O032 Is a fear of death keeping you awake at night? Examining the relationship between death anxiety and insomnia

Abstract Introduction The fear of death (death anxiety) is a risk factor for psychopathology, including anxiety and depressive disorders. There is little research on the role of death anxiety in sleep disorders like insomnia. We examined the relationship between death anxiety and insomnia and investigated whether distressing dreams/nightmares play a mediating role in this relationship. Methods The study consisted of 515 adult participants (360 females; M age=44.15 years) who completed an online survey via REDCAP. The survey assessed insomnia symptoms (ISI), death anxiety (DABBS), and nightmare severity (DDNSI). Correlations and hierarchical regression analyses were conducted to explore the relationship between insomnia symptoms and death anxiety, with an additional mediation analysis (Hayes PROCESS macro) examining the role of nightmare severity. Results Death anxiety was positively correlated with insomnia (r=.27; p<.001). In the hierarchical regression analysis, death anxiety remained a significant predictor of insomnia, even after controlling for general anxiety (p=.037). Notably, nightmare severity mediated the relationship between death anxiety and insomnia, with higher levels of death anxiety associated with more severe nightmares and, subsequently, more severe insomnia symptoms (all p’s<.001). As the direct effect of death anxiety on insomnia remained significant (p<.001) in the mediation model, our results suggest that nightmares are a partial mediator of the relationship. Discussion Death anxiety is associated with insomnia symptoms, with nightmares partially mediating the relationship. Fears of death may, therefore, play a greater role in insomnia symptomatology than previously thought. Targeting death anxiety in insomnia treatment may be an important avenue for future research.