The role of sleep and dreams in long-COVID.

Recent investigations show that many people affected by SARS-CoV2 (COVID-19) report persistent symptoms 2-3 months from the onset of the infection. Here, we report the Italian findings from the second International COVID-19 Sleep Study survey, aiming to investigate sleep and dream alterations in participants with post-acute symptoms, and identify the best determinants of these alterations among patients with long-COVID. Data from 383 participants who have had COVID-19 were collected through a web-survey (May-November 2021). Descriptive analyses were performed to outline the sociodemographic characteristics of long-COVID (N = 270, with at least two long-lasting symptoms) and short-COVID (N = 113, with none or one long-lasting symptom) participants. They were then compared concerning sleep and dream measures. We performed multiple linear regressions considering as dependent variables sleep and dream parameters discriminating the long-COVID group. Age, gender, work status, financial burden, COVID-19 severity and the level of care were significantly different between long-COVID and short-COVID subjects. The long-COVID group showed greater sleep alterations (sleep quality, daytime sleepiness, sleep inertia, naps, insomnia, sleep apnea, nightmares) compared with the short-COVID group. We also found that the number of long-COVID symptoms, psychological factors and age were the best explanatory variables of sleep and oneiric alterations. Our findings highlight that sleep alterations are part of the clinical presentation of the long-COVID syndrome. Moreover, psychological status and the number of post-acute symptoms should be considered as state-like variables modulating the sleep problems in long-COVID individuals. Finally, according to previous investigations, oneiric alterations are confirmed as a reliable mental health index.

Dreaming for the World: A Jungian Study of Dreams During the COVID‐19 Pandemic

This project explores what dreams might reveal about the collective psyche’s response to the COVID‐19 pandemic in its first year, before the development of vaccines. A brief survey, distributed to Jungian colleagues and organizations, and to various social media sites, invited people to submit online a dream related to the COVID‐19 pandemic. Four hundred and thirty‐six dreams were submitted. Forty additional Russian dreams were collected and submitted by Russian colleagues. Using qualitative research methods based on phenomenological hermeneutics, the researchers categorized and counted the range of COVID imagery. In addition, the researchers describe a range of psychic responses to the pandemic, including horror, grief, sickness, social discord, and violence, but also images of healing and transformation, increased sense of community, and spiritual renewal. Several healing nightmares are presented. Healing alchemical and anima/animus imagery is described. Twelve dreams are introduced and presented. It is concluded that the collective psyche, rooted in the Self, is a healing resource for social and cultural trauma. This project supports Beradt’s (1968) inspirational study of dreaming in Nazi Germany, as well as recent studies of COVID‐related dreams and recent publications on the social nature of dreaming.Alternate :Ce projet explore ce que les rêves peuvent révéler en ce qui concerne la réponse de la psyché collective à la pandémie de COVID‐19 dans sa première année, avant le développement des vaccins. Un court questionnaire, distribué à des collègues et des organisations Jungiennes, et à divers sites de réseaux sociaux, invitait les personnes à mettre en ligne un rêve en lien avec la pandémie de COVID‐19. Quatre cent trente‐six rêves ont été mis en ligne. D’autre part quarante rêves ont été collectés et mis en ligne par des collègues Russes. En utilisant les méthodes de recherche qualitative fondées sur l’herméneutique phénoménologique, les chercheurs ont établi des catégories et ont dénombré la variété de l’imagerie liée au COVID. De plus, les chercheurs ont décrit un certain nombre de réponses psychiques à la pandémie, par exemple l’horreur, le chagrin, la maladie, la discorde sociale et la violence, mais également des images de guérison et de transformation, un sentiment accru de communauté, et du renouveau spirituel. Plusieurs cauchemars de guérison sont présentés. L’imagerie de la guérison alchimique et celle liée à l’anima/animus est décrite. Douze rêves sont décrits et présentés. La conclusion apportée est que la psyché collective, enracinée dans le Soi, est une ressource de guérison en ce qui concerne le traumatisme social et culturel. Ce projet soutient l’étude inspirante de Beradt (1968) de rêves dans l’Allemagne Nazie, ainsi que des études récentes de rêves en lien avec la COVID et des publications récentes sur la nature sociale du rêve.Alternate :Dieses Projekt untersucht, was Träume über die Reaktion der kollektiven Psyche auf die COVID‐19‐Pandemie im ersten Jahr vor der Entwicklung von Impfstoffen verraten könnten. Eine kurze Umfrage, die an Jungianische Kollegen und Organisationen sowie an verschiedene Social‐Media‐Sites verteilt wurde, lud Menschen ein, online einen Traum im Zusammenhang mit der COVID‐19‐Pandemie einzureichen. Vierhundertsechsunddreißig Träume wurden eingereicht. Vierzig weitere russische Träume wurden gesammelt und von russischen Kollegen zugesandt. Unter Verwendung qualitativer Forschungsmethoden auf der Grundlage phänomenologischer Hermeneutik kategorisierten und zählten die Forscher die Bandbreite der COVID‐Bilder. Darüber hinaus beschreiben die Forscher eine Reihe psychischer Reaktionen auf die Pandemie, darunter Entsetzen, Trauer, Krankheit, soziale Zwietracht und Gewalt, aber auch Bilder von Heilung und Transformation, gesteigertem Gemeinschaftsgefühl und spiritueller Erneuerung. Mehrere heilende Albträume werden präsentiert. Heilend alchemistische und Anima/Animus‐Bilder werden beschrieben. Zwölf Träume werden vorgestellt und präsentiert. Es wird der Schluß gezogen, daß die im Selbst verwurzelte kollektive Psyche eine heilende Ressource für soziale und kulturelle Traumata darstellt. Dieses Projekt unterstützt Beradts (1968) inspirierende Studie über das Träumen in Nazi‐Deutschland sowie neuere Studien zu COVID‐bezogenen Träumen und neuere Veröffentlichungen über die soziale Natur des Träumens.Alternate :Questo progetto esplora cosa possono rivelare i sogni sulla risposta della psiche collettiva alla pandemia di COVID‐19 nel suo primo anno, prima dello sviluppo dei vaccini. Un breve sondaggio, distribuito a colleghi e organizzazioni junghiane, e a vari siti di social media, ha invitato le persone a presentare online un sogno legato alla pandemia di COVID‐19. Sono stati inviati 436 sogni. Altri quaranta sogni russi sono stati raccolti e inviati da colleghi russi. Usando metodi di ricerca qualitativa basati sull’ermeneutica fenomenologica, i ricercatori hanno categorizzato e contato l’assortimento dell’immaginario relativo al COVID‐19. Inoltre, i ricercatori descrivono una serie di risposte psichiche alla pandemia, incluso orrore, dolore, malattia, tensione sociale e violenza, ma anche immagini di guarigione e trasformazione, maggiore senso di comunità , e rinnovamento spirituale. Vengono presentati diversi incubi che sono stati terapeutici. Vengono descritte la guarigione alchemica e le immagini di anima/animus. Vengono introdotti e presentati dodici sogni. Gli Autori concludono che la psiche collettiva, radicata nel Sé, è una risorsa curativa per il trauma sociale e culturale. Questo progetto supporta lo stimolante studio di Berardt (1968) sui sogni nella Germania nazista, così come studi recenti sui sogni legati al COVID‐19 e con le recenti pubblicazioni sulla natura sociale dei sogni.Alternate :Ð' этом проекте исследуется, что могут рассказать сновидения о реакции коллективной психики на пандемию COVID‐19 в течение первого года, до того, как были разработаны вакцины. Ð' краткой анкете, рассылавшейся юнгианским коллегам и организациям, а также размещенной в социальных сетях, респондентам предлагалось предоставить в электронном виде свои сновидения, связанные с пандемией COVID‐19. Было прислано четыреста тридцать шесть сновидений. Еще сорок сновидений на русском языке было собрано и предоставлено российскими коллегами. Используя качественные методы исследования, основанные на феноменологической герменевтике, исследователи произвели подсчеты и классификацию и получили диапазон образов COVID. Кроме того, исследователи описали целый ряд психологических реакций на пандемию, среди которых ужас, горе, заболевания, социальные разногласия и насилие, но вместе с тем и образы исцеления и трансформации, усиленное чувства общности и духовное обновление. Описывается ряд кошмарных сновиденийс целебным эффектом. Приведены исцеляющие алхимические образы анимы/анимуса. Подробно представлено двенадцать сновидений. Исследователи приходят к заключению, что Ñ€ÐµÑ ÑƒÑ€ÑÐ¾Ð¼ для исцеления социальных и культурных травм является коллективная психика, опирающаяся на Самость. Ð'ыводы проекта подтверждают результаты вдохновляющего исследования Берадта о сновидениях в нацистской Ð"ермании (1968), а также недавних исследований сновидений, связанных с COVID, и публикаций о социальной природе сновидений.Alternate :Este proyecto explora lo que los sueños podrían revelar sobre la respuesta de la psique colectiva a la pandemia de COVID‐19 en su primer año, antes del desarrollo de las vacunas. A través de una breve encuesta, distribuida entre colegas y organizaciones Junguianas, así como en diversas redes sociales, se invitó a la gente a enviar en línea un sueño relacionado con la pandemia de COVID‐19. Se presentaron 436 sueños. Otros cuarenta sueños rusos fueron posteriormente recogidos y enviados por colegas rusos. Utilizando métodos de investigación cualitativa basados en la hermenéutica fenomenológica, los investigadores categorizaron y contaron una gama de imágenes de COVID. Además, los investigadores describen una serie de respuestas psíquicas a la pandemia, que incluyen horror, dolor, enfermedad, discordia social y violencia, pero también imágenes de curación y transformación, aumento del sentido de comunidad y renovación espiritual. Se presentan varias pesadillas curativas. Se describen imágenes alquímicas curativas y de anima/animus. Se introducen y presentan doce sueños. Se concluye que la psique colectiva, enraizada en el Self, es un recurso curativo para el trauma social y cultural. Este proyecto apoya el inspirador estudio de Beradt (1968) sobre los sueños en la Alemania nazi, así como estudios recientes sobre los sueños relacionados con el COVID y con publicaciones recientes sobre la naturaleza social de los sueños.Alternate :为世界做梦:æ–°å† ç–«æƒ…æœŸé—´æ¢¦å¢ƒçš„è£æ ¼å­¦æ´¾ç ”ç©¶è¿™ä¸ªé¡¹ç›®æŽ¢è®¨äº†æ¢¦å¢ƒå¦‚ä½•æ­ç¤ºé›†ä½"心灵对COVID‐19疫情所做出的反应, 这些梦境发生在疫情第一年, åœ¨ç–«è‹—å¼€å‘ä¹‹å‰ã€‚æœ¬ç ”ç©¶å‘è£æ ¼å­¦æ´¾åŒè¡Œå'Œç»„织, 以及通过各种社会åª'ä½"网站分发了一份简短的调查, 邀请人们在线提交与COVID‐19疫情有关的梦。共收集到四百三十六个梦。另外还收集了40个俄罗斯人的梦, å¹¶ç”±ä¿„ç½—æ–¯åŒäº‹æäº¤ã€‚ç ”ç©¶ä½¿ç”¨äº†åŸºäºŽçŽ°è±¡å­¦è¯ é‡Šå­¦çš„å®šæ€§ç ”ç©¶æ–¹æ³•, ç ”ç©¶äººå‘˜å¯¹ä¸Žæ–°å† ç›¸å…³çš„æ„è±¡è¿›è¡Œäº†åˆ†ç±»å'Œç»Ÿè®¡ã€‚此外, ç ”ç©¶äººå‘˜è¿˜æè¿°äº†æ¢¦ä¸­äººä»¬å¯¹ç–«æƒ…åšå‡ºçš„ä¸€ç³»åˆ—å¿ƒç†ååº”, 包括恐怖、悲伤、疾病、社会不å'Œè°å'Œæš´åŠ›, 但也有治愈å'Œè½¬å˜çš„意象、增强的社区感å'Œç²¾ç¥žæ›´æ–°çš„æ„è±¡ã€‚ç ”ç©¶ä»‹ç»äº†å‡ ä¸ªå¸¦æœ‰æ²»æ„ˆæ€§çš„å™©æ¢¦ã€‚æè¿°äº†æ²»æ„ˆæ€§çš„ç‚¼é‡‘æœ¯å'Œé˜¿å°¼çŽ›/阿尼玛斯意象。介绍并展示了12个梦。ç»"论是, æ¤æ ¹äºŽ “自性”的集ä½"心灵是治疗社会å'Œæ–‡åŒ–创伤的一种资源。这个项目的ç»"果支持了Beradt(1968)在纳粹德国的梦境的é¼"èˆžäººå¿ƒçš„ç ”ç©¶ç»"æžœ, ä¹Ÿä¸Žæœ€è¿‘å…³äºŽæ–°å† æ¢¦å¢ƒç ”ç©¶çš„ç»"æžœ, 及最近发表的关于梦境的社会性质的ç»"果一致。

PANDEMIC DREAMS ARE SUSCEPTIBLE TO PRIMING AND UNRELATED TO COVID-19 EXPOSURE

Surveys that have recruited participants through social media and news websites have led researchers and clinicians to conclude that the COVID-19 pandemic has precipitated a parallel pandemic of nightmares that reflect pandemic-induced psychological distress. Many of these surveys were administered to participants who intentionally opted into research knowing that the investigators were soliciting pandemic dream reports. This investigation surveyed 193 college students who were blind to the purpose of the study to assess the prevalence of pandemic dreams and to determine if the wording of the questions could shape responses. Fewer than half could recall a dream. Reports were brief, susceptible to priming, and unrelated to personal SARS-CoV-2/COVID-19 exposure. Although this sample was not truly random, it is probably more representative of the US population than those recruited through thematic websites. Clinicians should be aware of problems inherent in survey research and understand how their words can shape client responses.

Risk Perception, Perceived Government Coping Validity, and Individual Sleep Problems in the Early Stage of the COVID-19 Pandemic in China: Mediation Analysis Based on Negative Emotions.

This study aimed to investigate the relationship among risk perception, negative emotions, perceived government coping validity, and the sleep problem of the public, through regression analysis and mediation analysis of data from the early stages of the COVID-19 outbreak in China (three months after the outbreak). It found that people's perception of the risk of the pandemic, negative emotions, and perceived government coping validity significantly affected people's sleep quality and nightmares. Further analysis found that individuals' perception of risk not only affected their sleep but also intensified their negative emotions, ultimately impairing the quality of their sleep and leading to nightmares. However, having a high level of coping validity can mitigate negative emotions and consequently decrease the occurrence of nightmares, thereby enhancing the quality of sleep. Specifically, perceived government coping validity could not only directly reduce nightmares, but also indirectly reduce nightmares by lowering negative emotions. However, it could only indirectly improve sleep by reducing negative emotions. It implicated that improving and resolving sleep problems required not only medical intervention but also psychological intervention. Simultaneously, improving the government's response effectiveness could strengthen people's trust in the government, stabilize their mental states, and significantly improve their quality of life by reducing negative emotions and improving sleep.

Sleep disorders and COVID-19.

This chapter summarizes the known associations between COVID-19 and sleep dysfunction, including insomnia, excessive daytime sleepiness, restless legs syndrome and nightmares, and touches upon pandemic-related considerations for obstructive sleep apnea and continuous positive airway pressure treatment. Treatment strategies and management approaches are also briefly discussed.

Has the COVID-19 Pandemic Traumatized Us Collectively? The Impact of the COVID-19 Pandemic on Mental Health and Sleep Factors via Traumatization: A Multinational Survey.

Purpose: The COVID-19 pandemic affects mental health and sleep, resulting in frequent nightmares. Therefore, identifying factors associated with nightmare frequency is important, as it can indicate mental health issues. The study aimed to investigate increases in nightmare frequency comparing the pre-pandemic and pandemic period, and identify its risk factors. Further, the mediating role of post-traumatic stress disorder symptoms between the pandemic and nightmares is explored. Patients and Methods: For this cross-sectional survey data were obtained via self-rating online survey (ICOSS: details in Partinen et al, 2021), which was open to anyone older than 18 years. The final volunteer sample consisted of 15,292 participants, divided according to their nightmare frequency (high: ≥1-2 nights/week; low: <1-2 nights/week). A total of 9100 participants were excluded if answers on variables of interest were missing or receiving rewards for participation. Chi-square tests identified changes of nightmare frequency. Predictors of high nightmare frequency were assessed using logistic regression and presented as Odds Ratios. Post-hoc mediation models were used to investigate the role of post-traumatic stress symptoms (PTSS). Results: The mean age was 41.63 (SD=16.55) with 64.05% females. High nightmare frequency increased significantly from 13.24% to 22.35% during the pandemic. Factors associated with it included self-reported PTSS (OR=2.11), other mental disorders and various sleep disorders or problems. Financial burden due to the pandemic, confinement, having had COVID-19, and work situation during the pandemic were associated with nightmare frequency, those relations were partly mediated through PTSS. Conclusion: Our results display the pandemic influence on nightmare frequency, which in turn connects to multiple mental health and sleep factors. These relations were partly mediated through PTSS. The COVID-19 pandemic appears to have caused traumatization of a substantial proportion of society. Health care workers should consider nightmares in their screening routines, as it might indicate PTSS and/or other mental and sleep disorders.

Dreaming or daydreaming during COVID-19 lockdown: A comparison between maladaptive and nonmaladaptive daydreamers

Starting from the idea that dreaming could be considered an index of the psychological health of individuals regarding the COVID-19 outbreak, a major risk of psychological maladjustment has been registered for maladaptive daydreamers (MDers;i.e., people with a compulsive fantasy activity associated with distress and psychological impairment). Nevertheless, there is a gap in literature about dreaming in MDers in general and particularly during the COVID-19 pandemic. The aim of this study was to investigate differences in dreaming and dream content between probable MDers and non-MDers during the COVID-19 lockdown in Italy. A total of 3,857 Italian adults (664 probable MDers), completed the Maladaptive Daydreaming Scale (MDS-16) and the Mannheim Dream Questionnaire (MADRE). Among them, 1,095 participants (222 probable MDers) decided to recount their dreams, subsequently analysed through a cluster analysis performed by T-LAB software. Significantly higher levels of dream recall, emotional intensity of dreams, nightmare frequency, nightmare distress, recurring nightmares about daytime, lucid dreams, interest toward dreams, problem solving and creative dreams, and dreams affecting daytime mood emerged in probable MDers compared to non-MDers. No differences were observed in the emotional tone of dreams. From the quali-quantitative analysis of dream narratives, similar themes emerged in probable MDers and non-MDers, except for a cluster named Dreaming the loss of others, where the non-MDers variable is highly represented. Our results highlight some significant differences between probable MDers and non-MDers with respect to dreaming activity. The massive use of dream activity as an affective regulator emerges for both probable MDers and non-MDers during lockdown. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

DREAMS AND NIGHTMARES OF THE WORLD'S MIDDLE CLASSES

The world has been getting contradictory messages about its class structure. According to one authoritative account, it has reached a 'global tipping point' - 'half the world is now middle class or wealthier'. This was based on figures marshalled by Homi Kharas, a former World Bank chief economist now at Brookings. More excitably, the Economist has hailed the 'relentless rise' of a 'burgeoning bourgeoisie' and trumpeted the arrival of a middle-class world. The new middle-class dream in the Global South had, first and foremost, an Asian setting. It was woven and promoted by figures in the World Bank's orbit, seconded by business consultancies and investment bankers. The covid-19 pandemic is currently shattering the middle-class dream in the South and accelerating the inegalitarian tendencies analyzed above. Where this will lead is still an open question.

Insomnia and nightmare profiles during the COVID-19 pandemic in Portugal: characterization and associated factors.

OBJECTIVE/BACKGROUND: To describe and characterize insomnia symptoms and nightmare profiles in Portugal during the first six weeks of a national lockdown due to COVID-19. PATIENTS/METHODS: An open cohort study was conducted to collect information of the general population during the first wave of SARS-CoV-2/COVID-19 pandemic in Portugal. We analyzed data from 5011 participants (≥16 years) who answered a weekly questionnaire about their well-being. Two questions about the frequency of insomnia and nightmares about COVID-19 were consecutively applied during six weeks (March-May 2020). Latent class analysis was conducted and different insomnia and nightmare profiles were identified. Associations between individual characteristics and both profiles were estimated using odds ratios (ORs) and 95% confidence intervals (CI). RESULTS: Five insomnia (No insomnia, Stable-mild, Decreasing-moderate, Stable-severe, Increasing-severe) and three nightmares profiles (Stable-mild, Stable-moderate, Stable-severe) were identified. Being female, younger, perceiving their income as insufficient and feelings of fear towards COVID-19 were associated with higher odds of insomnia (Women: OR = 6.98 95%CI: 4.18-11.64; ≥60 years: OR = 0.30 95%CI: 0.18-0.53; Insufficient income: adjusted OR (aOR) = 8.413 95%CI: 3.93-16.84; Often presenting fear of being infected with SARS-CoV-2 infection: aOR = 9.13 95%CI: 6.36-13.11), and nightmares (Women: OR = 2.60 95%CI: 1.74-3.86; ≥60 years: OR = 0.45 95%CI: 0.28-0.74; Insufficient income: aOR = 2.60 95%CI: 1.20-5.20; Often/almost always presenting fear of being infected with SARS-CoV-2 infection: aOR = 6.62 95%CI: 5.01-8.74). Having a diagnosis of SARS-CoV-2 virus infection was associated with worse patterns of nightmares about the pandemic. CONCLUSIONS: Social and psychological individual factors are important characteristics to consider in the development of therapeutic strategies to support people with sleep problems during the COVID-19 pandemic.

Nightmares mediate the association between traumatic event exposure and suicidal ideation in frontline medical workers exposed to COVID-19.

BACKGROUND: Trauma experience increases the risk of suicidal ideation, but little is known about potentially psychological mechanisms underlying this relationship. This study aims to examine the relationship between coronavirus disease 2019 (COVID-19)-related traumatic event (CTE) exposure and suicidal ideation among hospital workers, and identify mediating roles of sleep disturbances in this relationship. METHODS: Workers in seven designated hospitals in Wuhan, China, were invited to participate in an online survey from May 27, 2020, to July 31, 2020. Participants completed a self-report questionnaire to evaluate demographic characteristics, level of CTE exposures, nightmare frequency, insomnia severity, symptoms of depression and anxiety, and suicidal ideation. A series of correlation analyses were performed, and a mediation model was generated to examine correlations between CTE exposure, sleep disturbances, and suicidal ideation. RESULTS: A total of 16,220 hospital workers were included in the final analysis, 13.3% of them reported suicidal ideation in the past month. CTE exposure was significantly associated with insomnia severity, nightmare frequency, and suicidal ideation. After controlling potential confounders, nightmares but not insomnia, depression, or anxiety were shown to be independent risk factors for suicidal ideation. Pathway analyses showed that the relationship between CTE exposure and suicidal ideation was fully mediated by nightmares (proportion mediated 66.4%) after adjusting for demographic characteristics and psychological confounders. LIMITATIONS: Cross-sectional design precluded the investigation of causal relationships. CONCLUSIONS: CTE exposure increases risk of hospital workers' suicidal ideation that is mediated by nightmares, suggesting nightmares intervention might be considered as a component when developing suicide prevention strategies.

Hearing the music in COVID-19's medically-induced coma: An interview with Dr. William C. Banfield

In this interview of Dr. William Banfield by music therapist, Dr. Suzanne Hanser, Banfield describes his diagnosis and treatment of COVID-19. While in a medically-induced coma, Banfield heard the music that his wife brought to the hospital, and the music became a vital part of the dreams and nightmares he experienced during his 17 days in a coma (April 4-20, 2020). Dr. Banfield describes how this affected his life and shares lessons about music and meaning. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Sleep, Dreams, and Nightmares During the COVID-19 Pandemic.

The COVID-19 pandemic has affected the sleep and dreams of many individuals. Some have experienced improvements, while others have had more complaints. The changes to daily life such as working from home and spending more time indoors in confinement may have disturbed the circadian rhythms of some individuals. There were many reports of a shift towards a later bedtime during the pandemic, with several studies showing that in general, females experienced worse sleep than males, including more nighttime awakenings and nightmares. Increased dream and nightmare frequency during the pandemic has been shown in multiple studies. It has been postulated that because dreams are often guided by the dominant emotional state, that dreams and nightmares related to pandemic themes are a result of specific stressors related to COVID-19. Those experiencing unwanted sleep disturbances and nightmares could stand to benefit from mindfulness and relaxation practices that can ease stress and anxiety before bedtime. Striving to maintain a regular sleep schedule and enhance exposure to daylight-particularly during the first half of the day-may also be helpful.

Dreams and Nightmares during the First and Second Wave of the COVID-19 Infection: A Longitudinal Study.

Recent literature shows that the Coronovirus-19 (COVID-19) pandemic has provoked significant changes in dreaming. The current study intends to provide an update about dream variable changes during the second wave of COVID-19. A total of 611 participants completed a web survey from December 2020 to January 2021. Statistical comparisons showed that subjects had lower dream-recall frequency, nightmare frequency, lucid-dream frequency, emotional intensity, and nightmare distress during the second than the first wave of the pandemic. Dreams had a higher negative tone during the second than first wave. We revealed significant differences concerning post-traumatic growth, sleep-related post-traumatic stress disorder (PTSD) symptoms and sleep measures between groups obtained as a function of the changes in the oneiric frequency between the first and second waves. We also found significant correlations between qualitative/emotional dream features and COVID-19-related factors (job change, forced quarantine, having COVID-19 infected relatives/friends, or asking for mental health help). Overall, we found that the second wave affected fewer quantitative features of dream activity and there was less emotional intensity. Moreover, we confirmed the relationship between nightmares and the high risk of PTSD when subjects were grouped as a function of the increasing/decreasing frequency. Finally, our findings are partly coherent with the continuity hypothesis between oneiric and waking experiences.

Dreaming during COVID-19: the effects of a world trauma.

On March 11, 2020, the World Health Organization (WHO) declared a state of health emergency affecting the entire world population. Given the serious practical and psychological difficulties and complications that have been experienced during this period, many scholars have created hypothesis, as a consequence, an increased possibility of developing post-traumatic stress disorder (PTSD) within the general population with significant implications for one's dream activity. Participants in the study were recruited via the instant messaging application 'WhatsApp' for a period of 14 days. The study consisted of three phases: the first phase provided information on the purpose of the research and how to carry it out; in the second phase, each participant, using the Bionian model of dream experience as a focus, was asked to write down dreams, emotions and free connections/associations related to the dream. At the end of the collection, the texts obtained were analysed by means of a qualitative analysis performed with the aid of the MAXQDA software. The study confirms the computational and exploratory analysis of the text carried out in the research of Pesonen et al. (2020), finding also in our sample the presence of the hypothesized clusters going to explain the manifestation of imagery related to COVID-19 also within the dream activity. To confirm this, the nightmare of participant number 6 of the study is reported. The following qualitative research has offered an insight into the traumatic nature of the COVID-19 pandemic, showing how many unmetabolized 'daytime elements' have been reproposed in the dream scenario, recalling the symptomatology of PTSD through the presence of distressing content that affect the quality of sleep and the daily life of the individual.

Dreaming during the COVID-19 lockdown: a comparison of Italian adolescents and adults.

Based on the continuity hypothesis of dreaming, we have studied the effects of lockdown measures on Italian adolescents' and adults' dreams during the first wave of the coronavirus disease 2019 (COVID-19) pandemic. A sample of 475 subjects (73.9% women; 48.4% adolescents; ages 12-70 years, M=25.10, SD=12.2) was recruited via the Internet between April 17, 2020 and May 18, 2020. Participants were asked to provide socio-demographic data, as well as to report their Most Recent Dream. Results indicated that adults' dreams were the longest, as well as characterized by higher emotional intensity, predominantly negative emotions, and a higher presence of sensory impressions. Furthermore, results indicated that the participants, especially adolescents, who were most directly affected by the COVID-19 pandemic reported the strongest effects on their dreams. Results also indicated that women recall dreams more often than men, in addition to reporting higher emotional intensity, predominantly negative emotions, and a higher presence of sensory impressions. Finally, results of the Thematic Analysis of Elementary Contexts showed that adults' dreams seem to be centered, above all, on both pleasant memories linked to experiences that are now forbidden (i.e., traveling, meeting friends) as well as on nightmares, while adolescents' dreams focused on relationships with others. Finally, both adults and adolescents reported dreams related to the experience of home confinement, which they described in terms of the negative emotions they experienced. In sum, the findings of this study indicate that the COVID-19 lockdown measures, understood as a contextual and traumatic event, significantly affect people's oneiric lives, regardless of age.

Nightmare content during the COVID-19 pandemic: Influence of COVID-related stress and sleep disruption in the United States.

Nightmares are often associated with psychiatric disorders and acute stress. This study explores how the COVID-19 pandemic may have influenced the content of nightmares. A sample of N = 419 US adults completed online surveys about sleep and COVID-19 experiences. Participants were asked about the degree to which they agreed with statements linking greater general stress, worse overall sleep and more middle-of-the-night insomnia with the COVID-19 pandemic. They were also asked if, during the pandemic, they experienced nightmares related to various themes. Logistic regression analyses examined each nightmare content as outcome and increased stress, worse sleep and more middle-of-the-night insomnia as predictors, adjusted for age, sex and race/ethnicity. Those who reported greater general COVID-related stress were more likely to have nightmares about confinement, failure, helplessness, anxiety, war, separation, totalitarianism, sickness, death, COVID and an apocalypse. Those who reported worsened sleep were more likely to have nightmares about confinement, oppression, failure, helplessness, disaster, anxiety, evil forces, war, domestic abuse, separation, totalitarianism, sickness, death, COVID and an apocalypse. Those who reported worsened middle-of-the-night insomnia were more likely to have nightmares about confinement, oppression, failure, helplessness, disaster, anxiety, war, domestic abuse, separation, totalitarianism, sickness, death, COVID and an apocalypse. These results suggest that increased pandemic-related stress may induce negatively-toned dreams of specific themes. Future investigation might determine whether (and when) this symptom indicates an emotion regulation mechanism at play, or the failure of such a mechanism.

Dream Activity in Narcoleptic Patients During the COVID-19 Lockdown in Italy.

Some studies highlighted that patients with narcolepsy type-1 (NT1) experience high lucid dream frequency, and this phenomenon has been associated with a creative personality. Starting from the well-known "pandemic effect" on sleep and dreaming, we presented a picture of dream activity in pharmacologically treated NT1 patients during the Italian lockdown. Forty-three NT1 patients completed a web-survey during Spring 2021 and were compared with 86 matched-controls. Statistical comparisons revealed that: (a) NT1 patients showed greater sleepiness than controls; (b) controls showed higher sleep disturbances than NT1 patients, and this result disappeared when the medication effect in NT1 was controlled; (c) NT1 patients reported higher lucid dream frequency than controls. Focusing on dreaming in NT1 patients, we found that (a) nightmare frequency was correlated with female gender, longer sleep duration, higher intrasleep wakefulness; (b) dream recall, nightmare and lucid dream frequency were positively correlated with sleepiness. Comparisons between low and high NT1 lucid dreamers showed that patients more frequently experiencing lucid dreams reported a greater influence of dreaming during wakefulness, especially concerning problem-solving and creativity. Overall, our results are consistent with previous studies on pandemic dreaming carried out on healthy subjects. Moreover, we confirmed a link between lucidity and creativity in NT1 patients. Considering the small sample size and the cross-sectional design, our findings cannot provide a causal relationship between lucid dreams and the COVID-19 lockdown. Nevertheless, they represent a first contribution to address future studies on this issue, suggesting that some stable characteristics could interact with changes provoked by the pandemic.

Dreaming in Adolescents During the COVID-19 Health Crisis: Survey Among a Sample of European School Students.

According to the continuity hypothesis of dreaming and contemporary psychodynamic approaches, dreams reflect waking life. The aim of the present study was to explore the relationship between the COVID-19 pandemic and dreaming in adolescents. A cross-sectional survey was conducted in Italy, Romania and Croatia involving 2,105 secondary school students (69% girls, mean age 15.6 ± 2.1 years; 31% boys, mean age 15.1 ± 2.2 years; mean age of whole sample 15.4 ± 2.1 years). No substantial differences between countries were found. Thirty-one percent of the participants reported heightened dream recall, 18% noticed an increase in nightmares during the lockdown, and 15% of the provided dreams (n = 498) included pandemic-related content. The results indicate that subjective emotional reactions to lockdown had a significantly higher correlation to dreaming than objective distress (i.e., illness or death of a close one because of COVID-19). These findings suggest that attention to dreams should be included in preventive programs for adolescents with pandemic-related stress.

Pandemic Nightmares: COVID-19 Lockdown Associated With Increased Aggression in Female University Students' Dreams.

The COVID-19 pandemic and its associated stressors have impacted the daily lives and sleeping patterns of many individuals, including university students. Dreams may provide insight into how the mind processes changing realities; dreams not only allow consolidation of new information, but may give the opportunity to creatively "play out" low-risk, hypothetical threat simulations. While there are studies that analyze dreams in high-stress situations, little is known of how the COVID-19 pandemic has impacted dreams of university students. The aim of this study was to explore how the dream content of students was affected during the university COVID-19 lockdown period (March-July, 2020). Using online survey methods, we analyzed dream recall content (n = 71) using the Hall-Van de Castle dream coding system and Fisher's exact tests for sex comparisons. Preliminary results indicate that female students experienced more nightmares as compared to male students. Dream analysis found that, relative to normative American College Student (ACS) samples generated pre-COVID-19, women were more likely to experience aggressive interactions in their dream content, including increased physical aggression. Results indicate that university students did experience changes in dream content due to the pandemic lockdown period, with women disproportionally affected. These findings can aid universities in developing support programs for students by bringing forth an understanding of students' concerns and anxieties as they process the "new normal" of social distancing.