An increase in nightmares could be an early sign of some autoimmune diseases, new research suggests.
Researchers at the University of Cambridge and King’s College London surveyed 676 people with lupus, a disease that causes the immune system to attack tissues and organs, and 400 clinicians, as well as interviewing 69 people living with various chronic inflammatory autoimmune disorders and 50 clinicians.
They said three in five of the patients who had lupus reported having disrupted dream sleep, with a third of them saying it started over a year before the onset of the disease.
Just under one in four patients reported hallucinations, though for 85% of these, the symptom did not appear until around the onset of disease or later, researchers added.
The researchers found three in five lupus patients and one in three with other rheumatology-related conditions reported having more nightmares just before hallucinations began.
Professor David D’Cruz, of King’s College London, said: “For many years I have discussed nightmares with my lupus patients and thought that there was a link with their disease activity.
“This research provides evidence of this, and we are strongly encouraging more doctors to ask about nightmares and other neuropsychiatric symptoms – thought to be unusual, but actually very common in systemic autoimmunity – to help us detect disease flares earlier.”
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Researchers said patients often described their dreams as “vivid and distressing”, commonly involving being attacked, trapped, crushed or falling.
One patient described their nightmares as “horrific, like murders, like skin coming off people”.
They added that they thought this happened when they were “overwhelmed” and “the more stress my body is under then the more vivid and bad the dreaming would be”.
The study, published in eClinicalMedicine on Monday, also found using the word “daymare” was more accurate for patients who reported experiencing hallucinations.
One patient said: “It’s like not necessarily scary, it’s just like you’ve had a dream and yet you’re sitting awake in the garden.
“I see different things, it’s like I come out of it and it’s like when you wake up and you can’t remember your dream and you’re there but you’re not there, it’s like feeling really disorientated. The nearest thing I can think of is that I feel like I’m Alice in Wonderland.”
Some interviewees with lupus were also misdiagnosed with mental health problems.
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Lead author Dr Melanie Sloan from the University of Cambridge said both patients and doctors “can be reluctant to discuss mental health and neurological symptoms, particularly if they don’t realise that these can be a part of autoimmune diseases”.
The researchers found many specialists they surveyed and interviewed said they had never considered nightmares and hallucinations as being related to disease flares – and that most agreed that recognising them as early flare symptoms moving forward may provide an “early warning system” for detecting diseases.
