Dream activity in narcoleptic patients during the COVID-19 lockdown in Italy

Some studies highlighted that patients with narcolepsy type-1 (NT1) experience highlucid dream frequency, and this phenomenon has been associated with a creativepersonality. Starting from the well-known “pandemic effect” on sleep and dreaming, wepresented a picture of dreamactivity in pharmacologically treated NT1 patients during theItalian lockdown. Forty-three NT1 patients completed a web-survey during Spring 2021and were compared with 86 matched-controls. Statistical comparisons revealed that:(a) NT1 patients showed greater sleepiness than controls; (b) controls showed highersleep disturbances than NT1 patients, and this result disappeared when the medicationeffect in NT1 was controlled; (c) NT1 patients reported higher lucid dream frequencythan controls. Focusing on dreaming in NT1 patients, we found that (a) nightmarefrequency was correlated with female gender, longer sleep duration, higher intrasleepwakefulness; (b) dream recall, nightmare and lucid dream frequency were positivelycorrelated with sleepiness. Comparisons between low and high NT1 lucid dreamersshowed that patients more frequently experiencing lucid dreams reported a greaterinfluence of dreaming during wakefulness, especially concerning problem-solving andcreativity. Overall, our results are consistent with previous studies on pandemic dreamingcarried out on healthy subjects. Moreover, we confirmed a link between lucidity andcreativity in NT1 patients. Considering the small sample size and the cross-sectionaldesign, our findings cannot provide a causal relationship between lucid dreams and theCOVID-19 lockdown. Nevertheless, they represent a first contribution to address futurestudies on this issue, suggesting that some stable characteristics could interact withchanges provoked by the pandemic.