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

Serena Scarpelli; Michael R Nadorff; Bjørn Bjorvatn; Frances Chung; Yves Dauvilliers; Colin A Espie; Yuichi Inoue; Kentaro Matsui; Ilona Merikanto; Charles M Morin; Thomas Penzel; Mariusz Sieminski; Han Fang; Tainá Macêdo; Sérgio A Mota-Rolim; Damien Leger; Giuseppe Plazzi; Ngan Yin Chan; Markku Partinen; Courtney J Bolstad; Brigitte Holzinger; Luigi De Gennaro

doi:10.2147/NSS.S344299

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

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

Authors

Serena Scarpelli¹, Michael R Nadorff^{2

3}, Bjørn Bjorvatn⁴, Frances Chung⁵, Yves Dauvilliers⁶, Colin A Espie⁷, Yuichi Inoue⁸, Kentaro Matsui^{9

10}, Ilona Merikanto^{11

12}, Charles M Morin¹³, Thomas Penzel¹⁴, Mariusz Sieminski¹⁵, Han Fang¹⁶, Tainá Macêdo¹⁷, Sérgio A Mota-Rolim¹⁸, Damien Leger¹⁹, Giuseppe Plazzi^{20

21}, Ngan Yin Chan²², Markku Partinen²³, Courtney J Bolstad², Brigitte Holzinger^{24

25}, Luigi De Gennaro^{1

26}

Affiliations

¹ Department of Psychology, Sapienza University of Rome, Rome, Italy.
² Mississippi State University, Mississippi State, MS, USA.
³ Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
⁴ Department of Public Health and Primary Care, University of Bergen and Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.
⁵ Department of Anesthesiology and Pain Medicine, University Health Network, University of Toronto, Toronto, Canada.
⁶ Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, INM, Univ Montpellier, INSERM, Montpellier, France.
⁷ Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
⁸ Tokyo Medical University, Tokyo, Japan.
⁹ Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan.
¹⁰ Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan.
¹¹ SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
¹² Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland.
¹³ École de Psychologie, Centre d'étude des troubles du sommeil, Centre de recherche CERVO/Brain Research Center, Université Laval, Québec, Canada.
¹⁴ Sleep Medicine Center, Charité Universitätsmedizin Berlin, Berlin, Germany.
¹⁵ Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland.
¹⁶ Department of Pulmonary and Critical Care Medicine, Peking University People's Hospital, Beijing, People's Republic of China.
¹⁷ Department of Psychology, Federal University of Rio Grande do Norte, Natal, Brazil.
¹⁸ Brain Institute, Physiology and Behavior Department, and Onofre Lopes University Hospital - Federal University of Rio Grande do Norte, Natal, Brazil.
¹⁹ Université de Paris, APHP, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, Paris, France.
²⁰ IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
²¹ Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
²² Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Regions, People's Republic of China.
²³ Helsinki Sleep Clinic, Terveystalo Healthcare, and Department of Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland.
²⁴ Institute for Consciousness and Dream Research, Vienna, Austria.
²⁵ Medical University Vienna, Postgraduate Master Program Medical Sleep Coaching, ZK-Schlafcoaching, Vienna, Austria.
²⁶ IRCCS Fondazione Santa Lucia, Rome, Italy.

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.

Grants and funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.