Nightmares are often associated with psychiatric disorders and acute stress. This study explores how the COVID‐19 pandemic may have influenced the content of nightmares. A sample of N = 419 US adults completed online surveys about sleep and COVID‐19 experiences. Participants were asked about the degree to which they agreed with statements linking greater general stress, worse overall sleep and more middle‐of‐the‐night insomnia with the COVID‐19 pandemic. They were also asked if, during the pandemic, they experienced nightmares related to various themes. Logistic regression analyses examined each nightmare content as outcome and increased stress, worse sleep and more middle‐of‐the‐night insomnia as predictors, adjusted for age, sex and race/ethnicity. Those who reported greater general COVID‐related stress were more likely to have nightmares about confinement, failure, helplessness, anxiety, war, separation, totalitarianism, sickness, death, COVID and an apocalypse. Those who reported worsened sleep were more likely to have nightmares about confinement, oppression, failure, helplessness, disaster, anxiety, evil forces, war, domestic abuse, separation, totalitarianism, sickness, death, COVID and an apocalypse. Those who reported worsened middle‐of‐the‐night insomnia were more likely to have nightmares about confinement, oppression, failure, helplessness, disaster, anxiety, war, domestic abuse, separation, totalitarianism, sickness, death, COVID and an apocalypse. These results suggest that increased pandemic‐related stress may induce negatively‐toned dreams of specific themes. Future investigation might determine whether (and when) this symptom indicates an emotion regulation mechanism at play, or the failure of such a mechanism.

Summary Female menstrual health and its relationship with sleep is an understudied subject. The aim of this investigation was to determine the association between the two in a community sample. Data were obtained from n = 579 menstruating females who participated in the Sleep and Health Activity, Diet, Environment, and Socialization (SHADES) study, a community‐based sample of adults aged 22–60 years. Participants were asked, “How regular is your period?”, with response choices of “very regular”, “mostly regular”, “fairly regular” and “not regular”. They were also asked, “How much bleeding do you usually experience during your period?” Response choices were: “very heavy”, “heavy”, “medium”, “light” or “very light”. These were evaluated as ordinal outcomes. Sleep‐related predictors included sleep duration (in hr; ≤ 6 [short], 7–9 [normal] and ≥ 9 [long]), Insomnia Severity Index score, Pittsburgh Sleep Quality Index score, Epworth Sleepiness Scale score and Fatigue Severity Scale score. Covariates included age, education, income, race/ethnicity and body mass index. Short sleep duration was associated with heavier bleeding (odds ratio = 1.46, p = 0.026) and greater cycle irregularity (odds ratio = 1.44, p = 0.031) as compared with normal sleep. Higher Pittsburgh Sleep Quality Index score was associated with greater cycle irregularity (odds ratio = 1.05, p = 0.022). Higher Fatigue Severity Scale score was associated with heavier bleeding (odds ratio = 1.02, p = 0.003) and greater cycle irregularity (odds ratio = 1.02, p = 0.008). Long sleep, Insomnia Severity Index and Epworth Sleepiness Scale were not associated with either outcome. These results demonstrate an association between short sleep duration, poor sleep quality, fatigue, stress and depression with heavier bleeding and menstrual cycle irregularity, highlighting the need for further studies to improve treatment options.

Despite the high prevalence of subclinical sleep disturbances, existing treatments are either potent prescription medications or over-the-counter supplements with minimal scientific support and numerous side effects. However, preliminary evidence shows that polyphenols such as rosmarinic acid and epigallocatechin gallate can support healthy sleep without significant side effects. Therefore, the present study examined whether a polyphenol botanical blend (PBB) could improve sleep and/or daytime functioning in individuals with subclinical sleep disturbances. A total of 89 individuals completed a double-blind, randomized trial of daily treatment with PBB (n = 43) or placebo (n = 46) 30 min before bed for 30 days. Participants were monitored for changes in sleep (by sleep diary and an activity tracker), mood, and neurocognitive functioning. After 30 days, PBB improved diary sleep quality (p = 0.008) and reduced insomnia severity (p = 0.044) when compared to placebo. No other changes in sleep outcomes were observed. Additionally, PBB did not impair neurocognitive functioning, and some improvement was noted in vigilant attention, working memory, and risk assessment. Among individuals with subclinical sleep disturbances, PBB improved sleep quality, insomnia severity, and neurocognitive functioning over placebo. These findings indicate that polyphenol compounds may be useful for improving certain aspects of sleep without compromising neurocognitive functioning.

The COVID-19 pandemic has affected the sleep and dreams of many individuals. Some have experienced improvements, while others have had more complaints. The changes to daily life such as working from home and spending more time indoors in confinement may have disturbed the circadian rhythms of some individuals. There were many reports of a shift towards a later bedtime during the pandemic, with several studies showing that in general, females experienced worse sleep than males, including more nighttime awakenings and nightmares. Increased dream and nightmare frequency during the pandemic has been shown in multiple studies. It has been postulated that because dreams are often guided by the dominant emotional state, that dreams and nightmares related to pandemic themes are a result of specific stressors related to COVID-19. Those experiencing unwanted sleep disturbances and nightmares could stand to benefit from mindfulness and relaxation practices that can ease stress and anxiety before bedtime. Striving to maintain a regular sleep schedule and enhance exposure to daylight–particularly during the first half of the day–may also be helpful.

Introduction Nightmares are often associated with psychiatric disorders, though acute stress can also induce them. This study explores how the COVID-19 pandemic may have influenced the frequency and content of nightmares. Methods A sample of N=419 US adults completed online surveys about sleep and COVID-19 experiences. Participants were asked the degree to which they agree with statements including that due to the COVID-19 pandemic, they have greater general stress, worse overall sleep, and more middle-of-the-night insomnia. They were also asked if they experienced nightmares during the pandemic on a range of topics, including confinement, claustrophobia, suffocation, oppression, drowning, failure, helplessness, natural disasters, anxiety, evil forces, war, domestic abuse, separation from loved ones, totalitarian regimes, being chased, dangerous animals, sickness, death, COVID-19, and apocalypse. Logistic regression analyses examined each nightmare content as outcome and increased stress, worse sleep, and more middle-of-the-night insomnia as predictors, adjusted for age, sex, and race/ethnicity. Results Those who reported greater general COVID-related stress were more likely to have nightmares about confinement (OR=1.66,p<0.03), failure (OR=1.64,p<0.005), helplessness (OR=2.89, 0<0.0005), anxiety (OR=2.37,p<0.0005), war (OR=3.42,p<0.0005), separation (OR=2.23,p<0.0005), totalitarianism (OR=3.78,p<0.003), sickness (OR=1.92,p<0.003), death (OR=1.66,p<0.01), COVID (OR=1.96,p<0.01), and apocalypse (OR=2.92,p<0.0005). Those who reported worsened sleep were more likely to have nightmares about confinement (OR=1.80,p<0.003), oppression (OR=2.99,p<0.0005), failure (OR=2.12,p<0.0005), helplessness (OR=1.67, 0<0.0005), disaster (OR=1.86,p<0.005), anxiety (OR=1.97,p<0.0005), evil forces (OR=1.56,p<0.02), war (OR=2.08,p<0.002), domestic abuse (OR=2.22,p<0.009), separation (OR=2.01,p<0.0005), totalitarianism (OR=3.39,p<0.0005), sickness (OR=1.74,p=0.003), death (OR=2.03,p<0.0005), COVID (OR=2.15,p<0.001), and apocalypse (OR=1.86,p<0.006). Those who reported worsened middle-of-the-night insomnia were more likely to have nightmares about confinement (OR=1.60,p<0.01), oppression (OR=1.97,p<0.002), failure (OR=2.00,p<0.0005), helplessness (OR=1.60,p<0.001), disaster (OR=1.52,p<0.04), anxiety (OR=2.27,p<0.0005), war (OR=2.10,p<0.001), domestic abuse (OR=1.74,p<0.04), separation (OR=1.86,p<0.0005), totalitarianism (OR=1.87,p<0.03), sickness (OR=1.80,p<0.001), death (OR=2.00,p<0.0005), COVID (OR=1.68,p<0.009), and apocalypse (OR=1.65,p<0.01). Conclusion The results suggest that increased stress may induce negatively-toned dreams related to that stress. Future studies will have to determine whether (and when) this symptom indicates an emotional regulation mechanism at play or the failure of such a mechanism. Support (if any):