Experts say they're usually more negatively-toned than other dreams—and can happen when someone has a fever for any reason.

By Claire Gillespie
April 09, 2020
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A fever—a temperature of at least 100.4 degrees Fahrenheit, per the Centers for Disease Control and Prevention (CDC)—is one of the most common symptoms of COVID-19. When the body is fighting a virus like the new coronavirus (or any other type of infection, really), its core temperature shoots up from its normal range (usually between 97 and 99 degrees Fahrenheit) to defend itself against temperature-sensitive pathogens like bacteria and viruses. The higher the temperature, the harder it is for pathogens to multiply in our bodies.

The telltale symptoms of a fever are pretty recognizable: aches, chills, sweating—but in some cases, those dealing with a higher-than-normal body temperature may also experience vivid, sometimes disturbing, negatively-toned dreams known as "fever dreams."

That's what reportedly what happened to CNN anchor Chris Cuomo, who tested positive for COVID-19 on March 31. Days later, on April 2, Chris shared his coronavirus symptoms with his brother, New York Governor Andrew Cuomo, during a TV press briefing. Chris, 49, shared that shortly after he received his diagnosis, he spiked a high fever and began experiencing rigors or shivers. "I had hallucinations—I was seeing pop," Chris said. "You came to me in a dream; you had on a very interesting ballet outfit, and you were dancing in the dream and you were waving a wand," Chris said, talking to his brother Andrew.

Turns out, Chris is not the only one dealing with those fever dreams right now—anecdotally speaking, there have been instances of this happening to those with COVID-19. "I've heard reports of this happening in some people I know with the coronavirus infection," Alcibiades Rodriguez, MD, medical director of the Comprehensive Epilepsy Center-Sleep Center at NYU Langone Health, tells Health. But these fever dreams aren't just COVID-19 specific—they can happen whenever a person's body temperature rises above normal. 

What exactly are fever dreams?

Essentially, fever dreams are the strange, often negatively-toned dreams one can experience with a higher-than-normal body temperature. Unfortunately, a lot of science behind fever dreams is lacking, but there have been a few studies on the topic. In one 2013 study, published in Journal of Pain and Symptom Management, 11% of people sick with a fever experienced fever dreams. One person in the study described a recurring dream they had during adolescence, which returned during a recent fever. Another reported dreams that switched from positive situations to negative ones. 

Another study, published in 2016 in International Journal of Dream Research, compared dreams people had during a fever to dreams they had when they weren’t sick. Around 94% of those who experienced fever dreams described them as negative and more “emotionally intense” than regular dreams. Some of them talked about giant insects, “creatures with oversized arms and legs,” and blackness “slowly spreading all over.” 

And more recently, an online study published in January 2020 in the journal Frontiers in Psychology, found that, out of 164 people, 100 had experienced recent fever dreams. According to the study authors, those fever dreams were “more bizarre and more negatively toned” than regular dreams. Many of the fever dreams also involved heat perception—one study participant described a dream in which they woke up from sleep because their body felt as if it was “blazing” and said “the most intense feelings were weakness and helplessness.”

It's still unknown exactly why these strange dreams can accompany fevers, but experts have a few theories. “We don’t exactly know why fever makes dreams more vivid and disturbing, although one theory is that the brain doesn’t process sensations normally when we have a fever,” Beth Malow, MD, a professor in the department of neurology and pediatrics and director of the sleep disorders division at Vanderbilt University Medical Center, tells Health.

Dr. Malow says fever dreams are believed to be more frequent during the rapid eye movement (REM) stage of sleep. Most dreams occur during REM sleep in any case, but there’s also a connection to temperature. “We don’t regulate our body temperature during REM sleep as well as we do during other stages of sleep, and temperature can swing out of control,” Dr. Malow says. Dr. Rodriguez adds, “if we get a spike in fever during REM sleep, we may feel more uncomfortable and have micro-arousals (shifts between deep and light sleep). This increases the likelihood of us remembering our dreams.” 

Of course, there's also a possibility that fever dreams might not always be dreams—or at least not as we know them. “We know in other medical conditions, such as encephalopathies [diseases that affect the function or structure of the brain], people may have hallucinations," says Dr. Rodriguez. "It is possible that hallucinations may be a form of ‘awake dreaming’ in those specific circumstances. The same could be said for when we have a fever.” 

The fragmented sleep that someone gets while sick may also contribute to strange dreams. "Having a fever is an unstable state that will fragment our sleep," says Dr. Rodriguez. "We know that patients with severe sleep apnea or narcolepsy, which both have a form of sleep fragmentation, have a tendency to remember more of their dreams." He also points out that whether we have a fever or not, we usually remember the dreams that are more disturbing, such as nightmares. 

And even if you're not ill with a fever right now, you may also still be experiencing strange dreams—especially with the added stress of the coronavirus pandemic. From a psychiatric perspective, dreams are important in understanding unconscious thoughts in the mind, Gail Saltz, MD, an associate professor of psychiatry at the NY Presbyterian Hospital Weill-Cornell School of medicine and host of “Personology” podcast, tells Health.  "If interpreted correctly by a patient and doctor working together, a dream can provide a window into unconscious anxieties, fears, desires, etc,” Dr. Saltz says. "COVID-19 is worrying for all of us," adds Dr. Rodriguez says. "And if you are sick and have a fever with the disease, your anxiety level may be even higher." 

While may not know exactly why a fever may cause vivid or disturbing dreams, and though there’s not a sure-fire way to avoid them completely, the more steps you take to control your core body temperature, the more likely you are to get a peaceful night’s sleep. That means getting plenty of rest, drinking lots of fluids (preferably water), taking the meds recommended by your doctor, such as ibuprofen or aspirin, taking lukewarm baths or sponging exposed skin with tepid water, and trying to eat nutritious, easily-digestible foods.

Also important: If you're ill with COVID-19 and your fever is a result of that, make sure you self-isolate, manage your symptoms, and keep an eye on how you're feeling. If your condition worsens—like, if you start to experience shortness of breath, or if your fever spikes to over 103 degrees Fahrenheit—seek medical attention ASAP.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDCWHO, and their local public health department as resources.

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