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. 2022 Jan 24:14:93-108.
doi: 10.2147/NSS.S344299. eCollection 2022.

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

Serena Scarpelli  1 , Michael R Nadorff  2   3 , Bjørn Bjorvatn  4 , Frances Chung  5 , Yves Dauvilliers  6 , Colin A Espie  7 , Yuichi Inoue  8 , Kentaro Matsui  9   10 , Ilona Merikanto  11   12 , Charles M Morin  13 , Thomas Penzel  14 , Mariusz Sieminski  15 , Han Fang  16 , Tainá Macêdo  17 , Sérgio A Mota-Rolim  18 , Damien Leger  19 , Giuseppe Plazzi  20   21 , Ngan Yin Chan  22 , Markku Partinen  23 , Courtney J Bolstad  2 , Brigitte Holzinger  24   25 , Luigi De Gennaro  1   26
Affiliations

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

Serena Scarpelli et al. Nat Sci Sleep. .

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.

Keywords: COVID-19 severity; PTSD; anxiety; dreaming; pandemic; sleep.

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Conflict of interest statement

Dr Frances Chung reports personal fees as a consultant from Takeda Pharma, outside the submitted work. Professor Colin A Espie is a Co-Founder and Chief Scientist of, and a shareholder in, Big Health the company that that developed Sleepio a digital CBT intervention for insomnia. Professor Yuichi Inoue reports personal fees in speaking activity from Eisai Co., Ltd., Otsuka Pharmaceutical Co., Ltd, Takeda Pharmaceutical Company Limited, Astellas Pharma Inc., and MSD K.K.; in addition, Professor Yuichi Inoue also reports the Department of Somnology is an endowment department, supported by an unrestricted grant from Phillips Japan, Ltd and KOIKE MEDICAL Co., LTD, outside the submitted work. Dr Kentaro Matsui reports personal fees from Eisai, Meiji Seika Pharma, MSD, Otsuka, Yoshitomi, and Takeda, outside the submitted work. Professor Charles M Morin reports grants from Idorsia, Eisai, l’allemand Health, outside the submitted work; and royalties from Mapi Research Trust. Professor Thomas Penzel reports grants or personal fees for speaker fee and consultation from Cidelec, Phasya, Neuwirth, Jazz, Cerebra, and National Sleep Foundation. He also owns shares from The Siesta Group, outside the submitted work. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Oneiric frequency changes between pre-pandemic and pandemic period. (A) shows the results of non-parametric (within) comparisons on Dream Recall Frequency (DRF) between pre-pandemic (black bars) vs pandemic period (grey bars), performed separately for the controls and COVID-19 group. (B) depicts the results of non-parametric comparisons on Nightmare Frequency (NF) between pre-pandemic (black bars) vs pandemic period (grey bars) performed separately for the controls and COVID-19 group. Error bars represent the standard errors. Significant results are asterisked. ***p<0.001.
Figure 2
Figure 2
Oneiric frequency differences between controls and COVID-19 participants. (A) shows the results of non-parametric (between) comparisons on Dream Recall Frequency (DRF) between controls (black bars) vs COVID-19 participants (grey bars), performed separately for the pre-pandemic and pandemic period. (B) depicts the results of non-parametric comparisons on Nightmare Frequency (NF) between controls (black bars) vs COVID-19 participants (grey bars) performed separately for the pre-pandemic and pandemic period. Error bars represent the standard errors. Significant results are asterisked. **p<0.01.
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