Sleep, nightmares and wellbeing: A complex interaction

To celebrate World Sleep Day 2024, we spoke to Dr Rowan Ogeil and Associate Professor Jillian Broadbear about their collaborative research into the complex relationship between nightmares and wellbeing among people with borderline personality disorder (BPD).

According to the team’s research, people with BPD experience nightmares more often than people in the general community, with common dream themes including re-experiences of trauma, interpersonal conflict, and fears of abandonment.

“Sleep quality impacts our cognitive abilities and resilience,” A/Prof Broadbear explained. “For someone who experiences BPD, current interpersonal stress and previous trauma can affect their sleep quality, which in turn may increase the intensity of BPD symptoms.”

By examining the relationships between sleep quality, nightmare frequency, and mental health stability across the week, the researchers hope to better understand the complex ways in which sleep health, wellbeing and functioning interact in people with BPD.

Insights from the team’s research will contribute to treatments that target sleep health and wellbeing.

A cutting-edge, collaborative approach

The project brings together the research team from Spectrum, with expertise in BPD and complex trauma disorder, in partnership with Turning Point’s Dr Ogeil, who has over a decade of experience examining the interactions between alcohol and other drug use and sleep and mental health outcomes.

“We know that disrupted sleep and nightmares are linked with poorer wellbeing, as well as physical and mental health outcomes. In people with BPD, poor sleep can also impact their emotional regulation.

“Substance use such as alcohol, cannabis and sedatives are also very common in this population and likely play a role in the complex relationship between BPD and the experience of a good night's sleep (sleep quality),” Dr Ogeil said.

Despite the negative effects that these drugs have on sleep in the general community, there is little previous research investigating these relationships in people with BPD.

By combining objective data from “actiwatch” wearable technology with subjective diaries and questionnaires about dream content, the researchers aim to build a comprehensive map of participants' sleep, functioning and wellbeing over a week. 

As a result, the project team aims to build a deeper understanding of the interactions between sleep, nightmares and functioning among people with BPD, and identify opportunities for future interventions to support their treatment.

Better sleep health for people with BPD

BPD is a psychiatric disorder in which people experience emotional dysregulation, impulsive behaviour, identity disturbance and fears of abandonment.

It is the most common of all personality disorders and is associated with significantly poorer mental health and wellbeing among people who experience it.

Given the theme for World Sleep Day this year is “Sleep Equity for Global Health”, this project is a powerful example of how differences in sleep health experienced by different populations can lead to inequities in health outcomes.

Ultimately, this important collaboration between Spectrum and Turning Point may lead to a future where health providers are better equipped to promote good sleep health and improve wellbeing for people with BPD.

People with BPD who would like to be involved in the project are invited to email [email protected] with the subject line “Sleep and BPD” to find out more about opportunities to participate.

For media enquiries email: [email protected] or call 0478 854 644.

Associate Professor Jillian Broadbear is an Adjunct Clinical Associate Professor, Monash University, and Head of Research & Innovation, Spectrum - Personality Disorder and Complex Trauma Service, Eastern Health

Dr Rowan P. Ogeil is the Strategic Lead, National Addiction and Mental Health Surveillance Unit (NAMHSU), and a Senior Research Fellow, Eastern Health Clinical School, Monash University