A team of researchers reveals that nightmares and hallucinations may be warning signs of autoimmune diseases, such as lupus.
- Recurring nightmares and hallucinations, often taken for signs of neurological or psychiatric pathologies, could actually be warning symptoms of autoimmune inflammatory diseases such as lupus, according to a study.
- Three in five lupus patients reported REM sleep disturbance, with “often intense and distressing nightmares involving being attacked, trapped, crushed, or falling.”
- Nearly one in four patients reported hallucinations (“daymares” in English). They are not “necessarily frightening,” says one patient. “It’s as if you are disoriented, […] with the impression of being Alice in Wonderland.”
Repeated nightmares and no less recurrent hallucinations, often taken for signs of neurological or psychiatric pathologies, could in reality be warning symptoms of autoimmune inflammatory diseases such as lupus.
This is what a new study published in the journal reports eClinicalMedicineopening perspectives for more effectively detecting these diseases resulting from a dysfunction of the immune system, which remain a mystery for the scientific community.
Disturbed sleep in three out of five lupus patients
To reach these conclusions, researchers from the University of Cambridge and King’s College London, UK, surveyed 676 people living with lupus and 400 doctors, and conducted interviews with a further 69 patients with rheumatic diseases. systemic autoimmune diseases, including lupus. Participants were asked to indicate the timing and duration of their neurological and psychiatric symptoms (hallucinations, loss of balance, depression, etc.), and to list the order in which the symptoms generally occurred during a flare-up of their illness.
Three in five patients with lupus (and one in three patients with other rheumatologic conditions) reported that the most common symptom was a disturbance in REM sleep, during which dreams occur. Of these, a third said it had occurred more than a year before the onset of lupus. They evoke “nightmares, often intense and distressing, involving being attacked, trapped, crushed or falling”, can we read in a communicated. A participant describes dreams “horrible”, with “murders”.
Nearly one in four patients also reported hallucinations (“daymares” in English, or a kind of nightmares during the day), although for 85% of them, the symptom only appeared at the beginning of the illness or later. These hallucinations are not “necessarily frightening, specifies a patient. It’s like you’re disoriented, […] with the impression of being Alice in Wonderland.”
Neurological symptoms as first signs of autoimmune disease
An autoimmune disease can affect any organ, including the brain. It is therefore not impossible, according to the researchers’ results, that neurological or psychiatric signs and symptoms could also indicate such a condition. In their study, they observed that a patient diagnosed with borderline personality disorder received a second diagnosis six months later, of lupus. This was actually one of the first signs of the autoimmune disease.
“For many years, I discussed nightmares with my lupus patients and thought there was a link to their disease activity, agrees Professor David D’Cruz, lead author of the study. This research provides evidence of this, and we strongly encourage more doctors to ask about nightmares and other neuropsychiatric symptoms – considered unusual, but in fact very common with autoimmune diseases – to help us detect disease outbreaks earlier.”
