Journal of Sleep Research
April 1, 2026
Severin Ableidinger, Luigi De Gennaro, Sérgio Mota-Rolim et al.
During the COVID-19 pandemic, about 30% of people frequently knew they were dreaming (lucid dreaming), and roughly half of those (17%) could influence their dreams (lucid dreaming with agency). Female gender and anxiety symptoms were linked to less ability to influence dreams, while dream recall, nightmares, insomnia, dream enactment behavior, sleep vocalization, short and long COVID, and PTSD were linked to more ability. Older age, dream recall, nightmares, and anxiety were linked to lucid dreaming without agency, while short sleep, being an evening type, and short COVID were linked to less of it. The different patterns suggest lucid dreaming with and without agency may be distinct sleep states, and this is the first study showing COVID-19 and long COVID are associated with lucid dreaming.
Journal of Sleep Research
February 1, 2026
Courtney J Bolstad, Bjørn Bjorvatn, Ngan Yin Chan et al.
In a large multi-country survey of 15,854 adults, frequent dream recall (at least weekly) was reported by 54.0% of participants in 2021 and 51.1% in 2019. Frequent nightmares rose from 6.9% in 2019 to 11.0% in 2021, suggesting an increase during the COVID-19 pandemic. Dream recall showed a linear relationship with sleep duration, while nightmare frequency had a quadratic relationship. Prevalence rates varied by age, gender, and country. This is the first multi-continent study to provide these prevalence estimates across 16 countries, including some never studied before.
Current Psychiatry Reports
November 1, 2025
Christine J So, Courtney J Bolstad, Katherine E Miller
Nightmares that persist after trauma often require targeted treatment, as trauma-focused therapies for PTSD may not fully resolve them. Imagery rehearsal therapy and the medication prazosin remain the most supported interventions, though results vary across studies. New consensus guidelines have produced Cognitive Behavioral Therapy for Nightmares, which combines rescripting, exposure, and sleep strategies. Emerging approaches such as digital self-management, brief coaching, lucid dreaming, and targeted memory reactivation show promise. Integrated treatments that sequence nightmare care with PTSD or insomnia therapies may improve outcomes, but evidence is mixed. The field needs standardized CBT-based approaches, consistent outcome measurement, and research on mechanisms and sequencing to optimize and expand access to nightmare treatment.
Journal of Sleep Research
October 1, 2024
Courtney J Bolstad, Brigitte Holzinger, Serena Scarpelli et al.
During the COVID-19 pandemic, suicidal ideation was 2% lower overall than before, while nightmare frequency increased by 4.50%. Data from 9328 individuals across 16 countries showed that suicidal ideation decreased significantly in Austria, Sweden, and Bulgaria but rose non-significantly in Italy and Portugal. Participants with long-COVID reported higher rates of suicidal ideation (21.10%) than those with short-COVID (12.40%), though ideation did not differ by COVID-19 history alone. Nightmare frequency was higher in those with prior COVID-19 (14.50% vs. 10.70%), during active infection (23.00% vs. 8.10%), and in long-COVID (18.00% vs. 8.50%). Frequent nightmares during the pandemic increased the odds of suicidal ideation (OR = 1.
Nature and Science of Sleep
January 1, 2022
Serena Scarpelli, Michael R Nadorff, Bjørn Bjorvatn et al.
People reported more dream activity during the pandemic than before it. Those who had COVID-19 reported significantly more nightmares during the pandemic than matched controls who had not had COVID-19, while dream recall frequency did not differ between the groups. COVID-19 participants also had higher anxiety, depression, and PTSD symptom scores, and lower quality of life and well-being scores than controls. Nightmare frequency was predicted by dream recall frequency, PTSD, anxiety, insomnia, COVID-19 severity, sleep duration, and age. The findings suggest that the more severely people were affected by COVID-19, the greater the impact on dream activity and quality of life.
Dreaming (New York, N.Y.)
September 1, 2021
Christina Pierpaoli-Parker, Courtney J Bolstad, E. Szkody et al.
Imagery rehearsal therapy (IRT) reduced nightmares and, according to the patient and her husband, decreased dream enactment in a person with both nightmare disorder and REM sleep behavior disorder (RBD). Five sessions of IRT over five months led to fewer nightmares and less dream enactment. The authors suggest that lowering the emotional intensity of dream content may make dream enactment less likely, and that IRT could serve as a helpful addition to medication for RBD.
Nature and Science of Sleep
January 1, 2021
Eirin Fränkl, Serena Scarpelli, Michael R Nadorff et al.
Dream recall frequency increased during the COVID-19 pandemic compared to pre-pandemic levels across four continents. In a cross-sectional web survey of 19,355 individuals from 14 countries, high dream recall (three or more nights per week) was associated with female gender, nightmares, sleep talking, sleep maintenance problems, symptoms of REM sleep behavior disorder, and repeated disturbing thoughts indicative of PTSD. Older adults aged 55-64 reported less high dream recall than younger participants. While unadjusted analyses showed associations between depression, anxiety, and dream recall, adjusted analyses revealed negative associations: depression and anxiety were linked to lower odds of high dream recall. The findings suggest that the pandemic's emotional intensity is reflected in dreams.