High nightmare frequency (≥1–2 nights/week) rose from 13.24% to 22.35% during the COVID-19 pandemic. Factors associated with high nightmare frequency included self-reported post-traumatic stress symptoms (OR=2.11), other mental disorders, sleep problems, financial burden, confinement, having had COVID-19, and work situation. Post-traumatic stress symptoms partly mediated the relationship between pandemic-related stressors and nightmare frequency. The authors conclude that the pandemic caused traumatization in a substantial proportion of society and suggest that health care workers screen for nightmares as an indicator of post-traumatic stress symptoms and other disorders.
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.
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.