Terrifying nightmares and “white dreams” associated with autoimmune diseases

Sign up for CNN's Sleep, But Better newsletter series. 7-part guide includes helpful tips to help you sleep better.

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 “horrifying, 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 upon waking, could be a little-known sign of the onset of dementia. lupus New research shows that systemic autoimmune diseases such as rheumatoid arthritis also Published 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 particularly true for a disease like lupus, which is well known to affect multiple organs, including the brain, but we have seen similar symptom patterns in other rheumatic diseases, such as rheumatoid arthritis, Sjögren's syndrome, and systemic sclerosis,” Sloan said in an email.

lupus It is a long-term disease in which the immune system goes awry and attacks healthy tissue, causing inflammation and pain in all parts of the body, including blood cells, the brain, heart, joints, 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.

“Although these symptoms are often invisible and untestable (at this time), this does not make them any less important to seek treatment and support for.”

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.

“Despite the fact that nightmares are a very distressing problem in many medical and psychiatric conditions, they receive very little attention, except in the context of post-traumatic stress syndrome (PTSD).” said Mundt.

“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.”

Doctors and patients need to know

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

In the study, a 57-year-old man recalled being “threatened by wild birds of prey” in a nightmare, while a 70-year-old woman dreamed that her nephew was in grave danger but was unable to save him.

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.

The researchers found that three in five lupus patients, and one in three patients with other rheumatoid-related diseases, experienced increasingly vivid and distressing nightmares immediately preceding the hallucinations. These nightmares often included falling, being attacked, trapped, crushed, or committing murder.

“I was riding around on a horse, cutting people down with my sword. One of them attacked me, and I ended up slitting his throat,'' the British man said. the 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 treatment of flares, some of which can damage organs and be fatal for lupus patients.” There is a possibility that it will.”

However, unique warning symptoms such as nightmares and daydreams are not 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 talking about them with their doctors.

“Although nightmares and other neuropsychiatric symptoms are considered rare, they are actually very common in systemic autoimmune diseases. We encourage more doctors to ask about this so they can catch disease recurrence early. I highly recommend it,” said David D'Cruz, consultant rheumatologist at Guy's Hospital and King's College London and lead author of the study.

At first glance, it would make sense that neurological symptoms like nightmares would occur if an autoimmune disease affected the brain, as is often the case with lupus, Sloan said, but that's not what the study found.

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

“This suggests monitoring for symptoms such as nightmares and mood changes, as well as the usual rash and protein 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. McConlogue, a sleep disorders expert, 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, 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, early reporting of these symptoms, even if they seem strange and unrelated, may allow doctors to 'connect the dots' to diagnose an autoimmune disease. There is a sex.”