Dreams and nightmares during COVID-19 lockdown Solomonova et al
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Stuck in a lockdown: dreams, bad dreams, nightmares, and their
relationship to stress, depression and anxiety during the COVID-19
pandemic.
Elizaveta Solomonova*
1,2
, Claudia Picard-Deland
3,4
, Iris Rapoport
5
, Marie-Hélène Pennestri
6,7
,
Mysa Saad
8
, Tetyana Kendzerska
9
, Samuel Paul Louis Veissiere
2
, Roger Godbout
7,11
, Jodi D.
Edwards
10,12
, Lena Quilty
13
, Rebecca Robillard
8,14
1
Neurophilosophy Lab, McGill University
2
Culture, Mind and Brain research group; Division of Social and Transcultural Psychiatry,
Department of Psychiatry, McGill University
3
Dream and Nightmare Laboratory, Center for Advanced Research in Sleep Medicine
4
Department of Neuroscience, University of Montreal
5
Department of Philosophy, McGill University
6
Department of Educational and Counselling Psychology, McGill University
7
Sleep Laboratory
& Clinic, Hôpital en santé mentale Rivière-des-Prairies, CIUSSS du Nord-de-
l'Île-de-Montréal
8
The Royal’s Institute of Mental Health Research
9
Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa
10
University of Ottawa Heart Institute
11
Department of Psychiatry, University of Montreal
12
Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto
13
School of Epidemiology and Public Health, University of Ottawa
14
School of Psychology, University of Ottawa
Target journal: PLOS One
*Corresponding author
Elizaveta Solomonova, PhD
Division of Social and Transcultural Psychiatry
McGill University
Montreal, Quebec, Canada
elizaveta.solomonova@mail.mcgill.ca
Dreams and nightmares during COVID-19 lockdown Solomonova et al
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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 the
disease, global uncertainty, , experience of social isolation, 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.
Keywords: dreams, nightmares, covid-19 pandemic, stress, anxiety, depression, inefficacy
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1. Introduction
Since the declaration of the global COVID-19 pandemic in March 2020 by the World
Health Organization and since measures of social isolation have been in place in many countries,
including Canada, dreams have been a hot topic of conversation. A number of popular outlets
reported an increase in dream reports, an increase in bizarre, threatening dreams (Carey, 2020;
Collie, 2020; Rani, 2020; Valenti, 2020; Weaver, 2020), and social media became saturated with
reports of new dream experiences, all related to the elements of COVID-19 – a phenomenon that
Nielsen called “a dream surge” (Nielsen, 2020). In line with renewed interest in dreams during
the pandemic, and following early anecdotal evidence for intensified dreaming, growing research
provides evidence for specific changes in dream content during the acute stage of the health
crisis. Dreams, currently defined as any cognitive activity that happens during sleep which has a
subjective component that is recalled in wake (Nielsen, 2000), are known to react to most
pressing concerns, both of personal and collective nature, and are thought to play a role in the
integration of lived experiences, in extracting the gist of new information and in emotion
regulation (Walker & van der Helm, 2009). The current pandemic offers a unique opportunity to
investigate changes to our oneiric lives brought about by shared concerns during the times of
dealing with illness/threat of illness and in context of unprecedented degree of change in socio-
economic aspects of life. In this paper, we present results of an ongoing national online survey
focused on multiple facets of mental health, social and economic impacts of COVID-19 and
including validated sleep and dream questionnaires. Our project had three goals: 1) to qualify
changes in dream, bad dream and nightmare recall; 2) to investigate most prevalent dream
themes; and 3) to assess the relationship between dreams, stress, and symptoms of anxiety and
depression during the first lockdown phase of COVID-19.
1.1. COVID-19, sleep and mental health
An emerging body of research shows the many ways in which the experience of the
pandemic, and in particular of social isolation, is affecting sleep specifically and mental health
more broadly, notably with documented increases and exacerbations in symptoms of depression
and anxiety (Gasteiger et al., 2021; Kornilaki, 2021; Mautong et al., 2021; Robillard, Daros, et
al., 2021; Robillard, Saad, et al., 2020; Salari et al., 2020). Mounting evidence shows widespread
Dreams and nightmares during COVID-19 lockdown Solomonova et al
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changes in sleep patterns, including increased sleep duration, later bedtime and later awakenings,
as well as a reduction in social jet lag (a form of circadian misalignment between one’s
endogenous best rhythm and demands of the social world, such as early work or school start)
(Blume, Schmidt, & Cajochen, 2020; Cellini, Canale, Mioni, & Costa, 2020; Kantermann, 2020;
Leone, Sigman, & Golombek, 2020; Robillard, Dion, et al., 2021; Wright et al., 2020). In a
number of studies, increased sleep time and opportunities for sleep schedules more aligned with
one’s chronotype, nevertheless, did not preclude reports of poor sleep quality, likely due to
increased levels of stress associated with pandemic, lockdown, and personal challenges
(Casagrande, Favieri, Tambelli, & Forte, 2020; Cellini et al., 2020; Huang & Zhao, 2020; Leone
et al., 2020). Unsurprisingly, then, increased rates of insomnia were also reported by multiple
teams (Gualano, Lo Moro, Voglino, Bert, & Siliquini, 2020; Marelli et al., 2020; Voitsidis et al.,
2020). Using data from the larger cohort of the current study, our group has previously reported
an important increase in stress levels during the pandemic, a relationship between increased
stress and pre-existing mental illness (Robillard, Daros, et al., 2021; Robillard, Saad, et al.,
2020), as well as changes in patterns of sleep duration (increase vs. decrease) and timing (delay)
during the pandemic (Robillard, Dion, et al., 2020). The role of disordered sleep in exacerbating
mental disorders, in particular, depression and anxiety, is well documented (Alvaro, Roberts, &
Harris, 2013). During confinement, poor sleep was similarly associated with higher levels of
psychotic-like experiences, rumination and somatic symptoms (Simor et al., 2020). This bi-
directional relationship between sleep and mental health may also be evidenced by dysphoric or
intensified dreaming.
1.2. Dream content: mental health and relationship to lived experiences
Dream content is often seen as a proxy for understanding individual experience of health
and distress: dreams are known to react to new experiences and life changes. Bad dreams and
nightmares tend to increase during periods of high stress (Carr & Nielsen, 2017; Nielsen, 2017;
Schredl et al., 2019), and are often exacerbated by, and potentially play a role in, flare-ups of
mental health issues, including depression (Marinova et al., 2014) and anxiety (Spoormaker,
Schredl, & van den Bout, 2006). In general, many current theories of dream formation and of
dream function converge on the following main ideas. It is suggested that dream content: 1)
reflects elements of daily lived experience (Eichenlaub, Cash, & Blagrove, 2017; Malinowski &
Dreams and nightmares during COVID-19 lockdown Solomonova et al
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Horton, 2014; Nielsen & Stenstrom, 2005); 2) extracts its meaning by creatively integrating new
information into existing autobiographical memory networks (Hartmann, 1996, 2010; Horton &
Malinowski, 2015; Malinowski & Horton, 2015; Wamsley & Stickgold, 2010); and 3)
preferentially responds to current concerns and to emotionally charged events with high personal
significance (Malinowski & Horton, 2014; van Rijn et al., 2015).
In addition to individual experiences, collective trauma can affect the content and
intensity of dreams in the general population. For example, studies tracking dreams before and
after the 9/11 attacks observed an increase in nightmare frequency in male respondents (Nielsen,
Stenstrom, & Levin, 2006), an increase in the intensity of the dream imagery (Hartmann &
Brezler, 2008) and clear incorporations of a variety of 9/11-related topics, such as planes
crashing into buildings, being hijacked and bombs (Bulkeley & Kahan, 2008). Similarly, studies
tackling dream content in prisoners of wars and Holocaust survivors (Barrett et al., 2013;
Bergman et al., 2020) revealed a profound intrusion of war-related themes in dreams, as well as a
long-lasting increase in dream negative emotions and threatening events. Lastly, a study on
WWII Veterans (Sandman et al., 2013) showed more frequent nightmares and symptoms of
insomnia, depression and anxiety that persisted even decades after the war.
The current pandemic, and in particular, the experience of a lockdown, presents a set of
new challenges to our psychological and social health. These include novel experiences which
have a strong emotional component, and of which we are, individually and collectively,
attempting to make sense. It is therefore unsurprising that dreams should change during these
times, as a process of making sense of and of adapting to these novel aspects of life. Thus, this
historical period represents a unique and naturalistic opportunity to explore current theories of
dream formation, including frameworks of environmental susceptibility and stress reactivity.
1.3. Typical Dream Themes
Previous work demonstrated a number of common themes in dream content. The Typical
Dreams Questionnaire, first used in a sample of Canadian University students (Nielsen et al.,
2003), investigates relative prevalence of different dream themes. This instrument has been
validated in a German (Schredl, Ciric, Gotz, & Wittmann, 2004) and a Chinese (Yu, 2008)
samples. Results of the three studies converge on the possibility that dream themes are relatively
stable across individual life span and are relatively similar across cultures, potentially
