Indian Journal of Sleep Medicine

Register      Login

VOLUME 17 , ISSUE 2 ( April-June, 2022 ) > List of Articles

Original Article

Sleep Health and COVID-19-related Anxiety during the Lockdown Phase of the Pandemic in Nigeria: A Preliminary Report

Bassey E Edet, Emmanuel A Essien, Chidi J Okafor, Emmanuel O Olose, Ginini E Atu, Olusola R Olojo, Alexander A Audu, Anya C Okoro

Keywords : Anxiety, COVID-19, Dreams, Pandemics, Sleep

Citation Information : Edet BE, Essien EA, Okafor CJ, Olose EO, Atu GE, Olojo OR, Audu AA, Okoro AC. Sleep Health and COVID-19-related Anxiety during the Lockdown Phase of the Pandemic in Nigeria: A Preliminary Report. Indian Sleep Med 2022; 17 (2):37-43.

DOI: 10.5005/jp-journals-10069-0099

License: CC BY-NC 4.0

Published Online: 27-07-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Background: During the pandemic's peak, changes in sleep and dreaming were reported around the world. Objective: The objective was to assess changes in sleep and dreaming during the lockdown phase of the coronavirus disease-2019 (COVID-19) pandemic in Nigeria. It also aimed to determine how these changes might be related to COVID-19-related fear. Methods: This was a cross-sectional study conducted during the lockdown period of the COVID-19 pandemic in Nigeria. Data were collected from 288 respondents using an online survey. Apart from sociodemographic characteristics, questions were asked about sleep and dream changes. The Pittsburgh Sleep Quality Index (PSQI) and the Fear of COVID-19 Scale (FCS) were also administered. Results: The mean age of respondents was 33 years, and 52% were females. Poor sleep quality was present in 65.1%. An increase in dream recall frequency (DRF) was reported in 20.5%, while 15.5% mainly had negatively themed dreams. Sleep latency, sleep disturbances, and daytime dysfunction were significantly associated with changes in DRF (p <0.05). Subjective sleep quality, habitual sleep efficiency, sleep disturbances, daytime dysfunction, overall sleep quality, and fear of COVID-19 were all significantly associated with the theme of dreams (p <0.05). In binary logistic regression, fear of COVID-19 [odds ratio (OR): 1.07, 95% confidence interval (CI): 1.02–1.13], negatively themed dreams (OR: 8.03, 95% CI: 1.81–35.57), and positively themed dreams (OR: 0.38 95% CI: 0.17–0.87) emerged as predictors of sleep quality. Conclusion: The COVID-19 pandemic impacted sleep quality at its peak. Clinical significance: Clinicians should pay more attention to dream changes as they could serve as indicators of sleep quality.

PDF Share
  1. World Health Organization (WHO). The Impact of COVID-19 on global health goals. Newsroom: Spotlight; 2021.
  2. World Health Organization (WHO). Impact of COVID-19 on people's livelihoods, their health and our food systems. 2021.
  3. Pfefferbaum B, North CS. Mental health and the Covid-19 pandemic. N Engl J Med 2020;383(6):510–512. DOI: 10.1056/NEJMp2008017.
  4. Qiu J, Shen B, Zhao M, et al. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. Gen Psychiatry 2020;33(2):e100213–e100213. DOI: 10.1136/gpsych-2020-100213.
  5. Shechory Bitton M, Laufer A. Mental health and coping in the shadow of the COVID-19 pandemic: the Israeli case. Front Public Health 2021;8:568016. DOI: 10.3389/fpubh.2020.568016.
  6. Panchal N, Kamal R, Orgera K, et al. The implications of COVID-19 for mental health and substance use | KFF. Kaiser Fam Found; 2020. p. 1–11.
  7. Fränkl E, Scarpelli S, Nadorff MR, et al. 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. DOI: 10.2147/NSS.S324142.
  8. Solomonova E, Picard-Deland C, Rapoport I, et al. 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(11):e0259040. DOI: 10.1371/journal.pone.0259040.
  9. Kennedy KER, Grandner MA. Sleep, dreams, and nightmares during the COVID-19 pandemic. Am J Health Promot 2021;35(8):1168–1173. DOI: 10.1177/08901171211055312.
  10. Herlin B, Leu-Semenescu S, Chaumereuil C, et al. Evidence that non-dreamers do dream: a REM sleep behaviour disorder model. J Sleep Res 2015;24(6):602–609. DOI: 10.1111/jsr.12323.
  11. Scarpelli S, Alfonsi V, Gorgoni M, et al. Dreams and nightmares during the first and second wave of the COVID-19 infection: a longitudinal study. Brain Sci 2021;11(11):1375. DOI: 10.3390/brainsci11111375.
  12. Cochran WG. Sampling techniques. New York: John Wiley and Sons; 1977. p. 428.
  13. Ogunsemi OO, Afe T, Osalusi BS, et al. Quality of sleep among adults in Sagamu, Southwest Nigeria. Niger Hosp Pract 2020;25(5–6). Available from:
  14. Buysse DJ, Reynolds CF, Monk TH, et al. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28(2):193–213. DOI: 10.1016/0165-1781(89)90047-4.
  15. Smyth C. Pittsburgh Sleep Quality Index (PSQI). General Assessment Series. 2012.
  16. Ahorsu DK, Lin CY, Imani V, et al. The fear of COVID-19 scale: development and initial validation. Int J Ment Health Addict 2020:1–9. DOI: 10.1007/s11469-020-00270-8.
  17. Lin YN, Liu ZR, Li SQ, et al. Burden of sleep disturbance during COVID-19 pandemic: a systematic review. Nat Sci Sleep 2021;13:933–966. DOI: 10.2147/NSS.S312037.
  18. Conte F, Rescott ML, De Rosa O, et al. Changes in dream features across the first and second waves of the Covid-19 pandemic. J Sleep Res 2021;31(10):e13425. DOI: 10.1111/jsr.13425.
  19. Scarpelli S, Gorgoni M, Alfonsi V, et al. The impact of the end of COVID confinement on pandemic dreams, as assessed by a weekly sleep diary: a longitudinal investigation in Italy. J Sleep Res 2022;31(1):e13429. DOI: 10.1111/jsr.13429.
  20. Pagel JF, Shocknesse S. Dreaming and insomnia: polysomnographic correlates of reported dream recall frequency. Dreaming 2007;17(3):140–151. DOI: 10.1037/1053-0797.17.3.140.
  21. van Wyk M, Solms M, Lipinska G. Increased awakenings from non-rapid eye movement sleep explain differences in dream recall frequency in healthy individuals. Front Hum Neurosci 2019;13:370. DOI: 10.3389/fnhum.2019.00370.
  22. Stepanski E, Lamphere J, Badia P, et al. Sleep fragmentation and daytime sleepiness. Sleep 1984;7(1):18–26. DOI: 10.1093/sleep/7.1.18.
  23. Rescott M, Conte F, De Rosa O, et al. 191 Dream features of the Italian population across the first and second wave of the COVID-19 pandemic. Sleep 2021;44(Supplement_2):A77–A77. DOI: 10.1093/sleep/zsab072.190.
  24. Blagrove M, Pace-Schott EF. Trait and neurobiological correlates of individual differences in dream recall and dream content. Int Rev Neurobiol 2010;92:155–180. DOI: 10.1016/S0074-7742(10)92008-4.
  25. Soffer-Dudek N. Arousal in nocturnal consciousness: how dream-and sleep-experiences may inform us of poor sleep quality, stress, and psychopathology. Front Psychol 2017;8:733. DOI: 10.3389/fpsyg.2017.00733.
  26. Schlarb A, Bihlmaier I, Hautzinger M, et al. Nightmares and associations with sleep quality and self-efficacy among university students. J Sleep Disord Manag 2015;1. DOI: 10.23937/2572-4053.1510006.
  27. Paul F, Schredl M, Alpers GW. Nightmares affect the experience of sleep quality but not sleep architecture: an ambulatory polysomnographic study. Borderline Personal Disord Emot Dysregulation 2015;2(1):3. DOI: 10.1186/s40479-014-0023-4.
  28. Gorgoni M, Scarpelli S, Alfonsi V, et al. Pandemic dreams: quantitative and qualitative features of the oneiric activity during the lockdown due to COVID-19 in Italy. Sleep Med 2021;81:20–32. DOI: 10.1016/j.sleep.2021.02.006.
  29. Ohayon MM, Morselli PL, Guilleminault C. Prevalence of nightmares and their relationship to psychopathology and daytime functioning in insomnia subjects. Sleep 1997;20(5):340–348. DOI: 10.1093/sleep/20.5.340.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.