 Apr. 2013. HHS Public Access. Web. 1 June 2015.


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