Pandemic-Trauma Stress Symptoms: Nightmares Significantly Increased Among Adults

Brigitte Hozinger, PhD

In recently published research, a team of investigators identified factors related to the COVID-19 pandemic that collectively exacerbated mental health and sleep burdens among adults. One of the most significant findings included the increase in nightmare frequency, which went from 13.24% to 22.3% during the pandemic.

Investigators suggested that healthcare professionals include nightmares in their screening practices. Post-traumatic stress symptoms (PTSS) were at least partially responsible for the rise in mental health and sleep outcomes, indicating that the pandemic had traumatizing effects on a substantial proportion of society.

Experiencing nightmares is related to a variety of sleep and mental health issues such as insomnia, post-traumatic stress disorder (PTSD), and depression. Independent of these relations, investigators emphasize that insomnia symptoms and nightmares are significantly related to risk of suicide, in more than one population.

Evaluating the Pandemic's Impact on Sleep

This cross-sectional survey study consisted of data obtained from a self-rating online survey available to adults 18 years or older. The final sample included 15,292 participating adults who were divided into study groups based on their nightmare frequency.

High nightmare frequency was defined as experiencing the phenomenon 1-2 nights per week, or more, while low nightmare frequency was considered less than 1-2 nights per week. The average age was 41.63 years, and 64.05% were women.

Led by Brigitte Holzinger, PhD, Institute for Consciousness and Dream Research, Vienna, Austria, the team performed chi-square tests in order to identify the changes of nightmare frequency. Then, to assess the predictors of high nightmare frequency , logistic regression was used and presented as Odds Ratios. The analysis of the impact of post-traumatic stress symptoms utilized post-hoc mediation models.

Pandemic Factors of Insomnia and Nightmares

Prior to the pandemic, 86.76% reported low nightmare frequency while 13.24% reported high nightmare frequency. The changes that occurred throughout the pandemic were significant, with low nightmare frequency shifting to 77.65% and high frequency increasing to 22.35%.

While 4.80% of adults experienced a decrease in this particular sleep disruption, the majority (75.37%) noticed no change, and 19.83% encountered an increase of nightmares. The factors associated with this increase included self-reported PTSS, other mental disorders, and various sleep disorders.

Additionally, the nightmare associations were partially mediated by the financial burden due to the pandemic, confinement, having had COVID-19, and the work situation during the pandemic, according to investigators.

"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," investigators wrote. "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."

The study, "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" was published in Nature and Science of Sleep.