Is a fear of death keeping you awake at night? Death anxiety predicts insomnia through nightmare severity

The fear of death (death anxiety) is a risk factor for various mental health conditions. Death anxiety has been theorized to elicit physiological arousal and worry and is empirically associated with attachment insecurity, each of which has been linked to disrupted sleep. However, limited research has explored the relationship between death anxiety, nightmares and insomnia. We examined the relationship between death anxiety and insomnia, as well as attachment style as a potential moderator, and nightmare severity as a possible mediator. Five hundred and fifteen adults completed an online survey; 70% were female, and 89% resided in Australia. Regression analyses revealed that death anxiety was positively related to insomnia, with no significant moderation by attachment style. Analyses using Hayes' PROCESS macro revealed that nightmare severity mediated this relationship. These findings suggest that death anxiety may play a greater role in insomnia than previously considered and may be an important intervention target.