Researchers Speculate Nightmares and Hallucinations May Indicate Early Stages of Autoimmune Disorders

A recent investigation has identified peculiar symptoms that might signal the onset of certain systemic autoimmune rheumatic diseases.

Nightmares and “daymares,” which are hallucinations experienced while awake, have emerged as potential early indicators of autoimmune diseases like lupus and rheumatoid arthritis.

Lead author Melanie Sloan, a researcher at the University of Cambridge’s Department of Public Health and Primary Care, highlighted the significance of these findings, suggesting that such symptoms could serve as an early warning system for escalating disease activity. This early detection could facilitate prompt treatment and improved support for patients.

Sloan emphasized that the study’s results were obtained through a patient-centered approach, prioritizing patients’ experiences and their descriptions of symptoms over solely relying on medical professionals’ observations.

The research, published in the journal eClinicalMedicine, sheds light on the recurring themes in nightmares and hallucinations reported by patients. These themes often include frightening and violent scenarios.

For instance, one patient from Canada described recurring nightmares involving a serial killer, while another from England recounted dreams where they were the perpetrator of violent acts, despite not being a violent person in reality.

While many patients reported experiencing nightmares and daymares to some extent, it remains unclear whether these neuropsychiatric symptoms can reliably predict undiagnosed cases of autoimmune diseases.

According to Sloan, the study revealed that symptoms preceding a flare-up are consistent but varied among patients. Some may experience cognitive issues, sensory symptoms, and mood changes, while others may suffer from nightmares and a sense of unreality.

Despite the consistency of symptoms leading up to a flare-up, establishing a standardized list of symptoms to monitor remains challenging due to the heterogeneity of autoimmune diseases like lupus.

Sloan stressed the importance of effective patient-clinician communication in detecting neuropsychiatric symptoms, which are often not visible or detectable in tests.

Unfortunately, many patients have reported that their neuropsychiatric symptoms were disregarded or disbelieved by their doctors, complicating the recognition and management of impending flare-ups.

The journey to diagnosis can be prolonged and traumatic for patients, with lasting impacts on their self-esteem and trust in healthcare professionals.