Fever dream: COVID-19 pandemic fuels nightmares

Distressing dreams about the novel coronavirus (COVID-19) pandemic are relatively common under lockdown, according to a recent Finland study.

“[W]e applied a network analysis to explore dream content during COVID-19 lockdown,” the researchers said. “We found several pandemic-specific dream contents and dream imagery that were associated with a variety of distressing events.”

On 27 April 2020, around 6 weeks after the COVID-19 lockdown restrictions went into force in Finland, the researchers sent out their crowdsourcing (CS) survey, in collaboration with the most widely circulated newspaper in the country. The questionnaire looked at changes in sleep duration, awakenings, and nightmare frequency, among other parameters, since the lockdown had started.

This outreach effort returned 4,725 respondents (mean age, 43±14 years; 79 percent female), of whom 811 reported their dream content. Most (56 percent) of the participants reported a spike in stress levels ever since the lockdown was enforced, which was true to a significantly greater degree in females (p<0.001). [Front Psychol 2020;doi:10.3389/fpsyg.2020.573961]

In turn, an increase in perceived stress correlated significantly with longer sleep latency, more nightly awakenings, a disturbed sleep rhythm, and more frequent nightmares (p<0.001).

Thirty-three unique dream clusters were found during dream content analysis, though there were more themes among participants who reported increasing stress levels since lockdown measures were put in place (27 vs 11).

While many dreams were typical of nightmares, with themes such as falling or the death of a loved one, the researchers observed subsets that were highly specific to the pandemic.

For example, in the analysis of all survey respondents, a cluster of dreams about the failure to adhere to the distancing directives was found. The answers tended to contain the words “handshake,” “distancing,” “hug,” and “mistake.” Another cluster of dreams was about fears of missing a trip due to overcrowding and travel difficulties associated with the lockdown.

Disaggregating according to stress levels, the researchers saw that participants who reported increasing stress had pandemic-specific nodes in their dream content clusters, while themes in those who reported stable or decreasing stress levels tended to be more idiopathic.

“The impact of lockdown on sleep quality was twofold,” the researchers said. “The majority of the respondents reported having a longer sleep duration, and almost a third reported having more regular sleep rhythms during the lockdown compared to the prelockdown situation, likely reflecting alleviated pressure in scheduling due to working from home.”

However, these seeming improvements in sleep parameters came with more frequent sleep complaints, including more awakenings at night and more nightmares.

“Because sleep disturbances and nightmares are known to predict depression and a range of other mental health problems a consequence of the COVID-19 pandemic may be that mental health is being impaired around the world,” they added. [Psychol Bull 2016;142:969-990; Sleep 2010;33:774-780; Sleep 2015;38:507-514]