The diagnosis of a nightmare disorder is based on clinically significant distress caused by the nightmares, e.g., sleep or mood disturbances during the day. The question what factors might be associated with nightmare distress in addition to nightmares frequency is not well studied.

Overall, 1474 persons (893 women, 581 men) completed an online survey. Nightmare distress was measured with the Nightmare Distress Questionnaire (NDQ).

The findings indicated that nightmare distress, measured by the NDQ, correlated with a variety of factors in addition to nightmare frequency: Neuroticism, female gender, low education, extraversion, low agreeableness, and sensation seeking. Moreover, the percentage of replicative trauma-related nightmares was also associated with higher nightmare distress.

A large variety of factors are associated with nightmare distress; a finding that is of clinical importance. The construct Harm Avoidance, however, was not helpful in explaining inter-individual differences in nightmare distress. Further, the relationship between nightmare distress and other factors, e.g., education or agreeableness, is not yet understood.