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Why Nightmares Might Mean You Have Lupus


If you’re having nightmares and dream-like hallucinations during the day, this could be your body’s early warning sign for autoimmune diseases like lupus. A study published in eClinicalMedicine suggests that psychiatric or neurological symptoms might be among the first indicators of an impending flare. Recognizing these symptoms early can potentially stop flares from progressing or help people get an accurate diagnosis sooner.

Individuals who develop autoimmune diseases, including multiple sclerosis (MS) and rheumatoid arthritis (RA), often experience psychological symptoms such as depression, agitation, feelings of “unreality,” and poor sleep before the more typical signs of these conditions emerge. This was a key finding from the research led by Dr. Melanie Sloan, a public health specialist at the University of Cambridge.

The study surveyed 676 people living with lupus and 400 healthcare providers, along with conducting detailed interviews with 69 people living with systemic autoimmune diseases and 50 clinicians. Participants were asked about the timing of 29 neurological and mental health symptoms, including depression, hallucinations, and loss of balance. Fatigue and low mood were frequently cited, and disrupted dream sleep was reported by 60% of participants, with a third experiencing this symptom over a year before the onset of lupus.

Vivid Dreams and Hallucinations

A notable finding was the pattern of disrupted dreaming sleep, with about three in five lupus patients and one-third of those with other rheumatic conditions reporting unusually vivid and distressing nightmares. Some individuals described nightmares of violence and feeling attacked, such as horrific scenes involving murders or skin coming off people. Others recounted frequent dreams of falling, being unable to breathe, or feeling trapped.

Interviews with specialists revealed that many had not previously considered nightmares and hallucinations as related to disease flares. This lack of awareness can lead to misdiagnosis, with some individuals initially being diagnosed with psychotic episodes or suicidal ideation before the correct autoimmune diagnosis was made. For example, a nurse from Scotland recounted instances where young women were hospitalized for psychosis that was later identified as an early sign of lupus.

The study has limitations, such as relying on participants’ recollections and not accounting for medication details. Dr. Dafna Gladman, a lupus researcher at the University of Toronto, noted that the mechanism causing these symptoms in autoimmune conditions is unclear. Sleep disorders in lupus patients can exacerbate other issues, highlighting the need for further research.

Addressing Mental Health Stigmas

Nightmares and hallucinations are more common in lupus and other systemic rheumatic diseases than previously realized, and there is a need for clinicians and patients to discuss these symptoms openly. The stigma around mental health and the frightening nature of these experiences often keep individuals silent. Education and empathy are crucial in changing this, as many patients have endured long and difficult diagnostic journeys, sometimes being misdiagnosed with psychiatric problems before receiving the correct autoimmune diagnosis.

Early detection of flares in lupus patients is vital as they can lead to severe organ damage and even death. Knowing that neurological and psychiatric symptoms can precede typical disease symptoms like rashes and joint pains can aid in earlier diagnosis. Patients often experience a consistent progression of symptoms with each flare, suggesting that documenting these patterns with their doctors can help monitor the disease more effectively. This can include symptoms not typically listed in standard diagnostics, such as nightmares and a “feeling of unreality,” which, although they don’t show on blood tests or brain scans, are relevant to monitoring the patient’s disease.

The study underscores the importance of recognizing psychiatric and neurological symptoms as potential early indicators of autoimmune diseases. By improving awareness and communication between patients and healthcare providers, it may be possible to achieve earlier diagnoses and better manage these conditions.

Do you suffer from nightmares? Are you concerned about lupus? Leave your thoughts in the comments below.

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