{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T18:17:18Z","timestamp":1768414638685,"version":"3.49.0"},"reference-count":28,"publisher":"PAGEPress Publications","issue":"2","license":[{"start":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:00:00Z","timestamp":1629763200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ResPsy"],"abstract":"<jats:p>Nightmares are frightening or disturbing dreams that awaken sleepers while bad dreams are disturbing dreams that do not awaken sleepers. Both types are known to be associated with psychological symptoms including anxiety and depression. Chronic pain is often comorbid with psychological symptoms and vitamin D deficiency increases risk of chronic musculoskeletal pain (MSP), which in turn is associated with increased risk of anxiety and depression. We aimed to investigate associations between types of dreams, psychological symptoms, vitamin D, and calcium intake in individuals with MSP. The study included 191 outpatients with MSP and 191 age\/gender matched healthy controls. Psychological symptoms were assessed using Hospital Anxiety and Depression Scale. Serum vitamin D was measured and daily calcium intake was estimated. Participants were asked about types of their dreams (normal, bad, or nightmares) during the past month. Binary logistic regression was used to find predictors of MSP and bad dreams and nightmares. Bad dreams and nightmares, vitamin D deficiency, low calcium intake, anxiety, and depression were more prevalent in cases versus controls (Ps&lt;0.001). Chi-square analyses showed that types of dreams were associated with anxiety, depression, and MSP (Ps&lt;0.001). Participants with normal dreams had higher vitamin D (P&lt;0.01) and calcium intake (P&lt;0.001) and lower anxiety and depression scores (Ps&lt;0.001) compared to participants with bad dreams and nightmares. Anxiety, depression and MSP were predictors for bad dreams and nightmares. Further studies are required to assess if vitamin D supplementation and increasing calcium intake may improve MSP, psychological symptoms and thus prevent nightmares and bad dreams.<\/jats:p>","DOI":"10.4081\/ripppo.2021.533","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T15:45:23Z","timestamp":1629819923000},"source":"Crossref","is-referenced-by-count":3,"title":["Nightmares and bad dreams among individuals with musculoskeletal pain: a link to vitamin D and calcium"],"prefix":"10.4081","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6880-8522","authenticated-orcid":false,"given":"Khalid K.","family":"Abdul-Razzak","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9490-0979","authenticated-orcid":false,"given":"Mohammad J.","family":"Alkhatatbeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2021,8,24]]},"reference":[{"key":"13620","doi-asserted-by":"crossref","unstructured":"Abdul-Razzak, K. K., Almanasrah, S. O., Obeidat, B. A., & Khasawneh, A. G. (2018). Vitamin D is a potential antidepressant in psychiatric outpatients. International Journal of Clinical Pharmacology and Therapy, 56(12), 585-596. doi: 10.5414\/cp203309.","DOI":"10.5414\/CP203309"},{"key":"13621","doi-asserted-by":"crossref","unstructured":"Abdul-Razzak, K. K., Alshogran, O. Y., Altawalbeh, S. M., Al-Ghalayini, I. F., Al-Ghazo, M. A., Alazab, R. S., ... &Sahawneh, F. E. (2019). Overactive bladder and associated psychological symptoms: A possible link to vitamin D and calcium. Neurourology and Urodynamic, 38(4), 1160-1167. doi: 10.1002\/nau.23975.","DOI":"10.1002\/nau.23975"},{"key":"13622","doi-asserted-by":"crossref","unstructured":"Abdul-Razzak, K. K., Mayyas, F. A., & Al-Farras, M. I. (2018). Vitamin D as potential antidepressant in outpatients with musculoskeletal pain. International Journal of Clinical Pharmacology and Therapy, 56(9), 400-410. doi: 10.5414\/cp203252.","DOI":"10.5414\/CP203252"},{"key":"13623","doi-asserted-by":"crossref","unstructured":"Alkhatatbeh, M. J., Abdul-Razzak, K. K., & Khwaileh, H. N. (2021). Poor sleep quality among young adults: The role of anxiety, depression, musculoskeletal pain, and low dietary calcium intake. Perspectives in Psychiatric Care, 57(1), 117-128. doi: 10.1111\/ppc.12533.","DOI":"10.1111\/ppc.12533"},{"key":"13624","doi-asserted-by":"crossref","unstructured":"Ashworth, P. C., Davidson, K. M., & Espie, C. A. (2010). Cognitive-behavioral factors associated with sleep quality in chronic pain patients. Behavioural Sleep Medicine, 8(1), 28-39. doi: 10.1080\/15402000903425587.","DOI":"10.1080\/15402000903425587"},{"key":"13625","doi-asserted-by":"crossref","unstructured":"Gieselmann, A., Ait Aoudia, M., Carr, M., Germain, A., Gorzka, R., Holzinger, B., ... & Pietrowsky, R. (2019). Aetiology and treatment of nightmare disorder: State of the art and future perspectives. Journal of Sleep Research, 28(4), e12820. doi: 10.1111\/jsr.12820.","DOI":"10.1111\/jsr.12820"},{"key":"13626","doi-asserted-by":"crossref","unstructured":"Gouda, M. A. (2015). Common Pitfalls in Reporting the Use of SPSS Software. Medical principles and practice: international journal of the Kuwait University, Health Science Centre, 24(3), 300-300. doi: 10.1159\/000381953.","DOI":"10.1159\/000381953"},{"key":"13627","doi-asserted-by":"crossref","unstructured":"Gureje, O., Von Korff, M., Kola, L., Demyttenaere, K., He, Y., Posada-Villa, J., ... & Alonso, J. (2008). The relation between multiple pains and mental disorders: results from the World Mental Health Surveys. Pain, 135(1-2), 82-91. doi: 10.1016\/j.pain.2007.05.005.","DOI":"10.1016\/j.pain.2007.05.005"},{"key":"13628","doi-asserted-by":"crossref","unstructured":"Hasler, B., & Germain, A. (2009). Correlates and Treatments of Nightmares in Adults. Sleep medicine clinics, 4(4), 507-517. doi: 10.1016\/j.jsmc.2009.07.012.","DOI":"10.1016\/j.jsmc.2009.07.012"},{"key":"13629","doi-asserted-by":"crossref","unstructured":"Holick, M. F. (2009). Vitamin D status: measurement, interpretation, and clinical application. Annals of Epidemiology, 19(2), 73-78. doi: 10.1016\/j.annepidem.2007.12.001.","DOI":"10.1016\/j.annepidem.2007.12.001"},{"key":"13630","doi-asserted-by":"crossref","unstructured":"Krystal, A. D. (2012). Psychiatric disorders and sleep. Neurology and Clinics, 30(4), 1389-1413. doi: 10.1016\/j.ncl.2012.08.018.","DOI":"10.1016\/j.ncl.2012.08.018"},{"key":"13631","doi-asserted-by":"crossref","unstructured":"Lemyre, A., Bastien, C., & Valli\u00e8res, A. (2019). Nightmares in mental disorders: A review. Dreaming, 29(2), 144-166. doi: 10.1037\/drm0000103.","DOI":"10.1037\/drm0000103"},{"key":"13632","unstructured":"Levin, R., & Fireman, G. (2002). Nightmare prevalence, nightmare distress, and self-reported psychological disturbance. Sleep, 25(2), 205-212."},{"key":"13633","doi-asserted-by":"crossref","unstructured":"Levin, R., & Nielsen, T. (2009). Nightmares, bad dreams, and emotion dysregulation: a review and new neurocognitive model of dreaming. Current Directions in Psychological Science, 18(2), 84-88. doi: 10.1111\/j.1467-8721.2009.01614.x.","DOI":"10.1111\/j.1467-8721.2009.01614.x"},{"key":"13634","doi-asserted-by":"crossref","unstructured":"Li, S. X., Zhang, B., Li, A. M., & Wing, Y. K. (2010). Prevalence and correlates of frequent nightmares: a community-based 2-phase study. Sleep, 33(6), 774-780. doi: 10.1093\/sleep\/33.6.774.","DOI":"10.1093\/sleep\/33.6.774"},{"key":"13635","doi-asserted-by":"crossref","unstructured":"Lima, G. A., Lima, P. D., Barros Mda, G., Vardiero, L. P., Melo, E. F., Paranhos-Neto Fde, P., ... &Farias, M. L. (2016). Calcium intake: good for the bones but bad for the heart? 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Current Pharmacology Development, 26(21), 2492-2496. doi: 10.2174\/1381612826666200310145935.","DOI":"10.2174\/1381612826666200310145935"},{"key":"13642","doi-asserted-by":"crossref","unstructured":"Scarpelli, S., Bartolacci, C., D\u2019Atri, A., Gorgoni, M., & De Gennaro, L. (2019). Mental Sleep Activity and Disturbing Dreams in the Lifespan. International journal of environmental research and public health, 16(19). doi: 10.3390\/ijerph16193658.","DOI":"10.3390\/ijerph16193658"},{"key":"13643","doi-asserted-by":"crossref","unstructured":"Schredl, M. (2014). Explaining the gender difference in nightmare frequency. American Journal of Psychology, 127(2), 205-213. doi: 10.5406\/amerjpsyc.127.2.0205.","DOI":"10.5406\/amerjpsyc.127.2.0205"},{"key":"13644","doi-asserted-by":"crossref","unstructured":"Spoormaker, V. I., Schredl, M., & van den Bout, J. (2006). Nightmares: from anxiety symptom to sleep disorder. 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