Expert suggestions to keep COVID-19 from infecting your dreamsPublished on Friday, May 1, 2020By: Gary Pettus, firstname.lastname@example.orgUnfortunately, in the age of the novel coronavirus, we can’t avoid the virulence of troubled sleep by sheltering in place, social distancing, wearing masks or washing our hands religiously.In fact, the surreal nature of those virus-fighting measures may be contributing to an epidemic that a flurry of social media exchanges and Internet queries has exposed: dreams – bizarre, vivid and just plain bad, dreams.The visions reportedly range from the apocalyptic to the absurd, from confrontations with monsters, zombies, bugs, shootings and worms to attending an elegant ball wearing toilet paper.SleepHelp.org reports that more than 20 percent of people surveyed say their sleep quality is worse since SARS-CoV-2 commenced; MarketWatch reveals that, for one week in April, the frequency of Google searches for “insomnia” set a record; and “why am I having weird dreams lately” is common web browser cry for help.Richert“It makes sense,” said Dr. Allen Richert, assistant professor of psychiatry at the University of Mississippi Medical Center and one of three UMMC experts who addressed the phenomenon. “Dreams are funny things. I tend to think of them as your brain working to interpret your emotions, the leftover thoughts of the day.“During sleep, the machinery of the brain is struggling to take impressionistic sensations and turn them into a meaningful story.”That story is your dream.“When things begin to worry us, we start having dreams that are weird or disturbing,” said Richert, director of the Sleep Disorders Fellowship at UMMC. “Not only that, we are also living in this time of increased stress, where people are sheltering in place, so their sleep schedules are off. Which can provide more opportunities for dreaming, which increases the likelihood of having a weird dream.”Bad-dream rashes are prone to break out following disasters and other crises – hurricanes, floods, tornadoes, 9-11. The difference with the new coronavirus is its scope: global. And its endurance: epic.“A tornado or hurricane comes and goes,” Richert said. But COVID-19 has settled in for the long haul, often occupying your head, and your bed.UllahPeople aren’t worried just about getting the disease, said Dr. Mohammad Ullah, UMMC associate professor of medicine and previous director of the Sleep Medicine Fellowship Program. They are also anxious about the collateral damage to their lives.“With the pandemic, we are seeing people lose their jobs or they fear losing their jobs,” Ullah said. “Anxiety will increase bad dreams.“If people you love are sick and you aren’t able to see them, if you can’t go out at all, if you had to cancel important life events, such as weddings or graduations – all that you fear or worry will be in your dreams in some form or fashion.“It’s a cycle: If you worry too much, you have disturbed sleep. When your sleep is disturbed, you are more anxious during the day.”With more anxiety during the day, Ullah said, your sleep becomes even more disturbed at night.Rodriguez“I’m guessing that people are drinking more at night, drinking more caffeine, and staying up late,” said Dr. Oscar Rodriguez, UMMC assistant professor of pediatrics, whose areas of practice include sleep medicine and children’s pulmonology. He also directs the Sleep Medicine Fellowship Program. “All of this may be affecting their sleep patterns and increasing their REM sleep as a rebound effect.”REM, or rapid eye movement, sleep is useful for helping us deal with fears and other negative feelings. REM sleep is the stage where, by and large, we dream, and then forget those dreams when we wake up – usually.But with COVID-19 worries weighing on our minds, that pattern could be changing: We may wake up more because of disturbing dreams. The more we wake up, the more likely we are to remember our dreams – in this case, visions of violence or zombies, or even stories with much more literal characters and plots.Health care workers, especially those on the front line of the pandemic response, are probably more likely to have dreams that are “realistic,” Richert said.“It wouldn’t surprise me: They are constantly dealing with patients and thinking about infections,” he said. “That’s what they do every day.”Ullah said they are like “soldiers.”“They are at the highest risk of getting an infection. And if they don’t have the proper PPE (personal protective equipment), that anxiety doubles.”Fear of contagion, at least, among non-health care workers may not be as high, Richert said.“Lawyers, for instance, aren’t normally thinking about infections and bugs, so their dreams about the virus would be more abstract.”The monsters are metaphors.No doubt, sleep patterns are changing for many, no matter what their job, Richert said.“People who are working from home may be allowing themselves to sleep later in the day, so they find it harder to fall asleep at night,” he said. “And then it’s a lighter sleep, when you’re more likely to have dreams.”Richert, Ullah and Rodriguez all said one way to drain these dreams of their power is to get the right amount of asleep – about eight hours in 24 hours – on a regular schedule. Don’t drink caffeine late in the day. Don’t drink alcohol to help you go to sleep. Don’t nap after about 4 p.m.Ullah also recommends physical exercise vigorous enough to launch you to a more desirable dream world.For persistent, alarming dreams, Ullah and Rodriguez also suggest looking into prescription medications, the kind that can relax you before you go to bed. Among them are prazosin and trazodone.“But you want to hold out on being prescribed medication until the nightmares are affecting you significantly,” Rodriguez said.It’s also vital that you get support, especially if the problem doesn’t go away, he said. Therapy may be needed.With or without therapy, there’s at least one other way to reduce, or forget, the unsettling stories of your dreams: Rewrite them.Also known as “programming your dreams,” or “dream incubation,” the strategy has been known to work, especially for recurring nightmares, Richert said.“If you know the dream is going to be the one, for example, where you go to the grocery store and see your friend Joe Smith on the second aisle and somebody robs you there, what you can do is rehearse that narrative throughout the day, but change the ending,” he said. “You go to the grocery store, and instead of turning down the second aisle, you go down the fifth one, and instead of seeing a robber, you see a friend from the past, and you have a good, long talk. And the dream is over.”For children, parents can talk to them about their dreams right before bedtime, Rodriguez said.“Adults or children can change the outcome of the dream by writing it down or just by thinking about it. Or by drawing it: Which superpower would you choose that would help you change your dream?“It’s been reported to be very successful in treating nightmares. So you can reprogram your dreams. But that is also after you have fixed your disrupted sleep schedule.“In the end, having good sleep hygiene is the best way of improving your dreams.”The above article appears in CONSULT, UMMC’s monthly e-newsletter sharing news about cutting-edge clinical and health science education advances and innovative biomedical research at the Medical Center and giving you tips and suggestions on how you and the people you love can live a healthier life. Click here and enter your email address to receive CONSULT free of charge. You may cancel at any time.