198 COVID-19 Pandemic Nightmares at the US-Mexico Border

Abstract Introduction The COVID-19 pandemic has impacted individuals in many ways, including anecdotal reports of nightmares. However, little data exists regarding the experience of COVID-related nightmares, especially among the distressed population at the US-Mexico Border. This is especially relevant given the clinical importance of nightmares as risk factors for poor mental health and sleep disturbances.

Methods: Participants were N=155 individuals who completed the Nogales Cardiometabolic Health and Sleep (NOCHES) and were contacted about completing a COVID sub-study (95% Hispanic/Latino). Participants were asked for the number of nightmares that they have experienced since the pandemic started. They were also asked whether they had nightmares about confinement, claustrophobia, suffocation, oppression, drowning, failure, helplessness, natural disasters, anxiety, evil forces, war, separation from loved ones, being chased, sickness, death, COVID, and apocalypse. They were also asked whether they experienced, due to the pandemic, increased general, financial, food, housing, familial, relationship, and media-related stress. Each of these items was coded from 0 (“Strongly Disagree”) to 3 (“Strongly Agree”), with total scores ranging from 0-21. Regression analyses (linear for frequency and binary logistic for content) examined stress score as independent variable, adjusted for age, sex, financial status, education, and mental health (PHQ4).

Results: Those who experienced greater pandemic-related stress reported more nightmares (age/sex-adjusted B=0.23, p<0.0005, fully-adjusted B=0.23, p<0.0005). They were also more likely to have nightmares about confinement (adjusted odds ratio [OR]=1.69, p=0.008), suffocation (OR=1.41, p=0.020), failure (OR=1.23, p=0.049), being chased (OR=1.24, p=0.013), sickness (OR=1.26, p=0.022), and COVID (OR=1.37, p=0.003).

Conclusion: Those who experienced more pandemic-related stress reported more nightmares, even after adjusting for depression/anxiety symptoms. In addition, those with more pandemic-related stress were more likely to have nightmares about COVID itself, as well as confinement and suffocation, being chased, failure, and sickness in general. Perhaps efforts to reduce pandemic-related stress will reduce these nightmare experiences, which may have beneficial effects on other areas of mental health. Support (if any) R01MD011600, R01DA051321