Horrible nightmares and ‘daymares’ linked to autoimmune disease

Sign up for CNN’s Sleep, But Better newsletter series. Our seven-part guide contains helpful tips for achieving better sleep.

CNN
—

of nightmare It is often intense and frightening, and sometimes lasts all day.

A Canadian patient said, “There’s a serial killer after me. I’ve had the same serial killer for the past few years.” “He’s holding my leg or I can still feel something on his leg when I’m awake.”

Another British patient said: nightmare “Where you can’t breathe, where someone is sitting on your chest.” Yet another person shared a story of having “really disturbing” violent visions while sleeping.

One Irish patient described his nightmares as “horrible, like a murder, like people’s skin coming off.” “It’s like when I’m overwhelmed and my lupus may be getting worse…so the more stress my body is under, the more vivid and bad the dreams are. I think it will be.”

nightmare And “daymares,” dream-like hallucinations that occur when you wake up, may be a little-known sign of the onset of dementia. lupus New research suggests that other systemic autoimmune diseases, such as rheumatoid arthritis, Released on Monday Published in eClinicalMedicine magazine.

Such unusual symptoms could also be a signal that an established disease has become extremely worsened, or ‘flare-up’, and may require treatment, said study lead author and Cambridge University Public said Melanie Sloan, a researcher in the Department of Hygiene and Primary Care. In England.

“This is especially true for diseases like lupus, which is well known to affect multiple organs, including the brain, but also for other rheumatic diseases such as rheumatoid arthritis, Sjögren’s syndrome, and systemic sclerosis. We see a similar pattern of symptoms,” Sloan said in an email.

lupus This is a long-term disease in which the body’s immune system becomes confused and attacks healthy tissue, causing inflammation and pain in all parts of the body, including blood cells, brain, heart, joints and muscles, kidneys, liver, and lungs. .

“Many of the cognitive problems and other neuropsychiatric symptoms we studied can have a significant impact on people’s ability to live, work, socialize and lead as normal a life as possible,” she said. says.

“These symptoms are often invisible and cannot be tested for (currently), but that doesn’t make it any less important to consider treatment and support.”

Jennifer Mundt, assistant professor of sleep medicine, psychiatry, and behavioral sciences at Northwestern University Feinberg School of Medicine in Chicago, who was not involved in the study, said in an email that the study focused on nightmares. He said he was happy about that.

“Even though nightmares are a highly distressing problem in many medical and psychiatric conditions, they rarely receive attention except in the context of PTSD (post-traumatic stress syndrome),” Mundt said.

“a recent research “18% of people with long-term COVID-19 infection have been shown to have (frequent) nightmares, compared to a prevalence of around 5% in the general population,” she said. Ta. “Hearing the patient perspective is critical in order to guide research and clinical care based on what is most important to patients themselves.”

What doctors and patients need to know

Although research in this area is fairly new, March 2019 survey Researchers have found that patients with inflammatory arthritis and other autoimmune and inflammatory diseases also experience REM sleep disorders such as nightmares and sleep paralysis. REM, short for rapid eye movement, is the stage of sleep where people dream and where information and experiences are consolidated and stored in memory.

In the study, a 57-year-old man recalled having nightmares in which he was “threatened by wild birds of prey,” and a 70-year-old woman said that her nephew was in grave danger, but that he had no choice but to leave him alone. He said he had a dream that he couldn’t help.

The new study surveyed 400 physicians and 676 people with lupus, and also conducted in-depth interviews with 50 clinicians and 69 people with systemic autoimmune rheumatic diseases, including lupus. did.

Researchers found that 3 in 5 lupus patients and 1 in 3 patients with other rheumatism-related diseases experience increasingly vivid and painful nightmares just before hallucinations. . These nightmares often included falling, being attacked, trapped, crushed, and committing murder.

“He was riding a horse and cutting people down with a sword. One of them was attacked by someone and he ended up slitting their throats,” the British patient said.

“I’m not a violent person. I don’t even kill bugs,” the patient continued. “And I came to the conclusion that maybe I’m fighting my own (autoimmune) system. … Maybe I’m attacking myself, which is why I logically It’s the only thing that makes sense.

Systemic autoimmune diseases often have a variety of symptoms called prodromes, which appear as signs of a sudden and dangerous worsening of the condition. For example, with lupus, common signs of an upcoming flare-up include headaches, increased fatigue, joint pain and swelling, rash, dizziness, and non-infectious fever.

Sloan said it’s important to be aware of these warning signs, which “allows for early detection and therefore treatment of flares, some of which can damage organs and be fatal for lupus patients.” There is a possibility that it will become.”

But distinctive warning symptoms such as nightmares and daydreams aren’t included in the diagnostic criteria for lupus or other diseases, Sloan said. The study found that doctors rarely ask about such experiences, and patients often avoid telling their doctors about them.

“We encourage people to ask more about nightmares and other neuropsychiatric symptoms (thought to be uncommon but are actually very common in systemic autoimmune diseases) so that disease flare-ups can be detected early.” “We strongly recommend it to doctors in the field,” said study senior author and consultant rheumatologist David D’Cruz. at Guy’s Hospital and King’s College London.

At first glance, it makes sense that an autoimmune disease that affects the brain would cause neurological symptoms such as nightmares, but Sloan says this is common in lupus. However, research has shown that this is not the case.

“Interestingly, we found that lupus patients who were classified as having damage to organs other than the brain, such as kidneys or lungs, often also reported a variety of neuropsychiatric symptoms, leading up to kidney or lung flare-ups. ,” Sloan said in an email. .

“This suggests that we are monitoring for symptoms such as nightmares and mood changes, as well as regular rashes and proteins in the urine (causes). kidney inflammation) could help detect flares early in many patients, not just those who develop significant brain damage,” she said.

But there’s no reason to worry that people who have occasional nightmares or daydreams might be suffering from an inflammatory autoimmune disease, says Dr. Petersen, a sleep disorders expert and professor and senior staff member at American University Hennepin County Medical Center. said physician Dr. Carlos Schenck. Minneapolis, Minnesota.

“This study warns the public not to believe or worry about whether they have lupus or a related autoimmune disease if they have nightmares or hallucinations, which doctors call ‘non-specific symptoms.’ There is a possibility. This refers to a variety of symptoms (medical and psychiatric). These symptoms may occur,” Schenck said in an email.

Indeed, it’s “totally normal” to have occasional nightmares, daydreams, or hallucinations, Sloan says, “and it’s also more common than we think.”

However, if they are intense, agitating, and occur along with other symptoms such as extreme fatigue or headaches, Signs of autoimmune diseasethose “should be discussed with your doctor,” Sloan said.

“People should not be afraid or embarrassed to talk about these symptoms,” she said. “In some cases, even if they seem strange and unrelated, reporting these symptoms early can help doctors ‘connect the dots’ to diagnose an autoimmune disease. There is a sex.”