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Camaioni M, Scarpelli S, Alfonsi V, Gorgoni M, Calzolari R, De Bartolo M, Mangiaruga A, Couyoumdjian A, De Gennaro L. How COVID-19 Affected Sleep Talking Episodes, Sleep and Dreams? Brain Sci 2024; 14:486. [PMID: 38790464 PMCID: PMC11119596 DOI: 10.3390/brainsci14050486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic increased symptoms of stress and anxiety and induced changes in sleep quality, dream activity, and parasomnia episodes. It has been shown that stressful factors and/or bad sleep habits can affect parasomnia behaviors. However, investigations on how COVID-19 has affected sleep, dreams, and episode frequency in parasomnias are rare. The current study focuses on the impact of the pandemic on a specific parasomnia characterized by speech production (sleep talking, ST). METHODS We selected 27 participants with frequent ST episodes (STs) during the pandemic and compared them with 27 participants with frequent STs from a previous study conducted during a pre-pandemic period. All participants performed home monitoring through sleep logs and recorded their nocturnal STs for one week. RESULTS We observed a higher frequency of STs in the pandemic group. Moreover, STs were related to the emotional intensity of dreams, independent of the pandemic condition. The pandemic was associated with lower bizarreness of dreams in the pandemic group. There were no differences in sleep variables between the two groups. CONCLUSION Overall, these results suggest a stressful effect of COVID-19 on the frequency of STs. Both the pandemic and the frequency of STs affect qualitative characteristics of dreams in this population.
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Affiliation(s)
- Milena Camaioni
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
| | - Valentina Alfonsi
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
| | - Rossana Calzolari
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
- Department of General Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy
| | - Mina De Bartolo
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
| | - Anastasia Mangiaruga
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
| | - Alessandro Couyoumdjian
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
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Ceolin C, Limongi F, Siviero P, Trevisan C, Noale M, Catalani F, Conti S, Di Rosa E, Perdixi E, Remelli F, Prinelli F, Maggi S. Changes in Sleep Duration and Sleep Timing in the General Population from before to during the First COVID-19 Lockdown: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:583. [PMID: 38791798 PMCID: PMC11121433 DOI: 10.3390/ijerph21050583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND The COVID-19 lockdown had a profound effect on everyday life, including sleep health. This systematic review and meta-analysis evaluated changes in quantitative sleep parameters during the first lockdown compared with pre-lockdown in the general population. METHODS A search in scientific databases was performed to identify eligible observational studies from inception to 8 February 2023. We performed a random effects meta-analysis of those studies reporting (a) means of sleep duration, time in bed (TIB), and sleep timing (bedtime and wake-up time); (b) the percentages of atypical sleep duration before and during the lockdown; (c) the percentages of change in sleep duration and sleep timing. RESULTS A total of 154 studies were included. A small increase in sleep duration (0.25 standardized mean difference, 95% CI 0.180-0.315) was found, with 55.0% of the individuals reporting changes, predominantly an increase (35.2%). The pooled relative risk for sleeping more than 8/9 h per night was 3.31 (95% IC 2.60-4.21). There was a moderately significant delay in sleep timing and a surge in napping. CONCLUSION An increase in sleep duration and napping, and delayed sleep timing were observed. High-quality studies should evaluate whether these parameters have now become chronic or have returned to pre-lockdown values.
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Affiliation(s)
- Chiara Ceolin
- Geriatric Unit, Department of Medicine (DIMED), University of Padova, 35128 Padova, Italy; (C.C.); (C.T.); (F.C.)
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, 17165 Solna, Sweden
| | - Federica Limongi
- Neuroscience Institute, Aging Branch, National Research Council, 35128 Padova, Italy; (F.L.); (M.N.); (S.M.)
| | - Paola Siviero
- Neuroscience Institute, Aging Branch, National Research Council, 35128 Padova, Italy; (F.L.); (M.N.); (S.M.)
| | - Caterina Trevisan
- Geriatric Unit, Department of Medicine (DIMED), University of Padova, 35128 Padova, Italy; (C.C.); (C.T.); (F.C.)
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, 17165 Solna, Sweden
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Marianna Noale
- Neuroscience Institute, Aging Branch, National Research Council, 35128 Padova, Italy; (F.L.); (M.N.); (S.M.)
| | - Filippo Catalani
- Geriatric Unit, Department of Medicine (DIMED), University of Padova, 35128 Padova, Italy; (C.C.); (C.T.); (F.C.)
| | - Silvia Conti
- Institute of Biomedical Technologies, National Research Council, 20054 Segrate, Italy; (S.C.); (F.P.)
- Neuropsychology Lab, Centre for Cognitive Disorders and Dementia IRCCS Mondino Foundation, 27100 Pavia, Italy;
| | - Elisa Di Rosa
- Department of General Psychology, University of Padua, 35131 Padova, Italy;
| | - Elena Perdixi
- Neuropsychology Lab, Centre for Cognitive Disorders and Dementia IRCCS Mondino Foundation, 27100 Pavia, Italy;
- Department of Neurology, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Francesca Remelli
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Federica Prinelli
- Institute of Biomedical Technologies, National Research Council, 20054 Segrate, Italy; (S.C.); (F.P.)
| | - Stefania Maggi
- Neuroscience Institute, Aging Branch, National Research Council, 35128 Padova, Italy; (F.L.); (M.N.); (S.M.)
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3
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Loukola V, Tuominen J, Kirsilä S, Kyyhkynen A, Lahdenperä M, Parkkali L, Ranta E, Malinen E, Vanhanen S, Välimaa K, Olkoniemi H, Revonsuo A, Valli K. Viral simulations in dreams: The effect of the COVID-19 pandemic on threatening dream content in a Finnish sample of diary dreams. Conscious Cogn 2024; 119:103651. [PMID: 38335898 DOI: 10.1016/j.concog.2024.103651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/23/2023] [Accepted: 01/22/2024] [Indexed: 02/12/2024]
Abstract
Previous research indicates that the COVID-19 pandemic has affected dreaming negatively. We compared 1132 dreams collected with prospective two-week dream diary during the pandemic to 166 dreams collected before the pandemic. We hypothesized that the pandemic would increase the number of threatening events, threats related to diseases, and the severity of threats. We also hypothesized that dreams that include direct references to the pandemic will include more threatening events, more disease-related threats, and more severe threats. In contradiction with our hypotheses, results showed no differences between pandemic and pre-pandemic samples in the number of threats, threats related to diseases, or severe threats. However, dreams with direct references to the pandemic had more threats, disease-related threats, and severe threats. Our results thus do not suggest a significant overall increase in nightmarish or threatening dream content during the pandemic but show a more profound effect on a minority of dreams.
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Affiliation(s)
- Ville Loukola
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland.
| | - Jarno Tuominen
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Santeri Kirsilä
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Annimaaria Kyyhkynen
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Maron Lahdenperä
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Lilja Parkkali
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Emilia Ranta
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Eveliina Malinen
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Sanni Vanhanen
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Katariina Välimaa
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Henri Olkoniemi
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland; Division of Psychology, Faculty of Education and Psychology, University of Oulu, Oulu, Finland
| | - Antti Revonsuo
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland; Department of Cognitive Neuroscience and Philosophy, University of Skövde, Skövde, Sweden
| | - Katja Valli
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland; Department of Cognitive Neuroscience and Philosophy, University of Skövde, Skövde, Sweden
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Bolstad CJ, Holzinger B, Scarpelli S, De Gennaro L, Yordanova J, Koumanova S, Mota-Rolim S, Benedict C, Bjorvatn B, Chan NY, Chung F, Dauvilliers Y, Espie CA, Inoue Y, Korman M, Koscec Bjelajac A, Landtblom AM, Matsui K, Merikanto I, Morin CM, Partinen M, Penzel T, Plazzi G, Reis C, Ross B, Wing YK, Nadorff MR. Nightmare frequency is a risk factor for suicidal ideation during the COVID-19 pandemic. J Sleep Res 2024:e14165. [PMID: 38366677 DOI: 10.1111/jsr.14165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/14/2024] [Accepted: 01/26/2024] [Indexed: 02/18/2024]
Abstract
The association between nightmare frequency (NMF) and suicidal ideation (SI) is well known, yet the impact of the COVID-19 pandemic on this relation is inconsistent. This study aimed to investigate changes in NMF, SI, and their association during the COVID-19 pandemic. Data were collected in 16 countries using a harmonised questionnaire. The sample included 9328 individuals (4848 women; age M[SD] = 46.85 [17.75] years), and 17.60% reported previous COVID-19. Overall, SI was significantly 2% lower during the pandemic vs. before, and this was consistent across genders and ages. Most countries/regions demonstrated decreases in SI during this pandemic, with Austria (-9.57%), Sweden (-6.18%), and Bulgaria (-5.14%) exhibiting significant declines in SI, but Italy (1.45%) and Portugal (2.45%) demonstrated non-significant increases. Suicidal ideation was more common in participants with long-COVID (21.10%) vs. short-COVID (12.40%), though SI did not vary by COVID-19 history. Nightmare frequency increased by 4.50% during the pandemic and was significantly higher in those with previous COVID-19 (14.50% vs. 10.70%), during infection (23.00% vs. 8.10%), and in those with long-COVID (18.00% vs. 8.50%). The relation between NMF and SI was not significantly stronger during the pandemic than prior (rs = 0.18 vs. 0.14; z = 2.80). Frequent nightmares during the pandemic increased the likelihood of reporting SI (OR = 1.57, 95% CI 1.20-2.05), while frequent dream recall during the pandemic served a protective effect (OR = 0.74, 95% CI 0.59-0.94). These findings have important implications for identifying those at risk of suicide and may offer a potential pathway for suicide prevention.
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Affiliation(s)
- Courtney J Bolstad
- Department of Psychology, Mississippi State University, Mississippi State, Mississippi, USA
- South Texas Veterans Health Care System, San Antonio, Texas, USA
| | - Brigitte Holzinger
- Institute of Consciousness and Dream Research, Vienna, Austria
- Medical University of Vienna, Wien, Postgraduate Sleep Coaching, Vienna, Austria
| | | | - Luigi De Gennaro
- Department of Psychology, University of Rome, Rome, Italy
- IRCCS Fondazione Santa Lucia, Roma, Italy
| | - Juliana Yordanova
- Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Silvia Koumanova
- Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Sérgio Mota-Rolim
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Christian Benedict
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Frances Chung
- Department of Anesthesiology and Pain Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Yves Dauvilliers
- Sleep and Wake Disorders Centre, Department of Neurology, Gui de Chauliac Hospital, University of Montpellier, INSERM Institute Neuroscience Montpellier (INM), Montpellier, France
| | - Colin A Espie
- Sir Jules Thorn Sleep & Circadian Neuroscience Institute and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Maria Korman
- Department of Occupational Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | | | - Anne-Marie Landtblom
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Kentaro Matsui
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ilona Merikanto
- SleepWell Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Orton Orthopaedics Hospital, Helsinki, Finland
| | - Charles M Morin
- Laval University, Department of Psychology and Centre de recherche CERVO/Brain Research Center, Quebec City, Canada
| | - Markku Partinen
- Helsinki Sleep Clinic, Terveystalo Healthcare, Helsinki, Finland
- Department of Clinical Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland
| | - Thomas Penzel
- Sleep Medicine Center, Charite - Universitätsmedizin Berlin, Berlin, Germany
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Cátia Reis
- Universidade Católica Portuguesa, Católica Research Centre for Psychological - Family and Social Welbeing, Lisbon, Portugal
- João Lobo Antunes Institute of Molecular Medicine, Faculty of Medicine of Lisbon, University of Lisbon, Lisbon, Portugal
| | - Biserka Ross
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Michael R Nadorff
- Department of Psychology, Mississippi State University, Mississippi State, Mississippi, USA
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
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Castelletti G, Misirocchi F, Zilioli A, Salvatelli ML, Rausa F, Pizzarotti S, Zinno L, Florindo I, Pedrazzi G, Parrino L, Mutti C. How can sleep disorders affect our reaction towards external stressors: a lesson from the COVID-19 outbreak. Neurol Sci 2024; 45:391-399. [PMID: 37587386 PMCID: PMC10791966 DOI: 10.1007/s10072-023-06938-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/01/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND The COVID-19 outbreak produced extensive psychological consequences, especially among vulnerable populations. Sleep was identified as one of the most common "indirect targets" of the pandemia, with up to 74.8% of patients surviving from COVID-19 complaining of new-onset sleep disorders. However, so far, the clinic-psychological impact of the outbreak in patients affected by pre-existing sleep disorders has not been examined in details. MATERIALS AND METHODS In the present study, we aim to assess the effect of the COVID-19 outbreak in a cohort of 190 adult patients affected by sleep disorders, compared to 265 age and sex-matched healthy sleepers. The assessment was implemented throughout the use of ad hoc anamnestic questions, exploration of dream content, and validated questionnaires, aiming to capture the broad range of the neuropsychological nuances of the COVID-19 impact. RESULTS Subjects with pre-existent sleep disorders faced a more severe impact in terms of sleep quality and amount compared to healthy sleepers, presenting longer sleep latency, reduced sleep efficacy, and greater use of hypnotics and medications. On the other hand, healthy sleepers experienced deeper variation in sleeping habits, sleep duration, and greater impact on dream activity in terms of content, emotionality, and presence of recurrent dreams. Finally, in our sample, being female represents an important aggravating factor in the pandemic experience, both in terms of sleep deterioration and with respect to physical and mental health. For instance, females indeed presented the highest scores of Pittsburgh Sleep Quality Index (PSQI) both in cases and control groups (respectively 10 ± 3.8 vs 7.3 ± 3.9 in cases and 6.6 ± 3.6 vs 6.0 ± 3.4 in controls, p-value < 0.001). CONCLUSION Pre-existent sleep disorders and the female sex might represent risk factors increasing the clinic-psychological burden in dramatic scenarios, such as the COVID-19 pandemia, requiring dedicated attention from clinicians.
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Affiliation(s)
- Gloria Castelletti
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | | | | | - Marcello Luigi Salvatelli
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Francesco Rausa
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Silvia Pizzarotti
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Lucia Zinno
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Irene Florindo
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giuseppe Pedrazzi
- Unit of Neuroscience & Interdepartmental Center of Robust Statistics, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Liborio Parrino
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Carlotta Mutti
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
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Pachi A, Tselebis A, Sikaras C, Sideri EP, Ivanidou M, Baras S, Milionis C, Ilias I. Nightmare distress, insomnia and resilience of nursing staff in the post-pandemic era. AIMS Public Health 2023; 11:36-57. [PMID: 38617404 PMCID: PMC11007420 DOI: 10.3934/publichealth.2024003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 04/16/2024] Open
Abstract
Introduction The pandemic has led to notable psychological challenges among healthcare professionals, including nurses. Objective Our aims of this study were to assess insomnia and nightmare distress levels in nurses and investigate their association with mental resilience. Methods Nurses participated in an online survey, which included the Nightmare Distress Questionnaire (NDQ), Brief Resilience Scale (BRS) and Athens Insomnia Scale (AIS). Demographic information, such as age, professional experience and gender, was also collected. Results The study included 355 female and 78 male nurses. Findings revealed that 61.4% had abnormal AIS scores, 7% had abnormal NDQ scores and 25.4% had low BRS scores. Female nurses had higher AIS and NDQ scores but lower BRS scores compared to males. BRS demonstrated negative correlations with both AIS and NDQ. Multiple regression analysis indicated that NDQ accounted for 24% of the AIS variance, with an additional 6.5% explained by the BRS. BRS acted as a mediator, attenuating the impact of nightmares on insomnia, with gender moderating this relationship. Conclusions Nursing staff experienced heightened sleep disturbances during the pandemic, with nightmares and insomnia being prevalent. Nightmares significantly contributed to insomnia, but mental resilience played a vital role in mitigating this effect. Strategies are warranted to address the pandemic's psychological impact on nursing professionals.
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Affiliation(s)
- Argyro Pachi
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
| | - Athanasios Tselebis
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
| | - Christos Sikaras
- Nursing Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
| | - Eleni Paraskevi Sideri
- Emergency Department of General Hospital of Athens Korgialeneio-Benakeio Hellenic Red Cross, 11526, Athens, Greece
| | - Maria Ivanidou
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
| | - Spyros Baras
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
| | | | - Ioannis Ilias
- Department of Endocrinology, “Elena Venizelou” Hospital, 11521 Athens, Greece
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7
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Roland A, Windal M, Briganti G, Kornreich C, Mairesse O. Intensity and Network Structure of Insomnia Symptoms and the Role of Mental Health During the First Two Waves of the COVID-19 Pandemic. Nat Sci Sleep 2023; 15:1003-1017. [PMID: 38059205 PMCID: PMC10697149 DOI: 10.2147/nss.s432944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/07/2023] [Indexed: 12/08/2023] Open
Abstract
Purpose Insomnia, being a mental disorder, is best conceived as a network of symptoms. With the important increase in insomnia prevalence during the COVID-19 pandemic, our aim was to investigate how the structure of insomnia symptoms in the general population has changed due to the pandemic. We also looked at the directional dependencies of nightmares and of covid- and lockdown-related stress/anxiety and depression in insomnia. Patients and Methods 5986 persons replied to our online questionnaire for the first wave and 2843 persons to our second wave questionnaire. Both questionnaires included the Insomnia Severity Index (ISI). Regularized Gaussian Graphical Models (GGM) and Bayesian Directed Acyclic Graphs (DAG) were estimated. Results The pre- and peri-lockdown networks were equally strongly connected (first wave: S = 0.13, p = 0.39; second wave: S = 0.03, p = 0.67), but differed for the first lockdown regarding only six edges (M = 0.13, p < 0.001) and for the second lockdown only five edges (M = 0.16, p < 0.001). These symptoms all worsened during the lockdowns in comparison to before the pandemic (p < 0.001). The diurnal items of the ISI had the highest predictability and centrality values in the GGMs. Lockdown-related stress/anxiety influenced indirectly nightmares through covid-related stress/anxiety, lockdown-related depressive affect and mental fatigue. These reported feelings of stress/anxiety and depression showed an indirect impact on insomnia symptoms through mental and physical fatigue. Conclusion Though the lockdown slightly intensified insomnia symptoms, it did not alter their network structure. Despite their differences, both GGMs and DAGs agree that the diurnal symptoms of the ISI, play an essential role in the network structure. Both methods confirm the need for emphasizing the cognitive/affective component in the treatment of insomnia (ie cognitive behavioral therapy).
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Affiliation(s)
- Aurore Roland
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maxime Windal
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Faculty of Psychology, Université Libre de Bruxelles, Brussels, Belgium
| | - Giovanni Briganti
- Laboratoire de Psychologie Médicale et Addictologie, CHU/UVC Brugmann, Brussels, Belgium
- Faculty of Medicine, Université libre de Bruxelles, Brussels, Belgium
- Faculty of Medicine, Université de Mons, Mons, Belgium
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Charles Kornreich
- Laboratoire de Psychologie Médicale et Addictologie, CHU/UVC Brugmann, Brussels, Belgium
- Faculty of Medicine, Université libre de Bruxelles, Brussels, Belgium
| | - Olivier Mairesse
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Laboratoire de Psychologie Médicale et Addictologie, CHU/UVC Brugmann, Brussels, Belgium
- Vital Signs and PERformance Monitoring (VIPER), LIFE Department, Royal Military Academy, Brussels, Belgium
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Scarpelli S, Alfonsi V, Camaioni M, Gorgoni M, Albano A, Musetti A, Quattropani MC, Plazzi G, De Gennaro L, Franceschini C. Longitudinal Findings on the Oneiric Activity Changes Across the Pandemic. Nat Sci Sleep 2023; 15:435-447. [PMID: 37313311 PMCID: PMC10259600 DOI: 10.2147/nss.s410732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/28/2023] [Indexed: 06/15/2023] Open
Abstract
Purpose COVID-19 pandemic waves have strongly influenced individuals' behaviors and mental health. Here, we analyzed longitudinal data collected in the Spring 2020 and 2021 from a large Italian sample with the aim of assessing changes in dream features between the first and third wave. Specifically, we evaluated the modifications of pandemic dream activity as a function of the general distress variations over time. Also, we detected the best explanatory variables of nightmare frequency and distress. Materials and Methods Participants previously involved in the web survey during the first wave of the pandemic were asked to complete a new online survey on sleep and dream features available in Spring 2021 (N=728). Subjects decreasing their level of psychological general distress in the third (T3) vs the first (T1) pandemic wave were defined as "Improved" (N=330). In contrast, participants with an unchanged or increased level of general distress were defined as "Not Improved" (N=398). Results Statistical comparisons revealed that dream recall frequency, nightmare frequency, lucid dream frequency, and emotional intensity show a reduction in T3 than T1. Moreover, the Improved group is characterized by lower nightmare rate and nightmare distress than Not Improved people. Our findings confirmed that beyond the trait-like variables (ie, age, sex), specific sleep-related measures are related to nightmare features. In particular, poor sleep hygiene was one of the best determinants of nightmare distress among Not Improved subjects. Conclusion Our findings revealed that people experienced an adaptation to the pandemic during the third wave. We also strengthen the notion that nightmares and their variations over time are strongly related to human well-being, suggesting that specific trait-like and sleep-related factors could modulate the relationship between mental health and nightmare features.
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Affiliation(s)
- Serena Scarpelli
- Department of Psychology, University of Rome Sapienza, Rome, Italy
| | | | - Milena Camaioni
- Department of Psychology, University of Rome Sapienza, Rome, Italy
| | - Maurizio Gorgoni
- Department of Psychology, University of Rome Sapienza, Rome, Italy
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Antonio Albano
- Department of Medicine and Surgery, Faculty of Medicine and Surgery, University of Parma, Parma, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Maria Catena Quattropani
- Department of Educational Sciences, University of Catania, Catania, Italy
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Luigi De Gennaro
- Department of Psychology, University of Rome Sapienza, Rome, Italy
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Christian Franceschini
- Department of Medicine and Surgery, Faculty of Medicine and Surgery, University of Parma, Parma, Italy
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9
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Margherita G, Caffieri A. An observatory on changes in dreaming during a pandemic: a living systematic review (part 1). J Sleep Res 2023; 32:e13742. [PMID: 36320190 PMCID: PMC9877779 DOI: 10.1111/jsr.13742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 01/28/2023]
Abstract
A 'new' way of dreaming has emerged during the pandemic, enhancing the interest of psychological literature. Indeed, during the years of the spread of coronavirus disease 2019 (COVID-19), many studies have investigated dream-related phenomena and dreaming functions. Considering the constant and rapid emergence of new results on this topic, the main aim of this study was to create an 'observatory' on the short- and long-term consequences of the COVID-19 pandemic on dreaming, by means of a living systematic review. The baseline results are presented, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines, to identify and discuss existing studies about dreams and dreaming during the COVID-19 pandemic published until February 2022. Web of Science, Embase, EBSCO, and PubMed were used for the search strategy, yielding 71 eligible papers included in the review. Our results show: (a) a more intense oneiric activity during lockdown; (b) changes in dreaming components (especially dream-recall and nightmare frequency); (c) a particular dreaming scenario ('pandemic dreams'); (d) an alteration of the dreaming-waking-life continuum and a specific function of dreaming as emotional regulator. Findings suggest that monitoring changes in dreaming provides important information about psychological health and could also contribute to the debate on the difficulties of dreaming, as well as sleeping, in particular during and after a period of 'collective trauma'.
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Affiliation(s)
- Giorgia Margherita
- Department of Humanistic StudiesUniversity of Naples Federico IINaplesItaly
| | - Alessia Caffieri
- Department of Humanistic StudiesUniversity of Naples Federico IINaplesItaly
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10
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Raffaelli Q, Andrews ES, Cegavske CC, Abraham FF, Edgin JO, Andrews-Hanna JR. Dreams share phenomenological similarities with task-unrelated thoughts and relate to variation in trait rumination and COVID-19 concern. Sci Rep 2023; 13:7102. [PMID: 37130841 PMCID: PMC10152021 DOI: 10.1038/s41598-023-33767-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/18/2023] [Indexed: 05/04/2023] Open
Abstract
While recent neurocognitive theories have proposed links between dreams and waking life, it remains unclear what kinds of waking thoughts are most similar in their phenomenological characteristics to those of dreams. To investigate this question and examine relevance of dreams to significant personal concerns and dispositional mental health traits, we employed ecological momentary assessment and trait questionnaires across 719 young adults who completed the study during the COVID-19 pandemic, a time marked by considerable societal concern. Across the group and at the level of individual differences, dreams showed the highest correspondence with task-unrelated thoughts. Participants who self-reported greater COVID-19 concern rated their dreams as more negative and unconstructive, a relationship which was moderated by trait rumination. Furthermore, dreams perceived as more negative unconstructive and immersive in nature associated with increased trait rumination beyond variation in rumination explained by waking task-unrelated thoughts alone. Together, these results point to similarities between perceived characteristics of dreams and task-unrelated thoughts, and support a relationship between dreams, current concerns, and mental health.
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Affiliation(s)
- Quentin Raffaelli
- Department of Psychology, University of Arizona, 1503 E University Blvd., Tucson, AZ, 85721, USA.
- Cognitive Science, University of Arizona, Tucson, AZ, USA.
| | - Eric S Andrews
- Department of Psychology, University of Arizona, 1503 E University Blvd., Tucson, AZ, 85721, USA
- Cognitive Science, University of Arizona, Tucson, AZ, USA
| | - Caitlin C Cegavske
- Department of Psychology, University of Arizona, 1503 E University Blvd., Tucson, AZ, 85721, USA
| | - Freya F Abraham
- Department of Psychology, University of Arizona, 1503 E University Blvd., Tucson, AZ, 85721, USA
| | - Jamie O Edgin
- Department of Psychology, University of Arizona, 1503 E University Blvd., Tucson, AZ, 85721, USA
| | - Jessica R Andrews-Hanna
- Department of Psychology, University of Arizona, 1503 E University Blvd., Tucson, AZ, 85721, USA.
- Cognitive Science, University of Arizona, Tucson, AZ, USA.
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11
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Navarro-Soria I, Costa-López B, Collado-Valero JA, de Mier RJR, Lavigne-Cervan R. Anxiety, sleep habits and executive function during the COVID-19 pandemic through parents’ perception: a longitudinal study. PSICOLOGIA-REFLEXAO E CRITICA 2023; 36:8. [PMID: 36988724 PMCID: PMC10050808 DOI: 10.1186/s41155-023-00251-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
AbstractThe present study therefore aims to examine trait and state anxiety, sleep habits and executive functioning during 1 year and a half of the COVID-19 pandemic in children and adolescents through the lens of parents. Assessments were conducted at three different times: April 2020 (T1), October 2020 (T2) and October 2021 (T3). The main sample included 953 children and adolescents aged 6 to 18 years, and scales were used to assess anxiety (STAIC), sleep habits (BEARS) and executive functioning (BRIEF-2). The results showed that 6 months after the outbreak of the pandemic, state and trait anxiety, sleep disturbances and executive dysfunctions increased significantly. One and a half year later, trait anxiety and sleep disturbances have been maintained, while state anxiety and executive dysfunction have decreased their scores obtaining scores similar to those of April 2020. In conclusion, there has been a further decrease in children and adolescents’ mental health since the beginning of the pandemic, and it seems to remain at the present time, such as trait anxiety as a part of the personality.
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12
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Ruiz-Herrera N, Díaz-Román A, Guillén-Riquelme A, Quevedo-Blasco R. Sleep Patterns during the COVID-19 Lockdown in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4841. [PMID: 36981756 PMCID: PMC10049045 DOI: 10.3390/ijerph20064841] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/04/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND To mitigate the spread of the coronavirus disease (COVID-19) pandemic, governments around the world adopted exceptional lockdown measures. This led to the disruption of normal life routines, including sleep. The aim of this study was to analyze differences in sleep patterns and subjective variables of sleep quality before and during lockdown. METHODS A sample of 1673 Spanish adults (30% men; 82% of the total were between 21 and 50 years of age) was evaluated. The following sleep variables were evaluated: Sleep latency, sleep time, number and duration of awakenings, sleep satisfaction, daytime sleepiness, and the manifestation of symptoms related to sleep problems. RESULTS Although 45% of people changed their sleep schedules (resulting in 42% sleeping longer during lockdown), sleep quality (37.6% worse), daytime sleepiness (28% worse), number of awakenings (36.9% more), and duration of awakenings (45% longer) were markedly worse. Statistical analyses indicated significant differences in all the evaluated sleep variables before and during lockdown in both men and women. Women reported less sleep satisfaction, and more symptoms related to sleep problems than men. CONCLUSIONS A deterioration in the sleep patterns of the Spanish population, especially women, because of the lockdown declared due to the COVID-19 pandemic.
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Affiliation(s)
- Noelia Ruiz-Herrera
- Faculty of Health Sciences, International University of La Rioja, 26006 Logroño, Spain
| | | | | | - Raúl Quevedo-Blasco
- Centre for Mind, Brain, and Behaviour Research (CIMCYC) and Faculty of Psychology, University of Granada, 18011 Granada, Spain
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13
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Slonkova J, Chudy M, Togtokhjargal A, Tomaskova H, Vacovska H, Rytirova G, Dolezalova I. The effects of COVID-19 on sleep and general health of Czech patients with epilepsy. Heliyon 2023; 9:e13413. [PMID: 36816256 PMCID: PMC9918435 DOI: 10.1016/j.heliyon.2023.e13413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/14/2022] [Accepted: 01/30/2023] [Indexed: 02/13/2023] Open
Abstract
Objectives To assess the impact of COVID-19 illness and pandemic era on sleep, general health, health care, and social status in patients with epilepsy in the Czech Republic. Methods Our designed and approved questionnaire consisted of 23 questions. We focused on (1) patients' demographic and epidemiological data regarding COVID-19, (2) subjective assessment of sleep; (3) epilepsy, and (4) perception of general health during the first year of the COVID-19 pandemic in the Czech Republic from March 2020 to May 2021. We administered the questionnaires during outpatient visits or by phone calls in three major university Czech epilepsy centers (Ostrava, Brno, Pilsen). Results We enrolled 227 (100%) patients. The mean age (±SD) was 41.2 ± 14.82 years (min 18, max 86 years), and 138 (61%) were women. COVID-19 was confirmed using the PCR test method in 57 (25.1%) patients. In the pre-pandemic era, 62 (27.3%) patients reported sleep disturbances. Insomnia in 46 (74.2%) and excessive daytime sleepiness in 6 (9.7%) were the most mentioned sleep abnormalities. Nocturnal seizures predispose to sleep impairment (p = 0.014) and vivid dreams and nightmares (p = 0.033). COVID-19 infection significantly increased the risk of vivid dreams and nightmares in patients with diurnal seizures (p = 0.006). Sleep quality impairment and seizure frequency worsening [(p < 0.001) and (p = 0.001), respectively] were the most significant risk factors to perform general health deterioration regardless of having COVID-19 (p = 0.559). The most affected age group was 51+ years (p = 0.033). The three centers provided adequate outpatient care during the first year of the pandemic. The employment and social status of the patients remained unchanged (p = 0.074). Conclusions COVID- 19 infection significantly increased the occurrence of vivid dreams and nightmares in patients with diurnal seizures. Sleep quality deterioration and seizure frequency worsening significantly negatively impacted general health performance.
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Affiliation(s)
- Jana Slonkova
- Department of Neurology, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava- Poruba, Czech Republic
- Center of Clinical Neurosciences, Faculty of Medicine University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic
| | - Milos Chudy
- Center of Clinical Neurosciences, Faculty of Medicine University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic
- Department of Epidemiology and Public Health, Faculty of Medicine University of Ostrava, Syllabova 19, Ostrava, Czech Republic
| | - Ariunjargal Togtokhjargal
- Department of Neurology, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava- Poruba, Czech Republic
- Center of Clinical Neurosciences, Faculty of Medicine University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic
| | - Hana Tomaskova
- Department of Epidemiology and Public Health, Faculty of Medicine University of Ostrava, Syllabova 19, Ostrava, Czech Republic
| | - Hana Vacovska
- Department of Neurology, University Hospital Pilsen, E. Benese 1128, Pilsen 3, Czech Republic
- Faculty of Medicine in Pilsen Charles University in Prague, Husova 3, Pilsen 3, 306 05, Czech Republic
| | - Gisela Rytirova
- Department of Neurology, University Hospital Pilsen, E. Benese 1128, Pilsen 3, Czech Republic
- Faculty of Medicine in Pilsen Charles University in Prague, Husova 3, Pilsen 3, 306 05, Czech Republic
| | - Irena Dolezalova
- First Department of Neurology, St. Anne′s University Hospital Brno, Pekarska 53, 656 91 Brno, Czech Republic
- Faculty of Medicine Masaryk University Brno, Kamenice 5, 625 00 Bohunice, Czech Republic
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14
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Alfonsi V, Scarpelli S, Gorgoni M, Couyoumdjian A, Rosiello F, Sandroni C, Corsi R, Pietrantonio F, De Gennaro L. Healthcare Workers after Two Years of COVID-19: The Consequences of the Pandemic on Psychological Health and Sleep among Nurses and Physicians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1410. [PMID: 36674167 PMCID: PMC9859438 DOI: 10.3390/ijerph20021410] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 05/06/2023]
Abstract
COVID-19 has challenged the health workforce worldwide. In this cross-sectional study with a retrospective assessment, we explored the impact of the pandemic on mental health and sleep among a sample of Italian nurses and medical doctors. A total of 287 healthcare workers (212 nurses and 75 physicians) completed a web survey on socio-demographic, psychological, and sleep-related aspects referring to the period before the pandemic and to the present period of February to June 2022. Comparisons between nurses and physicians revealed that the former had greater distress in response to the pandemic. Consistently, the multivariate analysis of covariance showed that even if both groups were negatively impacted by the pandemic, nurses presented a greater worsening over time regarding several psychological and sleep symptoms. Furthermore, we observed that working on the frontline represented an additional risk factor for nurses. In line with previous evidence, we also found that personal experiences with COVID-19 are significant predictors of the current health status. Our results underscore the urgent need for preventive programs among healthcare operators to increase their coping skills and prevent the long-term consequences of chronic stress, especially for high-risk professionals. Specific attention should also be devoted to programs to improve sleep quality and reduce sleep-related traumatic symptoms.
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Affiliation(s)
- Valentina Alfonsi
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | | | - Francesco Rosiello
- Internal Medicine Department, Ospedale dei Castelli, Azienda Sanitaria Locale Roma 6, Ariccia, 00040 Rome, Italy
| | - Cinzia Sandroni
- UOC Professione Infermieristica, Azienda Sanitaria Locale Roma 6, Albano, 00041 Rome, Italy
| | - Roberto Corsi
- Direzione Sanitaria Aziendale, Azienda Sanitaria Locale Roma 6, Albano, 00041 Rome, Italy
| | - Filomena Pietrantonio
- Internal Medicine Department, Ospedale dei Castelli, Azienda Sanitaria Locale Roma 6, Ariccia, 00040 Rome, Italy
- Department of Health Economics, St. Camillus International University of Health Sciences, 00131 Rome, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
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15
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Scarpelli S, De Santis A, Alfonsi V, Gorgoni M, Morin CM, Espie C, Merikanto I, Chung F, Penzel T, Bjorvatn B, Dauvilliers Y, Holzinger B, Wing YK, Partinen M, Plazzi G, De Gennaro L. The role of sleep and dreams in long‐
COVID. J Sleep Res 2022; 32:e13789. [PMID: 36398720 DOI: 10.1111/jsr.13789] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/24/2022] [Accepted: 11/04/2022] [Indexed: 11/19/2022]
Abstract
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.
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Affiliation(s)
| | | | | | - Maurizio Gorgoni
- Department of Psychology Sapienza University of Rome Rome Italy
- IRCCS Fondazione Santa Lucia Rome Italy
| | - Charles M. Morin
- Centre d'étude des troubles du sommeil, École de psychologie, Institut universitaire en santé mentale, Centre de recherche CERVO, Université Laval Quebec QC Canada
| | - Colin Espie
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences University of Oxford Oxford UK
| | - Ilona Merikanto
- SleepWell Research Program, Faculty of Medicine University of Helsinki Helsinki Finland
- Department of Public Health Solutions Finnish Institute for Health and Welfare Helsinki Finland
| | - Frances Chung
- Department of Anesthesiology and Pain Medicine University Health Network, University of Toronto Toronto ON Canada
| | - Thomas Penzel
- Interdisciplinary Sleep Medicine Center Charité—Universitätsmedizin Berlin Berlin Germany
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care University of Bergen Bergen Norway
- Norwegian Competence Center for Sleep Disorders Haukeland University Hospital Bergen Norway
| | - Yves Dauvilliers
- Sleep‐Wake Disorders Unit, Department of Neurology, Gui‐de‐Chauliac Hospital CHU Montpellier, INM, Univ Montpellier, INSERM Montpellier France
| | - Brigitte Holzinger
- Institute for Consciousness and Dream Research Vienna Austria
- Medical University Vienna Vienna Austria
| | - Yun K. Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China
| | - Markku Partinen
- Helsinki Sleep Clinic, Terveystalo Healthcare Helsinki Finland
- Department of Neurosciences, Clinicum University of Helsinki Helsinki Finland
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy
- IRCCS, Istituto delle Scienze Neurologiche Bologna Italy
| | - Luigi De Gennaro
- Department of Psychology Sapienza University of Rome Rome Italy
- IRCCS Fondazione Santa Lucia Rome Italy
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16
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De Luca R, Bonanno M, Calabrò RS. Psychological and Cognitive Effects of Long COVID: A Narrative Review Focusing on the Assessment and Rehabilitative Approach. J Clin Med 2022; 11:jcm11216554. [PMID: 36362782 PMCID: PMC9653636 DOI: 10.3390/jcm11216554] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
Long COVID is a clinical syndrome characterized by profound fatigue, neurocognitive difficulties, muscle pain, weakness, and depression, lasting beyond the 3–12 weeks following infection with SARS-CoV-2. Among the symptoms, neurocognitive and psychiatric sequelae, including attention and memory alterations, as well as anxiety and depression symptoms, have become major targets of current healthcare providers given the significant public health impact. In this context, assessment tools play a crucial role in the early screening of cognitive alterations due to Long COVID. Among others, the general cognitive assessment tools, such as the Montreal Cognitive assessment, and more specific ones, including the State Trait Inventory of Cognitive Fatigue and the Digit Span, may be of help in investigating the main neurocognitive alterations. Moreover, appropriate neurorehabilitative programs using specific methods and techniques (conventional and/or advanced) through a multidisciplinary team are required to treat COVID-19-related cognitive and behavioral abnormalities. In this narrative review, we sought to describe the main neurocognitive and psychiatric symptoms as well as to provide some clinical advice for the assessment and treatment of Long COVID.
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17
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Pellitteri G, Surcinelli A, De Martino M, Fabris M, Janes F, Bax F, Marini A, Milanic R, Piani A, Isola M, Gigli GL, Valente M. Sleep alterations following COVID-19 are associated with both neuroinflammation and psychological disorders, although at different times. Front Neurol 2022; 13:929480. [PMID: 36062000 PMCID: PMC9428349 DOI: 10.3389/fneur.2022.929480] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction By the end of 2019, severe acute respiratory syndrome coronavirus 2 rapidly spread all over the world impacting mental health and sleep habits. Insomnia, impaired sleep quality, and circadian rhythm alterations were all observed during the pandemic, especially among healthcare workers and in patients with acute and post-acute COVID-19. Sleep disruption may induce a pro-inflammatory state associated with an impairment of immune system function. Objective We investigated the relationship between sleep alterations, psychological disorders, and inflammatory blood biomarkers in patients with post-acute COVID-19. Methods We enrolled 47 subjects diagnosed with COVID-19 pneumonia at Santa Maria della Misericordia University Hospital (Udine, Italy) between March and May 2020. Selected patients were evaluated at 2 months (T1) and 10 months (T2) after discharge. Each time, we collected clinical interviews, neurological examinations, and self-administered questionnaires to assess sleep and life quality, anxiety, depression, and post-traumatic stress disorder. Blood biomarkers of endothelial activation, neuroinflammation, and inflammatory cytokines were also measured at each follow-up. Collected variables were analyzed using comparisons between groups and linear regression models. Results Prevalence of insomnia increased from 10.6% up to 27.3% after COVID-19. Poor sleep quality was found in 41.5% of patients at both study visits. At T1 follow-up, poor sleepers showed higher levels of neurofilament light chain, vascular cell adhesion molecule 1, and interleukin 10; no significant associations were found between sleep quality and psychological disorders. At T2 follow-up, lower sleep quality was associated with higher levels of vascular cell adhesion molecule 1 and interleukin 8, but also with higher scores for anxiety, depression, and post-traumatic stress disorder. Conclusion Our results suggest an association of poor sleep quality with both psychological disorders and neuroinflammation, although at different times, in previously hospitalized patients with moderate-to-critical COVID-19.
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Affiliation(s)
- Gaia Pellitteri
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Andrea Surcinelli
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Maria De Martino
- Division of Medical Statistics, Department of Medical Area, University of Udine, Udine, Italy
| | - Martina Fabris
- Institute of Clinical Pathology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Francesco Janes
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Francesco Bax
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | | | - Romina Milanic
- Institute of Clinical Pathology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Antonella Piani
- Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Miriam Isola
- Division of Medical Statistics, Department of Medical Area, University of Udine, Udine, Italy
| | - Gian Luigi Gigli
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Mariarosaria Valente
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- Department of Medical Area (DAME), University of Udine, Udine, Italy
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18
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Dreaming during the COVID-19 pandemic: A narrative review. Neurosci Biobehav Rev 2022; 138:104710. [PMID: 35643121 PMCID: PMC9132492 DOI: 10.1016/j.neubiorev.2022.104710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 12/05/2022]
Abstract
According to several influential models, dreams can be affected by state- and trait-like factors, sleep features, and diurnal experiences. The COVID-19 pandemic globally affected daily habits, emotional experiences, and sleep. Previous studies suggested an influence of collective traumatic events on dreaming. Starting from these premises, several studies assessed the effect of the pandemic on dreams. This paper aims to review findings concerning the oneiric activity during the COVID-19 pandemic. We report pandemic-related changes in dreams and nightmares, and we consider the possible factors associated with dreaming. Moreover, we provide results about changes in the oneiric activity in different phases of the pandemic. The reviewed findings suggest a pandemic-related enhancement of dream and nightmare frequency, emotional intensity, and distressing contents, modulated by modifications in restrictive measures and associated with diurnal experiences, emotional status, and sleep pattern. We highlight several methodological issues and a large heterogeneity in the present literature, limiting results’ generalizability. However, we provide possible interpretations of the most consistent findings in light of the main theoretical frameworks about dreaming.
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19
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Murillo-Rodríguez E, Coronado-Álvarez A, López-Muciño LA, Pastrana-Trejo JC, Viana-Torre G, Barberena JJ, Soriano-Nava DM, García-García F. Neurobiology of dream activity and effects of stimulants on dreams. Curr Top Med Chem 2022; 22:1280-1295. [PMID: 35761491 DOI: 10.2174/1568026622666220627162032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 03/18/2022] [Accepted: 04/11/2022] [Indexed: 11/22/2022]
Abstract
The sleep-wake cycle is the result of the activity of a multiple neurobiological network interaction. Dreaming feature is one interesting sleep phenomena that represents sensorial components, mostly visual perceptions, accompanied with intense emotions. Further complexity has been added to the topic of the neurobiological mechanism of dreams generation by the current data that suggests the influence of drugs on dream generation. Here, we discuss the review on some of the neurobiological mechanism of the regulation of dream activity, with special emphasis on the effects of stimulants on dreaming.
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Affiliation(s)
- Eric Murillo-Rodríguez
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud. Universidad Anáhuac Mayab. Mérida, Yucatán. México.,Intercontinental Neuroscience Research Group
| | - Astrid Coronado-Álvarez
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud. Universidad Anáhuac Mayab. Mérida, Yucatán. México.,Intercontinental Neuroscience Research Group
| | - Luis Angel López-Muciño
- Health Sciences Program. Health Sciences Institute. Veracruzana University. Xalapa. Veracruz. Mexico
| | - José Carlos Pastrana-Trejo
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud. Universidad Anáhuac Mayab. Mérida, Yucatán. México.,Intercontinental Neuroscience Research Group
| | - Gerardo Viana-Torre
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud. Universidad Anáhuac Mayab. Mérida, Yucatán. México.,Intercontinental Neuroscience Research Group
| | - Juan José Barberena
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud. Universidad Anáhuac Mayab. Mérida, Yucatán. México.,Intercontinental Neuroscience Research Group.,Escuela de Psicología, División Ciencias de la Salud. Universidad Anáhuac Mayab. Mérida, Yucatán. México
| | - Daniela Marcia Soriano-Nava
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud. Universidad Anáhuac Mayab. Mérida, Yucatán. México.,Intercontinental Neuroscience Research Group
| | - Fabio García-García
- Intercontinental Neuroscience Research Group.,Health Sciences Program. Health Sciences Institute. Veracruzana University. Xalapa. Veracruz. Mexico
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20
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Meaklim H, Burge M, Le F, Bains SK, Saunders W, Ghosh S, Junge MF, Varma P, Rehm IC, Jackson ML. Strange themes in pandemic dreams: Insomnia was associated with more negative, anxious and death-related dreams during the COVID-19 pandemic. J Sleep Res 2022; 32:e13655. [PMID: 35699296 PMCID: PMC9350044 DOI: 10.1111/jsr.13655] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 05/03/2022] [Accepted: 05/08/2022] [Indexed: 02/03/2023]
Abstract
Dreaming and insomnia are important markers of distress in times of crisis. Here, we present a longitudinal, mixed-methods study examining changes in dreaming between individuals with and without insomnia symptoms and their relationship to mental health during the COVID-19 pandemic. A global survey examining insomnia symptoms, dreams and mental health was launched in April 2020 and followed participants over 12 months. Of 2240 participants, 1009 (45%) reported dream changes at baseline. A higher proportion of participants with new-onset insomnia reported dream changes (55%) than those with pre-existing insomnia (45%) or good sleepers (36%). Overall, thematic analysis identified key dream change themes of increased dream activity, with participants dreaming vividly, in high-definition, and with a strong negative charge. Themes around survival, adjusting to pandemic life, meaning-making and poor sleep quality were also noted. Linguistic Inquiry Word Count showed that individuals with insomnia used more negative words to describe their dream changes than good sleepers. Specifically, the new-onset insomnia group used more anxious and death-related words than those who slept well. Notably, all groups experienced a significant reduction in dream activity by 3-month follow-up. Lastly, dream changes were associated with worse mental health symptoms over time, and this effect was more pronounced in individuals with insomnia. Our results highlight that insomnia symptoms, especially new-onset insomnia, are associated with more negative dream changes during collective stressful events, potentially compounding daytime distress and mental health symptoms over time. During times of crisis, dreaming and insomnia may reveal an important target for mental health interventions.
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Affiliation(s)
- Hailey Meaklim
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
| | - Malisa Burge
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
| | - Flora Le
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
| | - Sukjhit K. Bains
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
| | - William Saunders
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
| | - Stephen Ghosh
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
| | - Moira F. Junge
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia,The Sleep Health FoundationBlacktownNew South WalesAustralia
| | - Prerna Varma
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
| | - Imogen C. Rehm
- College of Health and BiomedicineVictoria UniversityMelbourneVictoriaAustralia
| | - Melinda L. Jackson
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
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21
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Koban K, Neureiter A, Stevic A, Matthes J. The COVID-19 infodemic at your fingertips. Reciprocal relationships between COVID-19 information FOMO, bedtime smartphone news engagement, and daytime tiredness over time. COMPUTERS IN HUMAN BEHAVIOR 2022; 130:107175. [PMID: 35035063 PMCID: PMC8752113 DOI: 10.1016/j.chb.2021.107175] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/27/2021] [Accepted: 12/29/2021] [Indexed: 01/29/2023]
Abstract
Considering that insufficient sleep has long been regarded as a significant public health challenge, the COVID-19 pandemic and its co-evolving infodemic have further aggravated many people's sleep health. People's engagement with pandemic-related news, particularly given that many people are now permanently online via smartphones, has been identified as a critical factor for sleep health, such that public health authorities have recommended limited news exposure. This two-wave panel survey, conducted with a representative sample in Austria during its first COVID-19 lockdown, examines (a) how fear of missing out on pandemic-related news (i.e., COVID-19 information FOMO) is reciprocally related to smartphone-based bedtime news engagement, as well as (b) how both bedtime news engagement and COVID-19 information FOMO predict daytime tiredness. Partial metric measurement invariant structural equation modeling revealed that COVID-19 information FOMO and bedtime news engagement are reciprocally associated over time, indicating a potentially harmful reinforcing loop. However, results further suggested that COVID-19 information FOMO may be the primary driver of daytime tiredness, not smartphone-based bedtime news engagement. These findings suggest that a perceived loss of (informational) control over the pandemic outbreak more strongly than poor sleep habits accounts for depleted energy resources during lockdown. However, given the initial evidence for a reinforcing loop, this effect pattern may change in the long term.
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Affiliation(s)
- Kevin Koban
- University of Vienna, Department of Communication, Austria
| | | | - Anja Stevic
- University of Vienna, Department of Communication, Austria
| | - Jörg Matthes
- University of Vienna, Department of Communication, Austria
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22
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Ossadnik S, Glos M, Fietze I. Bidirektionale Aspekte von SARS-CoV-2 und Schlafstörungen. SOMNOLOGIE 2022; 26:80-88. [PMID: 35528044 PMCID: PMC9052730 DOI: 10.1007/s11818-022-00350-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 11/25/2022]
Abstract
Im vorliegenden Überblick wird der Zusammenhang zwischen der Schlaflänge, der Schlafqualität, dem Immunsystem und einer SARS-CoV-2-Infektion aufgezeigt. Kurzer und/oder schlechter Schlaf kann einen Einfluss auf das Entstehen einer Infektion sowie deren Verlauf haben. Ebenso können eine SARS-CoV-2-Infektion sowie die pandemiebedingten Umstände den Schlaf negativ beeinflussen. Dabei nimmt insbesondere die Schlafqualität ab. Die Pandemie hat somit das Potenzial, Schlafstörungen auszulösen, zu verstärken und/oder aufrechtzuerhalten. Diese Befunde haben insofern Relevanz, als nur ein ausreichender und erholsamer Schlaf das Immunsystem stärkt und protektiv bezüglich einer Infektion und ihres Verlaufs wirken kann. Die Pandemie stellt somit eine weitere Herausforderung für die Schlafmedizin dar und bietet gleichzeitig die Chance, die Bedeutung des Schlafs für die Gesundheit und den Krankheitsverlauf zu vermitteln.
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Affiliation(s)
- Sarah Ossadnik
- Interdisziplinäres Schlafmedizinisches Zentrum, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Deutschland
| | - Martin Glos
- Interdisziplinäres Schlafmedizinisches Zentrum, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Deutschland
| | - Ingo Fietze
- Interdisziplinäres Schlafmedizinisches Zentrum, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Deutschland
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23
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The Oneiric Activity during and after the COVID-19 Total Lockdown in Italy: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073857. [PMID: 35409540 PMCID: PMC8997831 DOI: 10.3390/ijerph19073857] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 02/07/2023]
Abstract
A growing body of evidence highlights that the COVID-19 pandemic affected oneiric activity. However, only a few studies have assessed the longitudinal changes in dream phenomenology during different phases of the pandemic, often focused on a limited number of dream variables. The aim of the present study was to provide an exhaustive assessment of dream features during total lockdown (TL) and a post-lockdown (PL) period characterized by eased restrictive measures in Italy. We performed a longitudinal study using a web-based survey to collect demographic, COVID-19 related, clinical, sleep, and dream data at TL and PL. Our final sample included 108 participants. The high frequency of poor sleep quality, anxiety, and depressive symptoms observed during TL remained stable at PL, while sleep latency (t = −4.09; p < 0.001) and PTSD-related disruptive nocturnal behaviors (t = −5.68; p < 0.001) exhibited a reduction at PL. A PL decrease in time spent with digital media was observed (t = −2.77; p = 0.007). We found a strong PL reduction in dream frequency (t = −5.49; p < 0.001), emotional load (t = −2.71; p = 0.008), vividness (t = −4.90; p < 0.001), bizarreness (t = −4.05; p < 0.001), length (t = −4.67; p < 0.001), and lucid dream frequency (t = −2.40; p = 0.018). Fear was the most frequently reported emotion in dreams at TL (26.9%) and PL (22.2%). Only the frequency of specific lockdown-related dream contents exhibited a reduction at PL. These findings highlight that the end of the home confinement had a strong impact on the oneiric activity, in the direction of reduced dream frequency, intensity, and lockdown-related contents. The co-occurrence of such changes with a decline in nocturnal PTSD-related symptoms, sleep latency, and time with digital media suggests an influence of post-traumatic stress levels, lifestyle modifications, and sleep pattern on dream changes during different phases of the pandemic. The stable prevalence of fear in dreams and the large frequency of poor sleep quality, depressive symptoms, and anxiety are probably related to the persistence of many negative consequences of the pandemic. Overall, these results are consistent with the continuity hypothesis of dreams.
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24
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Sleepless in Solitude-Insomnia Symptoms Severity and Psychopathological Symptoms among University Students during the COVID-19 Pandemic in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052551. [PMID: 35270244 PMCID: PMC8909406 DOI: 10.3390/ijerph19052551] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/18/2022] [Accepted: 02/19/2022] [Indexed: 01/09/2023]
Abstract
Since 25 March 2020, all schools, colleges, and universities in Poland have indefinitely closed and, where possible, have activated distance learning because of the COVID-19 pandemic. Considering that the undergraduate years are usually characterized by a high prevalence of emotional disorders and sleep problems, it can be expected that the current situation may have a remarkable impact on the student population. This study aimed to investigate the occurrence of sleep problems among Polish university students as well as the relationship of insomnia symptoms severity with psychopathological symptoms, posttraumatic stress disorder (PTSD) symptoms, and behavioral factors, such as substance use, changes in the amount of sleep, and the level of physical activity during the COVID-19 pandemic. Data were collected from 1111 Polish university students via an online survey conducted between IV and VI 2020. The survey included demographic variables, the level of psychopathological symptoms (General Health Questionnaire, GHQ-28), insomnia (Insomnia Severity Index, ISI), and symptoms of posttraumatic stress (Impact of Events Scale-Revised, IES-R). The results showed that over half of the studied group of students had some form of sleep disturbances during the period of data collection, with moderate-to-severe insomnia symptoms noted in 21.6%. At the same time, the majority of the sample declared they slept more during the pandemic. A significant positive correlation was observed between the severity of insomnia symptoms and PTSD symptoms, as well as GHQ scores, increased substance use, and decreased physical activity. An additional association between the presence of dreams related to the event and insomnia symptoms as well as GHQ scores has been found. The results suggest that sleep problems may be prevalent among university students during the pandemic. Moreover, although the symptoms of insomnia, as well as the severity of sleep disturbance, significantly correlated with all the investigated variables, the direction of those associations remains to be established.
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25
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Alghamdi AA, Alafif NO, BaHammam AS, Almuammar M, Alharbi NS, Alhefdhi NA, Al-Musharaf S, Al Ghamdi KS, AlYousif GF, Al Muhanna NF. Nightmares' Pattern and Predictors among a Saudi University Students during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031776. [PMID: 35162799 PMCID: PMC8835620 DOI: 10.3390/ijerph19031776] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/21/2022] [Accepted: 01/30/2022] [Indexed: 12/16/2022]
Abstract
Purpose: During the coronavirus disease 2019 (COVID-19) pandemic quarantine, university students were under various types of stressors, including the exams period, which might have affected their quality and quantity of sleep, and consequently, their quality of life. This study aimed to investigate the pattern and predictors of nightmares among university students and coinvestigate the presence of other types of sleep disturbances, mental disorders, and quarantine-related stressors. Methods: This cross-sectional study included 368 university students who answered a self-completed questionnaire covering their sociodemographic features, nightmare indicators, and associated quarantine stressors. Additionally, sleep disturbances were measured using the Generalized Sleep Disturbance Scale (GSDS), anxiety using the Generalized Anxiety Disorder 2 scale, and depression using the Patient Health Questionnaire-2. Results: The participants’ mean age was 20.4 ± 1.6 years, and male participants represented 35.9% of the sample. Nightmares were experienced by 117 (31.8%) of the participants, of whom 44.4% had new-onset nightmares. The mean GSDS was 45.0 ± 14.9 (min. = 12, max. = 130). This value is associated with elevated odds of the following outcomes: the presence of nightmares (odds ratio [OR] = 1.8; confidence interval [CI] 95% = 1.1–3.0); new-onset nightmares at the time of pandemic (OR = 2.6; CI 95% = 1.3–5.5); and anxiety (OR = 1.74; CI 95% = 1.0–2.9). The presence of nightmares elevated the score of GSDS by 11.3 points (S.E. = 1.6, p < 0.001), elevated the odds of anxiety by 4.1 (CI 95% = 2.5–6.8), and depression by 2.1 (CI 95% = 1.3–3.4). Conclusions: Stressors resulting from both the exams period and the fact that it was conducted during COVID-19 quarantine increased the rate and affected the pattern of nightmares. These stressors also led to other sleep disturbances and mental disorders that were significantly more prevalent among females.
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Affiliation(s)
- Amal A. Alghamdi
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.A.A.); (G.F.A.)
| | - Nora O. Alafif
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 10219, Saudi Arabia; (M.A.); (N.S.A.); (N.A.A.); (S.A.-M.)
- Correspondence:
| | - Ahmed S. BaHammam
- The University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, Riyadh 11324, Saudi Arabia;
- The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh 11362, Saudi Arabia
| | - May Almuammar
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 10219, Saudi Arabia; (M.A.); (N.S.A.); (N.A.A.); (S.A.-M.)
| | - Najd S. Alharbi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 10219, Saudi Arabia; (M.A.); (N.S.A.); (N.A.A.); (S.A.-M.)
| | - Nouf A. Alhefdhi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 10219, Saudi Arabia; (M.A.); (N.S.A.); (N.A.A.); (S.A.-M.)
| | - Sara Al-Musharaf
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 10219, Saudi Arabia; (M.A.); (N.S.A.); (N.A.A.); (S.A.-M.)
| | - Kholoud S. Al Ghamdi
- Department of Physiology, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia;
| | - Ghada F. AlYousif
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.A.A.); (G.F.A.)
| | - Norah F. Al Muhanna
- Psychiatry Department, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia;
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26
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Scarpelli S, Nadorff MR, Bjorvatn B, Chung F, Dauvilliers Y, Espie CA, Inoue Y, Matsui K, Merikanto I, Morin CM, Penzel T, Sieminski M, Fang H, Macêdo T, Mota-Rolim SA, Leger D, Plazzi G, Chan NY, Partinen M, Bolstad CJ, Holzinger B, De Gennaro L. Nightmares in People with COVID-19: Did Coronavirus Infect Our Dreams? Nat Sci Sleep 2022; 14:93-108. [PMID: 35115852 PMCID: PMC8800372 DOI: 10.2147/nss.s344299] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/01/2022] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION A growing number of studies have demonstrated that the coronavirus disease-19 (COVID-19) pandemic has severely affected sleep and dream activity in healthy people. To date, no investigation has examined dream activity specifically in COVID-19 patients. METHODS As part of the International COVID-19 Sleep Study (ICOSS), we compared 544 COVID-19 participants with 544 matched-controls. A within-subjects comparison between pre-pandemic and pandemic periods computed separately for controls and COVID-19 participants were performed on dream recall and nightmare frequency (DRF; NF). Also, non-parametric comparisons between controls and COVID-19 participants were carried out. Further, we compared psychological measures between the groups collected during pandemic. Ordinal logistic regression to detect the best predictors of NF was performed. RESULTS We found that people reported greater dream activity during the pandemic. Comparisons between controls and COVID-19 participants revealed a) no difference between groups concerning DRF in the pre-pandemic period and during the pandemic; b) no difference between groups concerning nightmare frequency in the pre-pandemic period; and c) COVID-19 participants reported significantly higher NF than controls during pandemic (p = 0.003). Additionally, we showed that a) anxiety, depression, post-traumatic stress-disorder (PTSD) symptom scores were higher in COVID-19 participants than controls; and b) quality of life and health as well as wellbeing (WHO-5) scores were significantly higher in controls than COVID-19 participants. Finally, ordinal logistic regression indicates that DRF (p < 0.001), PTSD (p < 0.001), anxiety (p = 0.018), insomnia (p = 0.039), COVID-19 severity (p = 0.014), sleep duration (p = 0.003) and age (p = 0.001) predicted NF. DISCUSSION Our work shows strong associations between increased nightmares in those reporting having had COVID-19. This suggests that the more that people were affected by COVID-19, the greater the impact upon dream activity and quality of life.
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Affiliation(s)
- Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Michael R Nadorff
- Mississippi State University, Mississippi State, MS, USA
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Bjørn Bjorvatn
- Department of Public Health and Primary Care, University of Bergen and Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Frances Chung
- Department of Anesthesiology and Pain Medicine, University Health Network, University of Toronto, Toronto, Canada
| | - Yves Dauvilliers
- Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, INM, Univ Montpellier, INSERM, Montpellier, France
| | - Colin A Espie
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | | | - Kentaro Matsui
- Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Psychiatry, Tokyo Women’s Medical University, Tokyo, Japan
| | - Ilona Merikanto
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Charles M Morin
- École de Psychologie, Centre d’étude des troubles du sommeil, Centre de recherche CERVO/Brain Research Center, Université Laval, Québec, Canada
| | - Thomas Penzel
- Sleep Medicine Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Mariusz Sieminski
- Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Han Fang
- Department of Pulmonary and Critical Care Medicine, Peking University People’s Hospital, Beijing, People’s Republic of China
| | - Tainá Macêdo
- Department of Psychology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Sérgio A Mota-Rolim
- Brain Institute, Physiology and Behavior Department, and Onofre Lopes University Hospital - Federal University of Rio Grande do Norte, Natal, Brazil
| | - Damien Leger
- Université de Paris, APHP, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, Paris, France
| | - Giuseppe Plazzi
- IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Regions, People’s Republic of China
| | - Markku Partinen
- Helsinki Sleep Clinic, Terveystalo Healthcare, and Department of Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland
| | | | - Brigitte Holzinger
- Institute for Consciousness and Dream Research, Vienna, Austria
- Medical University Vienna, Postgraduate Master Program Medical Sleep Coaching, ZK-Schlafcoaching, Vienna, Austria
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
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27
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Gibson R, Shetty H, Carter M, Münch M. Sleeping in a bubble: factors affecting sleep during New Zealand's COVID-19 lockdown. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2022; 3:zpac017. [PMID: 35996713 PMCID: PMC9383987 DOI: 10.1093/sleepadvances/zpac017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/14/2022] [Indexed: 05/17/2023]
Abstract
New Zealand (NZ) enforced a rigorous lockdown in response to the outbreak of COVID-19 in 2020. Infection rates remained remarkably low, yet social and personal routines were affected. Factors associated with reporting worsening sleep were explored using an anonymous online survey launched during New Zealand's 2020 lockdown. Participants were 723 adults aged 20-85 years (median: 45 years, 82% women). Bed and wake times occurred significantly later compared to pre-lockdown estimates and resulted in shorter social jetlag (15 min). During lockdown, 54.5% were identified as "poor sleepers" [i.e. score > 5 on the Pittsburgh Sleep Quality Index (PSQI)]. Overall, 45% rated their sleep quality to worsen compared to pre-lockdown, 22% reported an improvement. Reports of worsening sleep were significantly related to increased sleep latency, reduced sleep efficiency, and heightened PSQI scores compared to those with better sleep or no change. Subjectively worse sleep was significantly associated with less time engaging in physical activity, less exposure to daylight, and social interactions compared to pre-lockdown estimates (p < .05). Logistic regression models identified significant relationships between having more vivid dreams and worsening sleep. Worse sleepers also had increased likelihoods of reporting poorer mood and they also scored higher for anxiety compared to those with no change or improved sleep during lockdown (p < .05). Pandemic-related restrictions contributed to poorer self-reported sleep which was linked to deterioration of mood. Negative affect was comparatively lower than reported elsewhere. These findings provide unique insights to the psychosocial impact of the initial COVID-19 lockdown in New Zealand, where the disease outbreak remained low.
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Affiliation(s)
- Rosemary Gibson
- Corresponding author. R. Gibson, School of Psychology, Massey University Private Bag 11 222, Palmerston North, New Zealand.
| | - Harshi Shetty
- Sleep/Wake Research Centre, Massey University, Wellington, New Zealand
| | - Mikaela Carter
- Sleep/Wake Research Centre, Massey University, Wellington, New Zealand
| | - Mirjam Münch
- Sleep/Wake Research Centre, Massey University, Wellington, New Zealand
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
- Centre for Chronobiology, University Psychiatric Clinics, Basel, Transfaculty Research Platform Molecular and Cognitive Neurosciences, Switzerland
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Lenzo V, Sardella A, Musetti A, Freda MF, Lemmo D, Vegni E, Borghi L, Plazzi G, Palagini L, Castelnuovo G, Cattivelli R, Mariani R, Michelini G, Manari T, Saita E, Quattropani MC, Franceschini C. The Relationship Between Resilience and Sleep Quality During the Second Wave of the COVID-19 Pandemic: A Longitudinal Study. Nat Sci Sleep 2022; 14:41-51. [PMID: 35023980 PMCID: PMC8747773 DOI: 10.2147/nss.s344042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/22/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Previous studies showed poor sleep quality during the first Italian lockdown consequent to the quick spread of the virus. Poor sleep quality remained stable during the so-called "second wave", which started in Autumn 2020. This study aimed to compare sleep quality between the two waves of contagions and to examine the effect of resilience, together with sociodemographic and COVID-related variables, on sleep quality during the second wave. PATIENTS AND METHODS A total of 648 participated in this longitudinal study through an online survey during the first lockdown consequent to the COVID-19 and during the second wave. The Medical Outcomes Study-Sleep Scale (MOS-SS) and the Resilience Scale (RS) were administered. Sociodemographic and COVID-related information were also collected. RESULTS The results showed sleep quality slightly increased in the second wave, even though with a small effect size. Correlational analysis showed that resilience is inversely correlated with sleep quality measured in the two waves. Sleep quality during the second wave was positively correlated with sleep quality in the first lockdown. Likewise, the results of multiple regression revealed that the sleep quality in the first lockdown and resilience were significant predictors of sleep quality during the second wave. CONCLUSION These findings highlighted that the prevalence of poor sleepers remained high during the second wave. Together with the sleep quality in the first lockdown, resilience represents an important factor related to sleep quality during the second wave. Interventions to improve sleep quality among the general population should take into account these findings.
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Affiliation(s)
- Vittorio Lenzo
- Department of Social and Educational Sciences of the Mediterranean Area, University for Foreigners "Dante Alighieri" of Reggio Calabria, Reggio, Calabria, Italy
| | - Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | | | - Daniela Lemmo
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Elena Vegni
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Lidia Borghi
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Laura Palagini
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy.,Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
| | | | - Rachele Mariani
- Department of Dynamic and Clinical Psychology, University of Rome "La Sapienza", Roma, Italy
| | | | - Tommaso Manari
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Emanuela Saita
- Department of Psychology, Catholic University of Milan, Milan, Italy
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Šćepanović S, Aiello LM, Barrett D, Quercia D. Epidemic dreams: dreaming about health during the COVID-19 pandemic. ROYAL SOCIETY OPEN SCIENCE 2022; 9:211080. [PMID: 35116145 PMCID: PMC8790359 DOI: 10.1098/rsos.211080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 12/09/2021] [Indexed: 05/04/2023]
Abstract
The continuity hypothesis of dreams suggests that the content of dreams is continuous with the dreamer's waking experiences. Given the unprecedented nature of the experiences during COVID-19, we studied the continuity hypothesis in the context of the pandemic. We implemented a deep-learning algorithm that can extract mentions of medical conditions from text and applied it to two datasets collected during the pandemic: 2888 dream reports (dreaming life experiences), and 57 milion tweets (waking life experiences) mentioning the pandemic. The health expressions common to both sets were typical COVID-19 symptoms (e.g. cough, fever and anxiety), suggesting that dreams reflected people's real-world experiences. The health expressions that distinguished the two sets reflected differences in thought processes: expressions in waking life reflected a linear and logical thought process and, as such, described realistic symptoms or related disorders (e.g. nasal pain, SARS, H1N1); those in dreaming life reflected a thought process closer to the visual and emotional spheres and, as such, described either conditions unrelated to the virus (e.g. maggots, deformities, snake bites), or conditions of surreal nature (e.g. teeth falling out, body crumbling into sand). Our results confirm that dream reports represent an understudied yet valuable source of people's health experiences in the real world.
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Affiliation(s)
| | | | - Deirdre Barrett
- Harvard Medical School, 352 Harvard Street, Cambridge, MA 02138, USA
| | - Daniele Quercia
- Nokia Bell Labs, 21 JJ Thomson Avenue, Cambridge CB30FA, UK
- CUSP, King's College London, Strand, London, WC2R 2LS, UK
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30
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Holzinger B, Nierwetberg F, Chung F, Bolstad CJ, Bjorvatn B, Chan NY, Dauvilliers Y, Espie CA, Han F, Inoue Y, Leger D, Macêdo T, Matsui K, Merikanto I, Morin CM, Mota-Rolim SA, Partinen M, Plazzi G, Penzel T, Sieminski M, Wing YK, Scarpelli S, Nadorff MR, De Gennaro L. 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. Nat Sci Sleep 2022; 14:1469-1483. [PMID: 36052103 PMCID: PMC9426865 DOI: 10.2147/nss.s368147] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/15/2022] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Brigitte Holzinger
- Institute for Consciousness and Dream Research, Vienna, Austria.,Medical University Vienna, Postgraduate Master ULG Sleep Coaching, Vienna, Austria
| | | | - Frances Chung
- Department of Anesthesiology and Pain Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
| | | | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen and Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region, People's Republic of China
| | - Yves Dauvilliers
- Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, INM, Univ Montpellier, INSERM, Montpellier, France
| | - Colin A Espie
- Sir Jules Thorn Sleep & Circadian Neuroscience Institute (SCNi), University of Oxford, Oxford, UK
| | - Fang Han
- Department of Pulmonary and Critical Care Medicine, Peking University People's Hospital, Beijing, People's Republic of China
| | | | - Damien Leger
- Université de Paris, APHP, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, Paris, France
| | - Tainá Macêdo
- Department of Psychology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Kentaro Matsui
- Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan.,Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan
| | - Ilona Merikanto
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Charles M Morin
- École de Psychologie, Centre d'étude des troubles du sommeil, Centre de recherche CERVO/Brain Research Center, Université Laval, Québec, QC, Canada
| | - Sérgio A Mota-Rolim
- Brain Institute, Physiology and Behavior Department, and Onofre Lopes University Hospital - Federal University of Rio Grande do Norte, Natal, Brazil
| | - Markku Partinen
- Helsinki Sleep Clinic, Terveystalo Healthcare, and Department of Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland
| | - Giuseppe Plazzi
- IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Thomas Penzel
- Sleep Medicine Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Mariusz Sieminski
- Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region, People's Republic of China
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Michael R Nadorff
- Mississippi State University, Mississippi State, MS, USA.,Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
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31
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Solomonova E, Picard-Deland C, Rapoport IL, Pennestri MH, Saad M, Kendzerska T, Veissiere SPL, Godbout R, Edwards JD, Quilty L, Robillard R. Stuck in a lockdown: Dreams, bad dreams, nightmares, and their relationship to stress, depression and anxiety during the COVID-19 pandemic. PLoS One 2021; 16:e0259040. [PMID: 34818346 PMCID: PMC8612516 DOI: 10.1371/journal.pone.0259040] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/12/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND An upsurge in dream and nightmare frequency has been noted since the beginning of the COVID-19 pandemic and research shows increases in levels of stress, depression and anxiety during this time. Growing evidence suggests that dream content has a bi-directional relationship with psychopathology, and that dreams react to new, personally significant and emotional experiences. The first lockdown experience was an acute event, characterized by a combination of several unprecedent factors (new pandemic, threat of disease, global uncertainty, the experience of social isolation and exposure to stressful information) that resulted in a large-scale disruption of life routines. This study aimed at investigating changes in dream, bad dream and nightmare recall; most prevalent dream themes; and the relationship between dreams, bad dreams, nightmares and symptoms of stress, depression and anxiety during the first COVID-19 lockdown (April-May 2020) through a national online survey. METHODS 968 participants completed an online survey. Dream themes were measured using the Typical Dreams Questionnaire; stress levels were measured by the Cohen's Perceived Stress Scale; symptoms of anxiety were assessed by Generalized Anxiety Disorder (GAD-7) scale; and symptoms of depression were assessed using the Quick Inventory of Depressive Symptomatology. RESULTS 34% (328) of participants reported increased dream recall during the lockdown. The most common dream themes were centered around the topics of 1) inefficacy (e.g., trying again and again, arriving late), 2) human threat (e.g., being chased, attacked); 3) death; and 4) pandemic imagery (e.g., being separated from loved ones, being sick). Dream, bad dream and nightmare frequency was highest in individuals with moderate to severe stress levels. Frequency of bad dreams, nightmares, and dreams about the pandemic, inefficacy, and death were associated with higher levels of stress, as well as with greater symptoms of depression and anxiety. CONCLUSIONS Results support theories of dream formation, environmental susceptibility and stress reactivity. Dream content during the lockdown broadly reflected existential concerns and was associated with increased symptoms of mental health indices.
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Affiliation(s)
- Elizaveta Solomonova
- Neurophilosophy Lab, McGill University, Montreal, Canada
- Division of Social and Transcultural Psychiatry, Department of Psychiatry, Culture, Mind and Brain research group, McGill University, Montreal, Canada
| | - Claudia Picard-Deland
- Dream and Nightmare Laboratory, Center for Advanced Research in Sleep Medicine, Montreal, Canada
- Department of Neuroscience, University of Montreal, Montreal, Canada
| | | | - Marie-Hélène Pennestri
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
- Sleep Laboratory and Clinic, Hôpital en Santé Mentale Rivière-des-Prairies, CIUSSS du Nord-de-l’Île-de-Montréal, Montreal, Canada
| | - Mysa Saad
- The Royal’s Institute of Mental Health Research, Ottawa, Canada
| | - Tetyana Kendzerska
- Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - Samuel Paul Louis Veissiere
- Division of Social and Transcultural Psychiatry, Department of Psychiatry, Culture, Mind and Brain research group, McGill University, Montreal, Canada
| | - Roger Godbout
- Sleep Laboratory and Clinic, Hôpital en Santé Mentale Rivière-des-Prairies, CIUSSS du Nord-de-l’Île-de-Montréal, Montreal, Canada
- Department of Psychiatry, University of Montreal, Montreal, Canada
| | - Jodi D. Edwards
- University of Ottawa Heart Institute, Ottawa, Canada
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Lena Quilty
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Rebecca Robillard
- The Royal’s Institute of Mental Health Research, Ottawa, Canada
- School of Psychology, University of Ottawa, Ottawa, Canada
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32
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Gorgoni M, Scarpelli S, Mangiaruga A, Alfonsi V, Bonsignore MR, Fanfulla F, Ferini-Strambi L, Nobili L, Plazzi G, De Gennaro L. Persistence of the Effects of the COVID-19 Lockdown on Sleep: A Longitudinal Study. Brain Sci 2021; 11:brainsci11111520. [PMID: 34827519 PMCID: PMC8615786 DOI: 10.3390/brainsci11111520] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/02/2021] [Accepted: 11/15/2021] [Indexed: 02/05/2023] Open
Abstract
The effects of the COVID-19 pandemic on sleep have been widely documented, but longitudinal evaluations during different phases of the “COVID-19 era” are needed to disentangle the specific consequences of the r145estrictive measures on sleep variables. The aim of this study was to assess the immediate effect of the lockdown’s end on sleep and sleep-related dimensions in an Italian sample, also considering the stress and depressive symptoms. We used an online survey to longitudinally collect data on sociodemographic, environmental, clinical, sleep, and sleep-related variables in two time points: during and immediately after the lockdown. The final sample included 102 participants. The large prevalence of poor sleep quality, clinically relevant pre-sleep arousal, and depressive symptoms, as well as poor sleep quality and pre-sleep arousal score observed during the lockdown, remained stable after its end. On the other hand, the prevalence of moderate-to-severe event-related stress and intrusive symptom scores exhibited a drastic reduction after the end of home confinement. Both bedtime and rise time were anticipated after the lockdown, while sleep quality exhibited only a trend of post-lockdown sleep disturbance reduction. Our findings point to a reduced stress level (specific for the intrusive symptomatology) after the end of the lockdown and persistence of sleep problems, suggesting two non-mutually exclusive hypotheses: (a) the strict restrictive measures are not the main cause of sleep problems during the pandemic and (b) home confinement induces long-lasting effects on sleep observable after its end, and a longer period of time might be needed to observe an improvement.
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Affiliation(s)
- Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.G.); (S.S.); (V.A.)
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.G.); (S.S.); (V.A.)
| | - Anastasia Mangiaruga
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Valentina Alfonsi
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.G.); (S.S.); (V.A.)
| | - Maria R. Bonsignore
- PROMISE Department, University of Palermo, and IRIB-CNR, 90127 Palermo, Italy;
| | - Francesco Fanfulla
- Sleep Medicine Unit, Clinical and Scientific Maugeri Institutes, Scientific Institute of Pavia, IRCCS, 27100 Pavia, Italy;
| | - Luigi Ferini-Strambi
- Sleep Disorders Center, Vita-Salute San Raffaele University, 20127 Milan, Italy;
| | - Lino Nobili
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy;
- Department of Medical and Surgical Neuroscience and Rehabilitation (DINOGMI), University of Genoa, 16147 Genoa, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy;
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.G.); (S.S.); (V.A.)
- Body and Action Lab, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
- Correspondence: ; Tel.: +39-064-9917-508
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O’Regan D, Jackson ML, Young AH, Rosenzweig I. Understanding the Impact of the COVID-19 Pandemic, Lockdowns and Social Isolation on Sleep Quality. Nat Sci Sleep 2021; 13:2053-2064. [PMID: 34795545 PMCID: PMC8593898 DOI: 10.2147/nss.s266240] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/17/2021] [Indexed: 12/15/2022] Open
Abstract
The uncertain, ever-changing and an ongoing nature of the COVID-19 pandemic means that it may take some time before we can fully appreciate the negative effect of the pandemic and lockdown on our sleep and mental health. It is increasingly recognised that in the aftermath of pandemic, several persistent sleep, neuropsychiatric and physical sequelae may continue long after the pandemic is over. A body of evidence to date also highlights a significant disparity in sleep and mental health difficulties in specific vulnerable groups in the community, with different temporal profiles and sleep issues that are reported. In this perspective, we argue for a possible mechanistic impact of the COVID-19 pandemic, with its imposed restrictions and social isolation on sleep quality. We similarly discuss some of the potential international differences, as well as similarities, behind reported idiosyncratic biological vulnerabilities that may have contributed to the genesis of sleep issues. Lastly, we propose some possible implementations and innovations that may be needed in restructuring of sleep disorders services in order to benefit recovering COVID-19 patients.
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Affiliation(s)
- David O’Regan
- Sleep Disorders Centre, Guy’s and St Thomas’ Hospital, GSTT NHS, London, UK
- Faculty of Life and Sciences Medicine, King’s College London, London, UK
| | - Melinda L Jackson
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Allan H Young
- School of Academic Psychiatry, IoPPN, King’s College London, London, UK
| | - Ivana Rosenzweig
- Sleep Disorders Centre, Guy’s and St Thomas’ Hospital, GSTT NHS, London, UK
- Sleep and Brain Plasticity Centre, CNS, IoPPN, King’s College London, London, UK
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34
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Mosher Henke R. Knowing Well, Being Well: well-being born of understanding: Shifts in Health Behaviors Amid the COVID-19 Pandemic. Am J Health Promot 2021; 35:1162-1183. [DOI: 10.1177/08901171211055310a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
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.
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Altered Sleep Duration and Poor Quality of Sleep Among Pharmacy Students Amidst COVID-19 Lockdown: A South-Indian Study. SLEEP AND VIGILANCE 2021; 6:123-129. [PMID: 34729450 PMCID: PMC8554515 DOI: 10.1007/s41782-021-00178-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/01/2021] [Accepted: 10/14/2021] [Indexed: 10/30/2022]
Abstract
Introduction/background The nationwide lockdown enforced due to the spread of coronavirus disease-2019 had a definite impact on sleep. Objective To observe any changes in the duration, pattern and quality of sleep among pharmacy students due to the lockdown. Methods A google form-based cross-sectional and descriptive study was carried out after approval was obtained from the ethical committee in the month of July 2021 among 310 pharmacy students. The validated form was electronically administered after obtaining the informed consent. All the data pertaining to duration, pattern and quality of sleep before and during the lockdown was collected and analyzed using STATA version 16.0. Results and Discussion Out of 310 participants, the study revealed an increase in the time needed to fall asleep (p value < 0.001) and in the total duration of sleep (p value < 0.001). A delay in the time of sleep in the morning (p value < 0.001) and at night (p value < 0.001) was also one among the many significant results. The incidences of jerky leg movements (p value < 0.001), snoring (p value < 0.001), frequent nightmares (p value < 0.001) and anxiety (p value < 0.001) were also increased as a direct effect of the lockdown. Conclusion The study has confirmed the detrimental impact of the lockdown on sleep among pharmacy students. All attributes of sleep duration and sleep quality have achieved statistical significance signifying the need to develop cognitive behavioral interventions and prevent the worsening of mental health amidst the COVID-19 era.
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Scarpelli S, Alfonsi V, Gorgoni M, Musetti A, Filosa M, Quattropani MC, Lenzo V, Vegni E, Borghi L, Margherita G, Freda MF, Saita E, Cattivelli R, Castelnuovo G, Manari T, Plazzi G, De Gennaro L, Franceschini C. Dreams and Nightmares during the First and Second Wave of the COVID-19 Infection: A Longitudinal Study. Brain Sci 2021; 11:brainsci11111375. [PMID: 34827374 PMCID: PMC8615577 DOI: 10.3390/brainsci11111375] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/13/2021] [Accepted: 10/17/2021] [Indexed: 02/05/2023] Open
Abstract
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.
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Affiliation(s)
- Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (V.A.); (M.G.); (L.D.G.)
- Correspondence:
| | - Valentina Alfonsi
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (V.A.); (M.G.); (L.D.G.)
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (V.A.); (M.G.); (L.D.G.)
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, 43125 Parma, Italy; (A.M.); (T.M.)
| | - Maria Filosa
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.F.); (C.F.)
| | - Maria C. Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy;
| | - Vittorio Lenzo
- Department of Social and Educational Sciences of the Mediterranean Area, “Dante Alighieri” University for Foreigners of Reggio Calabria, 89125 Reggio Calabria, Italy;
| | - Elena Vegni
- Department of Health Sciences, University of Milan, 20146 Milan, Italy; (E.V.); (L.B.)
| | - Lidia Borghi
- Department of Health Sciences, University of Milan, 20146 Milan, Italy; (E.V.); (L.B.)
| | - Giorgia Margherita
- Department of Humanistic Studies, Federico II University, 80138 Naples, Italy; (G.M.); (M.F.F.)
| | - Maria Francesca Freda
- Department of Humanistic Studies, Federico II University, 80138 Naples, Italy; (G.M.); (M.F.F.)
| | - Emanuela Saita
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (E.S.); (R.C.); (G.C.)
| | - Roberto Cattivelli
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (E.S.); (R.C.); (G.C.)
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, 28824 Verbania, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (E.S.); (R.C.); (G.C.)
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, 28824 Verbania, Italy
| | - Tommaso Manari
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, 43125 Parma, Italy; (A.M.); (T.M.)
| | - Giuseppe Plazzi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy;
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (V.A.); (M.G.); (L.D.G.)
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Christian Franceschini
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.F.); (C.F.)
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Alfonsi V, Gorgoni M, Scarpelli S, Zivi P, Sdoia S, Mari E, Quaglieri A, Ferlazzo F, Giannini AM, De Gennaro L. Changes in sleep pattern and dream activity across and after the COVID-19 lockdown in Italy: A longitudinal observational study. J Sleep Res 2021; 31:e13500. [PMID: 34595786 PMCID: PMC8646575 DOI: 10.1111/jsr.13500] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/08/2021] [Accepted: 09/14/2021] [Indexed: 02/05/2023]
Abstract
A large body of evidence has documented the impact of the global COVID‐19 outbreak – and especially the lockdown period – on sleep quality and quantity. Here, we present the first Italian longitudinal study on sleep and COVID‐19 considering four different time points collected during lockdown (from 29 March 2020 to 3 May 2020) and a subsequent follow‐up period (October 2020). We used an online survey to collect socio‐demographic and COVID‐19 related information. Subjects were also asked to complete a sleep diary at each time point of the study. Our longitudinal sample included 147 participants. Statistical comparison across time intervals showed remarkable changes in sleep patterns during and after the lockdown. In particular, during lockdown we observed longer sleep latency, less ease of falling asleep, a higher total bedtime, and a lower dream frequency. The week‐by‐week evaluation described relatively stable patterns in the observed measures during the lockdown period, except for dream frequency, affected by a rapid increase in the early phase of lockdown. Our findings are in line with the current literature. Furthermore, the prospective longitudinal investigation comprising several time points offered the possibility of (a) observing the temporal dynamics and the different entities of such changes over time, and (b) reducing the typical memory bias for these studies.
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Affiliation(s)
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Pierpaolo Zivi
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Stefano Sdoia
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Emanuela Mari
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Fabio Ferlazzo
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy
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Fränkl E, Scarpelli S, Nadorff MR, Bjorvatn B, Bolstad CJ, Chan NY, Chung F, Dauvilliers Y, Espie CA, Inoue Y, Leger D, Macêdo T, Matsui K, Merikanto I, Morin CM, Mota-Rolim S, Partinen M, Penzel T, Plazzi G, Sieminski M, Wing YK, De Gennaro L, Holzinger B. How our Dreams Changed During the COVID-19 Pandemic: Effects and Correlates of Dream Recall Frequency - a Multinational Study on 19,355 Adults. Nat Sci Sleep 2021; 13:1573-1591. [PMID: 34588830 PMCID: PMC8473566 DOI: 10.2147/nss.s324142] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/21/2021] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Many have reported odd dreams during the pandemic. Given that dreams are associated with mental health, understanding these changes could provide crucial information about wellbeing during the pandemic. This study explored associations between COVID-19 and dream recall frequency (DRF), and related social, health, and mental health factors. METHODS We conducted a cross-sectional web survey of 19,355 individuals in 14 countries from May to July 2020. We collected data on COVID-19, mental health, sleep and DRF during the pandemic. We performed McNemar Tests to compare low (<3 nights per week) and high DRF (≥3 nights per week) before and during COVID-19 and to evaluate changes in sleep variables segmented by DRF. Chi-square tests were conducted to compare characteristics between low and high DRF. Logistic regression analyses were conducted to examine associations between various independent variables and DRF. RESULTS Reports of high DRF during the pandemic were higher than before the pandemic (P<0.001). Female gender (aOR=1.25, 95% CI 1.10-1.41), nightmares (aOR=4.22, 95% CI 3.45-5.17), sleep talking (aOR= 2.36, 1.73-3.23), sleep maintenance problems (aOR=1.34, 95% CI 1.15-1.56), symptoms of REM sleep behavior disorder (RBD; aOR=1.24, 95% CI 1.09-1.41) and repeated disturbing thoughts (posttraumatic stress disorder (PTSD) symptoms) were associated with high DRF. Age group 55-64 years (aOR=0.69, 95% CI 0.58-0.83) reported less high DRF than younger participants. Unadjusted OR showed associations between depression, anxiety, and DRF; however, in adjusted regression depression (aOR= 0.71, 0.59-0.86) and anxiety (aOR=0.79, 95% CI 0.66-0.94) were negatively associated with high DRF. CONCLUSION AND RELEVANCE DRF was higher than pre-pandemic levels across four continents. DRF was associated with gender and parasomnias like nightmares and RBD symptoms, sleep maintenance problems, PTSD symptoms and negatively associated with depression and anxiety. The results implicate that COVID-19 is reflected in our dreams as an expression of the emotional intensity of the pandemic.
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Affiliation(s)
- Eirin Fränkl
- Institute for Consciousness and Dream Research, Vienna, Austria
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Michael R Nadorff
- Mississippi State University, Mississippi State, MS, USA
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, and Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | | | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Frances Chung
- Department of Anesthesiology and Pain Medicine, University Health Network, University of Toronto, Toronto, Canada
| | - Yves Dauvilliers
- Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, Institute for Neurosciences of Montpellier INM, INSERM, University of Montpellier, Montpellier, France
| | - Colin A Espie
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Damien Leger
- Université de Paris, VIFASOM (EA 7331 Vigilance Fatigue, Sommeil et Santé Publique), Paris, France
- APHP, Hotel-Dieu de Paris, Centre du Sommeil et de la Vigilance, Paris, France
| | - Tainá Macêdo
- Department of Psychology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Kentaro Matsui
- Department of Clinical Laboratory and Department of Sleep-Wake Disorders, National Center of Neurology and Psychiatry National Institute of Mental Health, Kodaira, Japan
- Department of Psychiatry, Tokyo Women’s Medical University, Tokyo, Japan
| | - Ilona Merikanto
- Sleep Well Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
- Orton Orthopaedics Hospital, Helsinki, Finland
| | - Charles M Morin
- École de Psychologie, Centre d’étude des troubles du sommeil, Centre de recherche CERVO/Brain Research Center, Université Laval, Québec, Canada
| | - Sérgio Mota-Rolim
- Brain Institute, Physiology and Behavior Department, and Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Markku Partinen
- Helsinki Sleep Clinic, Terveystalo Healthcare, Helsinki, Finland
- Department of Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland
| | - Thomas Penzel
- Sleep Medicine Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Giuseppe Plazzi
- IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Mariusz Sieminski
- Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Brigitte Holzinger
- Institute for Consciousness and Dream Research, Vienna, Austria
- Medical University Vienna, ZK-Schlafcoaching, Vienna, Austria
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Bruni O, Breda M, Ferri R, Melegari MG. Changes in Sleep Patterns and Disorders in Children and Adolescents with Attention Deficit Hyperactivity Disorders and Autism Spectrum Disorders during the COVID-19 Lockdown. Brain Sci 2021; 11:1139. [PMID: 34573161 PMCID: PMC8469743 DOI: 10.3390/brainsci11091139] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The COVID-19 lockdown determined important changes in the sleep of a large percentage of the world population. We assessed the modifications of reported sleep patterns and disturbances in Italian children and adolescents with autism spectrum disorders (ASD) or attention deficit hyperactivity disorders (ADHD), compared to control children, before and during the COVID-19 lockdown in Italy. METHODS Parents of 100 ASD, 236 ADHD patients, and 340 healthy children filled out an anonymous online survey and a modified version of the Sleep Disturbance Scale for Children (SDSC), advertised via social media, to evaluate sleep patterns and disturbances of their children before and during the lockdown. RESULTS Before the lockdown, bedtime and risetime were not different between the three groups. During the lockdown, ADHD children tended to have a later bedtime and risetime than ASD and controls, while ASD children tended to maintain similar bedtime and risetime. Overall, during the lockdown, a reduced sleep duration significantly differentiated clinical groups from controls. Anxiety at bedtime, difficulties in falling asleep, and daytime sleepiness increased in all groups during the lockdown. Hypnic jerks, rhythmic movement disorders, night awakenings, restless sleep, sleepwalking, and daytime sleepiness increased in ASD and ADHD patients, in particular. CONCLUSIONS This is the first study comparing sleep habits and disorders in ASD and ADHD during the lockdown showing specific differences consistent with the core characteristics of two neurodevelopmental disorders.
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Affiliation(s)
- Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University, 00185 Rome, Italy;
| | - Maria Breda
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University, 00185 Rome, Italy;
| | - Raffaele Ferri
- Sleep Research Centre, Department of Neurology IC, Oasi Research Institute—IRCCS, 94018 Troina, Italy;
| | - Maria Grazia Melegari
- Department of Developmental and Social Psychology, Sapienza University, 00185 Rome, Italy;
- Consortium “Humanitas” LUMSA University, 00193 Rome, Italy
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41
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Borghi L, Bonazza F, Lamiani G, Musetti A, Manari T, Filosa M, Quattropani MC, Lenzo V, Freda MF, Lemmo D, Saita E, Cattivelli R, Castelnuovo G, Vegni E, Franceschini C. Dreaming during lockdown: a quali-quantitative analysis of the Italian population dreams during the first COVID-19 pandemic wave. RESEARCH IN PSYCHOTHERAPY (MILANO) 2021; 24:547. [PMID: 34568113 PMCID: PMC8451213 DOI: 10.4081/ripppo.2021.547] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 07/29/2021] [Indexed: 12/02/2022]
Abstract
This study aims to explore the emotional experiences related to the lockdown during the first pandemic wave, analysing the dreams of the Italian population. Through an online survey spread throughout the country, participants completed the Depression Anxiety Stress Scale-21 (DASS-21), the Resilience Scale (RS) and were asked to narrate a dream they had during the lockdown. The dreams were qualitatively analysed through the thematic content analysis. Logistic regression analyses were then conducted to verify the relationship among the categories that emerged and between these categories and the DASS-21 and RS scores. In the dreams 8 categories were identified (Places, Characters, Relationships, Actions, Danger, Death, Processes, and Emotions) composed of specific sub-categories, which seem to compose a sort of narrative structure of the dream. Some sub-categories were found to be predictor of depression and resilience or with exposure to COVID-19. Dreams can be a valid tool both to understand the experiences of the population during the pandemic and to evaluate those at risk of developing distress in clinical practice.
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Affiliation(s)
- Lidia Borghi
- Psicologia Clinica, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano
| | - Federica Bonazza
- Psicologia Clinica, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano
| | - Giulia Lamiani
- Psicologia Clinica, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano
| | - Alessandro Musetti
- Dipartimento di Discipline Umanistiche, Sociali e delle Imprese culturali, Università di Parma, Parma
| | - Tommaso Manari
- Dipartimento di Discipline Umanistiche, Sociali e delle Imprese culturali, Università di Parma, Parma
| | - Maria Filosa
- Dipartimento di Medicina e Chirurgia, Università di Parma, Parma
| | | | - Vittorio Lenzo
- Dipartimento di Scienze della Società e della Formazione d’Area Mediterranea, Università per Stranieri ‘Dante Alighieri’ di Reggio Calabria
| | | | - Daniela Lemmo
- Dipartimento di Scienze Umanistiche, Università Federico II, Napoli
| | - Emanuela Saita
- Dipartimento di Psicologia, Università Cattolica di Milano, Milano
| | - Roberto Cattivelli
- Dipartimento di Psicologia, Università Cattolica di Milano, Milano
- Istituto Auxologico Italiano IRCCS, Laboratorio di Ricerca Psicologica, Milano, Italy
| | - Gianluca Castelnuovo
- Dipartimento di Psicologia, Università Cattolica di Milano, Milano
- Istituto Auxologico Italiano IRCCS, Laboratorio di Ricerca Psicologica, Milano, Italy
| | - Elena Vegni
- Psicologia Clinica, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano
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Marogna C, Montanari E, Contiero S, Lleshi K. Dreaming during COVID-19: the effects of a world trauma. RESEARCH IN PSYCHOTHERAPY (MILANO) 2021; 24:541. [PMID: 34568109 PMCID: PMC8451215 DOI: 10.4081/ripppo.2021.541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/29/2021] [Indexed: 11/23/2022]
Abstract
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.
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Affiliation(s)
- Cristina Marogna
- Department of Philosophy, Sociology, Education & Applied Psychology (FISPPA), University of Padua, Italy
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Sommantico M, Iorio I, Lacatena M, Parrello S. Dreaming during the COVID-19 lockdown: a comparison of Italian adolescents and adults. RESEARCH IN PSYCHOTHERAPY: PSYCHOPATHOLOGY, PROCESS AND OUTCOME 2021; 24:536. [PMID: 34568105 PMCID: PMC8451218 DOI: 10.4081/ripppo.2021.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/03/2021] [Indexed: 11/23/2022]
Abstract
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.
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Giovanardi G, Spangler P. Introduction to the Special Section on Working on dreams, from psychotherapy to neuroscience. RESEARCH IN PSYCHOTHERAPY (MILANO) 2021; 24:578. [PMID: 34568115 PMCID: PMC8451211 DOI: 10.4081/ripppo.2021.578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 07/25/2021] [Indexed: 11/23/2022]
Abstract
Not available
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Affiliation(s)
- Guido Giovanardi
- Department of Dynamic and Clinical Psychology, and Health Studies, La Sapienza University of Rome, Italy
| | - Patricia Spangler
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, and The Henry M. Jackson Foundation, Bethesda, MD, USA
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Dream Recall/Affect and the Hypothalamic-Pituitary-Adrenal Axis. Clocks Sleep 2021; 3:403-408. [PMID: 34449575 PMCID: PMC8395463 DOI: 10.3390/clockssleep3030027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/08/2021] [Accepted: 07/16/2021] [Indexed: 12/02/2022] Open
Abstract
In this concise review, we present an overview of research on dream recall/affect and of the hypothalamic–pituitary–adrenal (HPA) axis, discussing caveats regarding the action of hormones of the HPA axis (mainly cortisol and its free form, cortisol-binding globulin and glucocorticoid receptors). We present results of studies regarding dream recall/affect and the HPA axis under physiological (such as waking) or pathological conditions (such as in Cushing’s syndrome or stressful situations). Finally, we try to integrate the effect of the current COVID-19 situation with dream recall/affect vis-à-vis the HPA axis.
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Scarpelli S, Alfonsi V, D'Anselmo A, Gorgoni M, Musetti A, Plazzi G, De Gennaro L, Franceschini C. Dream Activity in Narcoleptic Patients During the COVID-19 Lockdown in Italy. Front Psychol 2021; 12:681569. [PMID: 34122276 PMCID: PMC8187856 DOI: 10.3389/fpsyg.2021.681569] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/29/2021] [Indexed: 02/05/2023] Open
Abstract
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.
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Affiliation(s)
- Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Anita D'Anselmo
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Giuseppe Plazzi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
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47
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Guerrero-Gomez A, Nöthen-Garunja I, Schredl M, Homberg A, Vulcan M, Brusić A, Bonizzi C, Iannaco C. Dreaming in Adolescents During the COVID-19 Health Crisis: Survey Among a Sample of European School Students. Front Psychol 2021; 12:652627. [PMID: 33959080 PMCID: PMC8093446 DOI: 10.3389/fpsyg.2021.652627] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/10/2021] [Indexed: 12/11/2022] Open
Abstract
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.
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Affiliation(s)
| | | | - Michael Schredl
- Sleep Laboratory, Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany
| | | | - Maria Vulcan
- Timișoara 2021 – European Capital of Culture Association, Timișoara, Romania
| | - Asja Brusić
- Rijeka 2020 – European Capital of Culture, Croatian Cultural Centre, Rijeka, Croatia
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48
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Scarpelli S, Alfonsi V, Mangiaruga A, Musetti A, Quattropani MC, Lenzo V, Freda MF, Lemmo D, Vegni E, Borghi L, Saita E, Cattivelli R, Castelnuovo G, Plazzi G, De Gennaro L, Franceschini C. Pandemic nightmares: Effects on dream activity of the COVID-19 lockdown in Italy. J Sleep Res 2021; 30:e13300. [PMID: 33547703 PMCID: PMC7994972 DOI: 10.1111/jsr.13300] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/08/2021] [Accepted: 01/15/2021] [Indexed: 02/06/2023]
Abstract
COVID‐19 has critically impacted the world. Recent works have found substantial changes in sleep and mental health during the COVID‐19 pandemic. Dreams could give us crucial information about people's well‐being, so here we have directly investigated the consequences of lockdown on the oneiric activity in a large Italian sample: 5,988 adults completed a web‐survey during lockdown. We investigated sociodemographic and COVID‐19‐related information, sleep quality (by the Medical Outcomes Study‐Sleep Scale), mental health (by the Depression, Anxiety, and Stress Scales), dream and nightmare frequency, and related emotional aspects (by the Mannheim Dream Questionnaire). Comparisons between our sample and a population‐based sample revealed that Italians are having more frequent nightmares and dreams during the pandemic. A multiple logistic regression model showed the predictors of high dream recall (young age, female gender, not having children, sleep duration) and high nightmare frequency (young age, female gender, modification of napping, sleep duration, intrasleep wakefulness, sleep problem index, anxiety, depression). Moreover, we found higher emotional features of dream activity in workers who have stopped working, in people who have relatives/friends infected by or who have died from COVID‐19 and in subjects who have changed their sleep habits. Our findings point to the fact that the predictors of high dream recall and nightmares are consistent with the continuity between sleep mentation and daily experiences. According to the arousal‐retrieval model, we found that poor sleep predicts a high nightmare frequency. We suggest monitoring dream changes during the epidemic, and also considering the implications for clinical treatment and prevention of mental and sleep disorders.
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Affiliation(s)
- Serena Scarpelli
- IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Anastasia Mangiaruga
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | | | - Vittorio Lenzo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | - Daniela Lemmo
- Department of Humanistic Studies, Federico II University, Naples, Italy
| | - Elena Vegni
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Lidia Borghi
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Emanuela Saita
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Roberto Cattivelli
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Verbania, Italy
| | - Giuseppe Plazzi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi De Gennaro
- IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Psychology, Sapienza University of Rome, Rome, Italy
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