Nightmares May Have Disturbing Link to Autoimmune Diseases: ScienceAlert

Nightmares could be an early warning system for the onset of autoimmune disorders in the brain.

A new study led by Cambridge University public health researcher Melanie Sloan has found that bad dreams are one of the most common and earliest signs of a lupus flare.

In an online survey of 676 patients with lupus – technically known as systemic lupus erythematosus (SLE) – about a third of patients reported disturbed dreams in the year before other symptoms of the disease appeared.

The findings add to anecdotal reports that dreams and the brain’s immune system are somehow intertwined.

“We have long been aware that disturbances in dreams can signify changes in physical, neurological and mental health and can sometimes be early indicators of illness,” says neurologist and study author Guy Leschziner of Guy’s Hospitals. and St Thomas’ London.

“However, this is the first evidence that nightmares can also help us manage an autoimmune disease as serious as lupus, and it is an important warning to both patients and doctors that sleep symptoms can tell us about a imminent relapse.”

SLE is a lifelong autoimmune disease of unknown cause that most often begins between the ages of 15 and 45. About every few years, it triggers intermittent flare-ups of joint pain, fever, chest pain, fatigue, or hair loss.

Not all people with SLE develop neuropsychiatric symptoms during these flares. But for the roughly 40 percent who do, diagnosis and treatment are a challenge, since symptoms such as nightmares and hallucinations are subjective and many patients are hesitant to talk about them.

People with autoimmune brain diseases often experience vivid dreams that are emotionally charged, but these cognitive symptoms have tended to go unnoticed.

However, recently, studies have shown that many who develop Parkinson’s disease (which is linked to autoimmune problems) are plagued by distressing dreams for up to a decade before diagnosis.

Nightmares are also potentially predictive of dementia, which again is related to the immune system. And some multiple sclerosis patients say their dreams become unpleasant before an outbreak.

Now it appears the same is true for some people with lupus.

In addition to the online survey, the researchers conducted in-person interviews with 69 people suffering from systemic autoimmune rheumatic diseases, including lupus.

One respondent said their nightmares during a lupus flare were so “horrible” that they saw “skin coming off people.” “I think the more stress I have under my body, the more vivid and bad the dreams will be,” they told researchers.

Another patient had a similar theory: “I’ve come to the conclusion that (the nightmares) are probably me fighting my own system,” they said.

Because these experiences can be so emotionally charged, the researchers gently introduced hallucinations into the conversation by asking about “nightmares,” and some patients immediately knew what they were referring to.

“As soon as you said (nightmare), it all made sense,” said one participant. “It’s not necessarily scary; it’s like you’ve had a dream and yet you’re sitting awake in the garden… it’s like feeling really disoriented. The closest thing I can think of is that I feel like I’m Alice in Wonderland“.

Just before experiencing these nightmares, the online survey found that more than 60 percent of respondents reported having increasingly disturbed nighttime dreams.

These findings support recent clinical observations by two of the study’s authors, Sloan and rheumatologist David D’Cruz of Kings College London, who noted that asking lupus patients about nightmares “elicits a surprising response.”

“For many years, I have discussed nightmares with my lupus patients and thought there was a link to their disease activity,” D’Cruz says of the new findings.

“This research provides evidence for this and we strongly recommend that more doctors ask about nightmares and other neuropsychiatric symptoms.”

The team also surveyed doctors about their understanding of lupus. Only one rheumatologist had considered dreams to be potentially linked to lupus flares, but most experts were open to asking patients about their nightmares to possibly detect and treat flares earlier.

Our dreams really could be telling us something. Even scientists suspect it.

The study was published in eMedicineClinical.