Nightmares in People with COVID-19: Did Coronavirus Infect Our Dreams?

Abstract

Introduction A growing number of studies have demonstrated that the coronavirus disease-19 (COVID-19) pandemic has severely affected sleep and dream activity in healthy people. To date, no investigation has examined dream activity specifically in COVID-19 patients. Methods As part of the International COVID-19 Sleep Study (ICOSS), we compared 544 COVID-19 participants with 544 matched-controls. A within-subjects comparison between pre-pandemic and pandemic periods computed separately for controls and COVID-19 participants were performed on dream recall and nightmare frequency (DRF; NF). Also, non-parametric comparisons between controls and COVID-19 participants were carried out. Further, we compared psychological measures between the groups collected during pandemic. Ordinal logistic regression to detect the best predictors of NF was performed. Results We found that people reported greater dream activity during the pandemic. Comparisons between controls and COVID-19 participants revealed a) no difference between groups concerning DRF in the pre-pandemic period and during the pandemic; b) no difference between groups concerning nightmare frequency in the pre-pandemic period; and c) COVID-19 participants reported significantly higher NF than controls during pandemic (p = 0.003). Additionally, we showed that a) anxiety, depression, post-traumatic stress-disorder (PTSD) symptom scores were higher in COVID-19 participants than controls; and b) quality of life and health as well as wellbeing (WHO-5) scores were significantly higher in controls than COVID-19 participants. Finally, ordinal logistic regression indicates that DRF (p < 0.001), PTSD (p < 0.001), anxiety (p = 0.018), insomnia (p = 0.039), COVID-19 severity (p = 0.014), sleep duration (p = 0.003) and age (p = 0.001) predicted NF. Discussion Our work shows strong associations between increased nightmares in those reporting having had COVID-19. This suggests that the more that people were affected by COVID-19, the greater the impact upon dream activity and quality of life.

Dreams and nightmares during the pandemic

“…A multinational study found that the proportion of people who reported remembering dreams on three or more nights per week increased by 9% [ 8 ]. Also, participants with COVID-19 infections reported even higher rates of nightmares than others without an infection [ 31 ]. In one study comparing two timepoints, the first during a lockdown near the beginning of the pandemic in April 2020, and the second during a partial lockdown later in November 2020, at both timepoints, some of the participants stated experiencing changes in dream frequency.…”

“…Mental health problems and high dream recall were especially frequent in women and younger people [ 8 , 22 ]. COVID-19 infections also increase the risk for anxiety, depression, and PTSD [ 31 ]. Additional pandemic-related factors, like financial burden, social isolation, and subjective risks have also been identified to contribute to mental health and dream recall during the pandemic.…”

The Oneiric Activity during and after the COVID-19 Total Lockdown in Italy: A Longitudinal Study

“…Quantitative and emotional dream features were associated with pandemic-related factors, and the relationship between nightmares and greater risk of post-traumatic stress disorder (PTSD) was highlighted. This association is still stronger in people infected by COVID-19 [ 35 ].…”

Cognitive Impairment in Convalescent COVID-19 Patients Undergoing Multidisciplinary Rehabilitation: The Association with the Clinical and Functional Status

“…A number of neurological manifestations (e.g., myalgia, headache, dizziness, hyposmia, hypogeusia, ataxia-encephalitis, stroke, seizures, sleep problems) are considered both a direct effect of the virus infection on the central nervous system and the consequence of immune-mediated reactions during coronavirus disease 2019 (COVID-19) [ 1 , 2 , 3 ]. After recovery from the acute illness, many sequelae have been described [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. In the psychological and behavioral domains, a recent large-scale study [ 5 ] reported that the prevalence of long-lasting symptoms can be as high as 75% among hospitalized patients, and encompass persistent fatigue, muscle weakness, depression, and non-restorative sleep 6 months after recovery from COVID-19 [ 6 , 7 ].…”

“…In the psychological and behavioral domains, a recent large-scale study [ 5 ] reported that the prevalence of long-lasting symptoms can be as high as 75% among hospitalized patients, and encompass persistent fatigue, muscle weakness, depression, and non-restorative sleep 6 months after recovery from COVID-19 [ 6 , 7 ]. Moreover, COVID-19 survivors experience a range of symptoms of psychological distress, depression, anxiety, frequent nightmares and post-traumatic stress disorder (PTSD) [ 8 , 9 , 10 ]. Clinically relevant depression and anxiety were detected in about 30–40% of convalescent patients [ 2 ], and one-quarter of them had persisting symptoms even after 6 months [ 4 ], regardless of the need for hospitalization [ 10 ].…”