Dream Experiences During Intensive Care Unit Stay: Occurrence, Content, Vividness and Associated Factors

Vivid dream experiences are common among intensive care unit (ICU) patients and often carry a negative emotional impact. In a retrospective survey of 80 adults previously admitted to the ICU for at least four days or due to COVID-19, 79% reported dream experiences, with 73% describing them as life-like, 49% associating them with negative emotions, and 54% saying the dreams affected them even after waking. Dream content frequently related to the ICU admission. Younger age and longer ICU stay were linked to vivid dreams. Many participants also experienced delirium or perceptual disturbances, and some had difficulty distinguishing these from dreams. The findings suggest that providing anticipatory support may help patients process these experiences during recovery.

Study at a glance

Abstract

BACKGROUND: Vivid dream experiences in the intensive care unit (ICU) are common, but poorly understood. AIM: We investigated the occurrence, vividness, content, emotional impact and associated factors of dream experiences in the ICU. STUDY DESIGN: Retrospective mixed methods study with subjects ≥ 18 years, previously admitted to the ICU for ≥ 4 days and/or due to COVID-19, who were not sedated for ≥ 24 h during their stay (n = 80). Participants answered a retrospective questionnaire by telephone. Clinical data were collected from electronic health records. RESULTS: The questionnaires were taken a median of 9 months post-discharge. Dream experiences were reported by 79%. Of participants who recollected dream experiences, 73% reported "life-like" dreams, 49% associated their dreams with negative emotions and 54% said their dreams impacted them even after awaking. Some participants (28.6%) continued to have similar dreams at home. After being asked if they had additional comments, some participants suggest receiving information during their hospital stay about the potential for vivid dream experiences could be beneficial. The dream content was often related to the ICU admission. Younger age and longer length of stay were related to vivid dream experiences. Of participants with dream experiences 62.5% had experienced delirium during their ICU stay. Perceptual disturbances were also frequently reported by participants (50%) and only 45% could clearly distinguish them from dream experiences. There was an overlap between participants reporting perceptual disturbances and confirmed delirium (70%). CONCLUSIONS: Vivid dream experiences are common in ICU patients and often have a negative emotional impact. Future studies should dive deeper into effective ways to distinguish dreams, delirium and perceptual disturbances and how to reduce their impact. RELEVANCE TO CLINICAL PRACTICE: ICU nurses should be aware of the occurrence and psychological burden of vivid negative dreams in ICU patients. Providing anticipatory support may help patients process these experiences during recovery.