210 Changes in Dream Recall During the COVID-19 Pandemic: Associations with Sleep, Stress and Dream Content

Abstract Introduction During the COVID-19 pandemic, individuals have faced unprecedented events, which are often stressful. Stress has an important impact on dreams, and stress-induced sleep difficulties may also impact dream recall. The present study evaluated associations between sleep, stress and dream content on dream recall during the pandemic.

Methods: A sample of N=419 US adults completed online surveys about sleep and COVID-19 experiences. Participants were asked if they remember more, fewer or about the same amount of dreams as before the pandemic. They were also asked whether the pandemic was associated with more stress, a more regular schedule, improved sleep, worse sleep, more early insomnia, more middle-of-the-night insomnia, more sleepiness, and more naps. They also completed the Insomnia Severity Index, Fatigue Severity Scale, Epworth Sleepiness Scale, Brief Index of Sleep Control, Assessment of Sleep Environment, GAD-7 anxiety scale, and PHQ9 depression scale. Multinomial logistic regressions examined correlates of increased or decreased recall (versus same), adjusted for age, sex, and race/ethnicity.

Results: Those who experienced greater schedule regularity were less likely to report decreased recall (RRR=0.50,p<0.0005), as were those who reported sleep improvement (RRR=0.48,p=0.006). Those whose sleep worsened were more likely to report both increased (RRR=1.64,p=0.003) and decreased (RRR=2.16,p<0.0005) recall. Those suffering maintenance insomnia were more likely to report both increased (RRR=1.70,p=0.001) and decreased (RRR=2.68,p<0.0005) recall, as did those who reported more daytime sleepiness (Increased RRR=1.57,p=0.006; Decreased RRR=1.94,p=0.001). Those whose dream content was more negative were more likely to report both increased (RRR=4.05,p<0.005) and decreased (RRR=3.35,p<0.0005) recall, as did those who reported less negative content (Increased RRR=4.20,p<0.0005; Decreased RRR=5.05,p<0.0005). Similarly, those who reported more positive dream content reported both increased (RRR=17.37,p<0.0005) and decreased (RRR=7.14,p=0.02) recall, as did those who reported less positive content (Increased RRR=4.49,p<0.0005; Decreased RRR=5.59,p<0.0005). Less recall was associated with greater insomnia severity (RRR=1.08,p=0.001), fatigue (RRR=1.04,p=0.001), sleepiness (RRR=1.09,p=0.01), COVID stress (RRR=1.67,p=0.03), anxiety (RRR=1.08,p=0.01), and depression (RRR=1.06,p=0.007), worse sleep environment (RRR=1.06,p=0.005), and less sleep control (RRR=0.56,p=0.001).

Conclusion: The results of this survey suggest that a sudden decrease in dream recall in reaction to a new stress could be considered as a pejorative indicator regarding sleep quality and mental health. Support (if any) R01MD011600, R01DA051321