Reduced Sleep Duration and Sleep Efficiency Were Independently Associated With Frequent Nightmares in Chinese Frontline Medical Workers During the Coronavirus Disease 2019 Outbreak.
Yi-Qi Lin, Ze-Xin Lin, Yong-Xi Wu, Lin Wang, Zhao-Nan Zeng, Qiu-Yang Chen, Ling Wang, Xiao-Liang Xie, Shi-Chao Wei
Frontiers in Neuroscience January 20, 2021 DOI: 10.3389/fnins.2020.631025 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional survey Peer reviewed |
|---|---|
| Sample size | 528 |
| Population | Frontline health-care workers from Fujian province providing medical aid in Wuhan during the COVID-19 outbreak (114 doctors and 414 nurses) |
| Measures | Pittsburgh Sleep Quality Index (PSQI), 12-item General Health Questionnaire (GHQ-12) |
| Topics | Dreaming |
| Keywords | Sleep duration Sleep efficiency Covid-19 Frontline medical workers Frequent nightmares |
| Key findings | Frequent nightmares were reported by 27.3% of frontline medical workers and were independently associated with reduced sleep duration (OR = 1.96) and reduced sleep efficiency (OR = 2.17) after adjustment; having both was associated with higher odds (OR = 2.70). The authors argue that nightmares and possible ensuing PTSD symptoms warrant attention in workers with reduced sleep duration or efficiency facing potential traumatic exposure. |
Abstract
Objectives: Nightmares were related to emotion and behavioral problems and also emerged as one of the core features of post-traumatic stress disorder (PTSD). Our study aimed to investigate the associations of frequent nightmares with sleep duration and sleep efficiency among frontline medical workers in Wuhan during the coronavirus disease 2019 (COVID-19) outbreak.
Methods: A total of 528 health-care workers from the province of Fujian providing medical aid in Wuhan completed the online questionnaires. There were 114 doctors and 414 nurses. The age, sex, marital status, and work situation were recorded. A battery of scales including the Pittsburgh Sleep Quality Index (PSQI) and the 12-item General Health Questionnaire (GHQ-12) were used to evaluate subjects' sleep and general mental health. Frequent nightmares were defined as the response of at least once a week in the item of "nightmare" of PSQI.
Results: Frequent nightmares were found in 27.3% of subjects. The frequent nightmare group had a higher score of PSQI-sleep duration and PSQI-habitual sleep efficiency (frequent nightmares vs. non-frequent nightmares: PSQI-sleep duration, 1.08 ± 0.97 vs. 0.74 ± 0.85, P < 0.001; PSQI-habitual sleep efficiency, 1.08 ± 1.10 vs. 0.62 ± 0.88, P < 0.001). Reduced sleep duration and reduced sleep efficiency were independently associated with frequent nightmares after adjustment for age, sex, poor mental health, and regular sleeping medication use (reduced sleep duration: OR = 1.96, 95% CI = 1.07-3.58, P = 0.029; reduced sleep efficiency: OR = 2.17, 95% CI = 1.09-4.32, P = 0.027). Subjects with both reduced sleep duration and sleep efficiency were also associated with frequent nightmares (OR = 2.70, 95% CI = 1.57-4.65, P < 0.001).
Conclusion: The present study found that sleep duration and sleep efficiency were both independently associated with frequent nightmares among frontline medical workers in Wuhan during the COVID-19 pandemic. We should pay attention to nightmares and even the ensuing PTSD symptoms among subjects with reduced sleep duration or sleep efficiency facing potential traumatic exposure.
Comparable studies
Other cross-sectional and survey studies on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Insomnia Symptoms, Nightmares, and Suicidal Ideation in a College Student Sample Undergraduate students at a large, public university in the southeastern United States | 2011 | Observational cross-sectional survey | n = 583 |
| Prevalence and Correlates of Frequent Nightmares: A Community-Based 2-Phase Study Middle-aged Hong Kong Chinese adults from the community, mean age 40.9 years (SD 5.5,... | 2010 | Cross-sectional survey with subsequent clinical evaluation (two-phase design) | n = 8,558 |
| Factors of home dream recall: a structural equation model Adults (general population sample) | 2003 | Cross-sectional survey with structural equation modeling | n = 444 |
| The Phenomenology of Lucid Dreaming: An Online Survey Respondents to an online survey about lucid dreams | 2014 | Online survey | n = 684 |
| Frequency of Lucid Dreaming in a Representative German Sample Representative sample of German adults | 2011 | Cross-sectional survey | n = 919 |
Citations in the library
Cited by 7
- Dreaming during COVID-19: the effects of a world trauma Research in Psychotherapy Psychopathology Process and Outcome August 24, 2021
- Nightmare Relief: Implementing Imagery Rehearsal Therapy in Counseling Journal of Mental Health Counseling April 1, 2025
- Nightmare distress, insomnia and resilience of nursing staff in the post-pandemic era AIMS Public Health December 18, 2023
- An observatory on changes in dreaming during a pandemic: a living systematic review (part 1). Journal of Sleep Research June 1, 2023
- Nightmare frequency and nightmare distress during the COVID-19 pandemic. Journal of Clinical Sleep Medicine 2023
and 2 more in the library
Cites 9
- Prevalence and Correlates of Frequent Nightmares: A Community-Based 2-Phase Study Sleep June 1, 2010
- Nightmares in the general population: identifying potential causal factors Social Psychiatry and Psychiatric Epidemiology July 15, 2017
- Increased Awakenings From Non-rapid Eye Movement Sleep Explain Differences in Dream Recall Frequency in Healthy Individuals Frontiers in Human Neuroscience October 15, 2019
- Sleep extension: an explanation for increased pandemic dream recall? Sleep September 4, 2020
- Dream Recall upon Awakening from Non-Rapid Eye Movement Sleep in Older Adults: Electrophysiological Pattern and Qualitative Features. Brain Sciences June 3, 2020
and 4 more in the library