The return to normal life: sleep, anxiety upon awakening, and nightmares following the crisis caused by the COVID-19 pandemic

After the COVID-19 pandemic, a survey of 501 adults in Spain found that 46.5% recalled at least one dream scene, and nightmares occurred in 4.6% of cases—rates similar to before and during lockdown. Compared with earlier periods, people reported more anxious dreams and greater dream recall, and sleep duration returned to 6–7 hours. However, anxiety upon awakening remained elevated, indicating that full normalization had not yet occurred. Nightmare frequency was less sensitive than morning anxiety to post-pandemic emotional activation, consistent with the idea that emotional dream content did not necessarily cause awakenings.

Study at a glance

Abstract

Introduction: The return to normal life following the COVID-19 pandemic was evaluated in terms of anxiety upon awakening, sleep quality indicators, and dream characteristics. Methods: The sample comprised 394 women and 107 men who completed an online self-report questionnaire between August 15, 2022, and December 8, 2022 about their sleep and dream experience from the previous night. Respondents completed the Anxiety upon Awakening Assessment Questionnaire (CEAD, as per the Spanish acronym) and evaluated their experiences of the pandemic. The data were compared to those obtained before the pandemic and those collected during lockdown in a previous study. Results: After the return to normal life, 46.5% of respondents recalled at least one dream scene, and nightmares were recorded in 4.6% of cases. This percentage did not differ significantly from those observed during lockdown or before the pandemic. Compared with the previous periods, participants also reported more dreams with anxious content and greater dream recall. A return to a sleep duration of between 6 and 7 h was observed. However, anxiety upon awakening was higher, suggesting that full normalization had not yet occurred at the time of this study. Conclusion: In this sample, nightmare frequency was less sensitive than anxiety upon awakening to post-pandemic sleep-related emotional activation. The findings may be compatible with emotional-processing accounts of dreaming and with a homeostatic interpretation of sleep in which emotional dream content did not translate into more awakenings.