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Delage JP, Côté J, Journault WG, Lemyre A, Bastien CH. The relationships between insomnia, nightmares, and dreams: A systematic review. Sleep Med Rev 2024; 75:101931. [PMID: 38733767 DOI: 10.1016/j.smrv.2024.101931] [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: 10/07/2023] [Revised: 03/29/2024] [Accepted: 04/04/2024] [Indexed: 05/13/2024]
Abstract
Insomnia and nightmares are both prevalent and debilitating sleep difficulties. The present systematic review aims to document the relationships between insomnia and nightmares in individuals without a concomitant psychopathology. The relationships between insomnia and dreams are also addressed. PsycINFO and Medline were searched for papers published in English or French from 1970 to March 2023. Sixty-seven articles were included for review. Most results support positive relationships between insomnia variables and nightmare variables in individuals with insomnia, individuals with nightmares, the general population, students, children and older adults, and military personnel and veterans. These positive relationships were also apparent in the context of the COVID-19 pandemic. Some psychological interventions, such as Imagery Rehearsal Therapy, might be effective in alleviating both nightmares and insomnia symptoms. Regarding the relationships between insomnia and dreams, compared with controls, the dreams of individuals with insomnia are characterized by more negative contents and affects. The results show that insomnia and nightmares are connected and may be mutually aggravating. A model is proposed to explain how insomnia might increase the likelihood of experiencing nightmares, and how nightmares can in turn lead to sleep loss and nonrestorative sleep.
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Affiliation(s)
- Julia-Pizzamiglio Delage
- École de Psychologie, Université Laval, Québec, QC, Canada; CERVO Brain Research Center, Québec, QC, Canada
| | - Jeannie Côté
- École de Psychologie, Université Laval, Québec, QC, Canada
| | | | - Alexandre Lemyre
- École de Criminologie, Université de Montréal, Montréal, QC, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
| | - Célyne H Bastien
- École de Psychologie, Université Laval, Québec, QC, Canada; CERVO Brain Research Center, Québec, QC, Canada; Research Laboratory on Human Neurophysiology and Sleep, Université Laval, Québec, QC, Canada.
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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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3
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Gaynor N, Fitzgerald L. Mind-Wandering and Its Relationship With Psychological Wellbeing and Obsessive-Compulsive Symptomatology in the Context of Covid-19. Psychol Rep 2023:332941231203563. [PMID: 37787173 DOI: 10.1177/00332941231203563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Mind-wandering (MW) as a research topic has received considerable attention over the last several decades. The recent differentiation between spontaneous and deliberate MW has suggested a particular effect of the former on psychopathology; in that increased spontaneous MW may precede mental illness. The present study sought to explore MW as a potential contributing factor to poor mental health in the context of the Covid-19 pandemic. More specifically, we sought to determine firstly, whether the effects of MW frequency, type and content on subjective psychological wellbeing was consistent with previous findings after controlling for the impacts of Covid-related stress. Secondly, previous research has demonstrated an effect of both Covid-stress and spontaneous MW on the experience of obsessive-compulsive symptomatology (OCS), and so the present study explored this relationship further by assessing whether Covid-stress mediated the relationship between spontaneous MW and OCS. Participants completed measures of MW, OCS and psychological wellbeing through an online questionnaire. The results indicated that increased spontaneous MW was indicative of both poorer subjective psychological wellbeing and OCS, with Covid-stress partially mediating the relationship between spontaneous MW and OCS. Our findings provide further support for the adverse effect of unintentional MW on psychological wellbeing, as well as for the differentiation between both forms of the cognitive phenomenon. Additionally, they provide an important insight into one of the factors that may have preceded poor mental health among the Irish population during Covid-19. Future research may build upon the present study by exploring similar relationships among clinical populations.
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Affiliation(s)
- Niamh Gaynor
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Lisa Fitzgerald
- School of Psychology, Dublin City University, Dublin, Ireland
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4
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Pawar N, Taylor KE, Yang M, Deepak P, Kim W, Paley MA, Matloubian M, Carvidi A, Ciorba MA, Demissie E, El‐Qunni A, Huang K, Kinnett B, McMorrow LE, Paez D, Poole M, Rose A, Schriefer RE, Kim AH, Nakamura M, Katz P, Gensler LS. Sleep Disturbance and SARS-CoV-2 Vaccinations in Patients With Chronic Inflammatory Disease. Arthritis Care Res (Hoboken) 2023; 75:1849-1856. [PMID: 36479599 PMCID: PMC9877722 DOI: 10.1002/acr.25065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 10/26/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Immunocompromised patients with chronic inflammatory disease (CID) may have experienced additional psychosocial burden during the COVID-19 pandemic due to their immunocompromised status. This study was undertaken to determine if vaccination would result in improved patient-reported outcomes longitudinally among individuals with CID undergoing SARS-CoV-2 vaccination regardless of baseline anxiety. METHODS Data are from a cohort of individuals with CID from 2 sites who underwent SARS-CoV-2 vaccination. Participants completed 3 study visits before and after 2 messenger RNA vaccine doses in the initial vaccination series when clinical data were collected. Patient-reported outcomes were measured using the Patient-Reported Outcomes Measurement Information System 29-item Health Profile and expressed as T scores, with 2 groups stratified by high and low baseline anxiety. Mixed-effects models were used to examine longitudinal changes, adjusting for age, sex, and study site. RESULTS A total of 72% of the cohort was female with a mean ± SD age of 48.1 ± 15.5 years. Overall, sleep disturbance improved following both doses of SARS-CoV-2 vaccinations, and anxiety decreased after the second dose. Physical function scores worsened but did not meet the minimally important difference threshold. When stratifying by baseline anxiety, improvement in anxiety, fatigue, and social participation were greater in the high anxiety group. Physical function worsened slightly in both groups, and sleep disturbance improved significantly in the high anxiety group. CONCLUSION Sleep disturbance decreased in a significant and meaningful way in patients with CID upon vaccination. In patients with higher baseline anxiety, social participation increased, and anxiety, fatigue, and sleep disturbance decreased. Overall, results suggest that SARS-CoV-2 vaccination may improve mental health and well-being, particularly among those with greater anxiety.
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Affiliation(s)
- Niti Pawar
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Kimberly E. Taylor
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Monica Yang
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Parakkal Deepak
- Division of Gastroenterology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Wooseob Kim
- Division of Immunobiology, Department of Pathology & ImmunologyWashington University School of Medicine
| | - Michael A. Paley
- Division of Rheumatology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Mehrdad Matloubian
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Alex Carvidi
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Matthew A. Ciorba
- Division of Gastroenterology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Emanuel Demissie
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Alia El‐Qunni
- Division of Rheumatology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Katherine Huang
- Division of Gastroenterology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Baylee Kinnett
- Division of Gastroenterology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Lily E. McMorrow
- Division of Rheumatology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Diana Paez
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Mackenzie Poole
- Division of Rheumatology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Abigail Rose
- Division of Rheumatology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Rebecca E. Schriefer
- Division of Rheumatology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Alfred H.J. Kim
- Division of Rheumatology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Mary Nakamura
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Patricia Katz
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Lianne S. Gensler
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
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5
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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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Margherita G, Caffieri A. An observatory on changes in dreaming during a pandemic: a living systematic review (part 1). J Sleep Res 2022; 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] [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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CampBell T, Hurwitz A, Bartel R, Rose R, Dean J, Markle T. COVID-19 nightmare response and stress: A new Mexico sample based survey. Sleep Med 2022; 99:23-29. [PMID: 35930935 PMCID: PMC9296252 DOI: 10.1016/j.sleep.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/03/2022] [Accepted: 07/14/2022] [Indexed: 11/20/2022]
Abstract
Studies conducted during the COVID-19 Pandemic have reported increased rates of mental illnesses including depression, anxiety, and post-traumatic stress disorder (PTSD) [1]. A common symptom of mental illness is change in Rapid Eye Movement (REM) sleep, the phase of sleep associated with dreaming and nightmares. The COVID-19 pandemic offers a unique opportunity to evaluate the effects of systemic stress on nightmares. In this study, we investigate whether the COVID-19 pandemic affects nightmare frequency and content using a web-based survey within the state of New Mexico. The survey returned 197 responses showing an increase in the quantity of both bad dreams and nightmares. Furthermore, significant changes in nightmare themes were reported compared to relative rates prior to the pandemic (RR 1,42, p < 0.01; RR 5, p < 0.001). This novel data supports that increased stress from the COVID-19 pandemic has altered dream and nightmare content and frequency.
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Affiliation(s)
- Tim CampBell
- University of New Mexico, 1 University Hospital, Albuquerque, NM, 87110, USA
| | - Ariel Hurwitz
- University of New Mexico, 1 University Hospital, Albuquerque, NM, 87110, USA
| | - Robyn Bartel
- University of New Mexico, 1 University Hospital, Albuquerque, NM, 87110, USA
| | - Rachel Rose
- University of New Mexico, 1 University Hospital, Albuquerque, NM, 87110, USA
| | - Jeremy Dean
- University of New Mexico, 1 University Hospital, Albuquerque, NM, 87110, USA
| | - Tom Markle
- University of New Mexico, 1 University Hospital, Albuquerque, NM, 87110, USA.
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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] [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
IntroductionBy 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.ObjectiveWe investigated the relationship between sleep alterations, psychological disorders, and inflammatory blood biomarkers in patients with post-acute COVID-19.MethodsWe 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.ResultsPrevalence 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.ConclusionOur 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
- *Correspondence: Gaia Pellitteri
| | - 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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9
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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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10
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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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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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Orr K, Ta Z, Shoaf K, Halliday TM, Tobin S, Baron KG. Sleep, Diet, Physical Activity, and Stress during the COVID-19 Pandemic: A Qualitative Analysis. Behav Sci (Basel) 2022; 12:66. [PMID: 35323385 PMCID: PMC8945701 DOI: 10.3390/bs12030066] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/13/2022] [Accepted: 02/25/2022] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 pandemic has changed routines and habits, raising stress and anxiety levels of individuals worldwide. The goal of this qualitative study was to advance the understanding of how pandemic-related changes affected sleep, diet, physical activity (PA), and stress among adults. We conducted semi-structured, qualitative interviews with 185 participants and selected 33 interviews from a represented sample based on age, race, and gender for coding and analysis of themes. After coding for thematic analysis, results demonstrated four primary themes: sleep, diet, PA, and stress. Sleep sub-themes such as poorer sleep quality were reported by 36% of our participants, and 12% reported increased an frequency of vivid dreams and nightmares. PA was decreased in 52% of our participants, while 33% experienced an increase and 15% experienced no change in PA. Participants also reported having an improved diet, mostly among women. Stress was elevated in 79% of our participants and was more likely to be discussed by women. Many participants reported how stress was involved in precipitating health behavior change, especially for sleep. Increased stress was also linked to elevated anxiety and depression among participants. The results of this qualitative study demonstrate how managing stress could have a beneficial effect on promoting health behaviors and mental health during the COVID-19 pandemic and beyond.
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Affiliation(s)
- Kyanna Orr
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way A, Salt Lake City, UT 84108, USA; (K.O.); (Z.T.); (K.S.)
| | - Zachary Ta
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way A, Salt Lake City, UT 84108, USA; (K.O.); (Z.T.); (K.S.)
| | - Kimberley Shoaf
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way A, Salt Lake City, UT 84108, USA; (K.O.); (Z.T.); (K.S.)
| | - Tanya M. Halliday
- Department of Health and Kinesiology, College of Health, University of Utah, 250 S. 1850 E., Salt Lake City, UT 84112, USA; (T.M.H.); (S.T.)
| | - Selene Tobin
- Department of Health and Kinesiology, College of Health, University of Utah, 250 S. 1850 E., Salt Lake City, UT 84112, USA; (T.M.H.); (S.T.)
| | - Kelly Glazer Baron
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way A, Salt Lake City, UT 84108, USA; (K.O.); (Z.T.); (K.S.)
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