Researchers from the University of Cambridge and King’s College London conducted a study that found an increase in nightmares and hallucinations, or “daymares,” could be early indicators of autoimmune diseases like lupus. The study surveyed 676 lupus patients and 400 clinicians, as well as conducted in-depth interviews with 69 individuals living with autoimmune rheumatic diseases. Symptoms such as disrupted dream sleep, hallucinations, and loss of balance were reported by patients, with disrupted dream sleep often appearing more than a year before the onset of lupus.
One of the key findings from the study was that neuropsychiatric symptoms could serve as an early warning system for disease flare-ups. Participants reported vivid and distressing nightmares before the onset of hallucinations, often involving scenarios of being attacked, trapped, or falling. The term “daymares” was used during interviews to describe these hallucinations in a less stigmatizing way, prompting patients to open up about their experiences. Many individuals experiencing these symptoms were reluctant to discuss them with doctors, fearing misdiagnosis or stigma associated with mental health symptoms.
The study authors emphasized the importance of patients and doctors working together to identify patterns of symptoms that could indicate an upcoming flare-up. Early detection of these neuropsychiatric symptoms could serve as an “early warning system” for patients with autoimmune diseases like lupus, leading to earlier intervention and treatment. Lupus can cause organ damage, including the brain, so early detection is crucial in preventing severe complications.
While the mechanisms by which nightmares may be precipitated by lupus flare-ups are currently unknown, inflammation or infection in the body can lead to disruptions in REM sleep and dreaming. Direct inflammation of the brain may also disrupt brain circuits involved in regulating sleep and dreaming. The study highlighted that psychiatric signs and symptoms often precede formal diagnosis or flare-ups of neuropsychiatric lupus, providing valuable insights for both initial diagnosis and assessment of disease exacerbations.
The study also pointed out that not every presentation of psychiatric signs and symptoms should be considered indicative of lupus or other autoimmune conditions, as individuals with a history of psychiatric issues may have other underlying causes for these symptoms. However, recognizing the presence of psychiatric features in conjunction with other rheumatological signs could aid in establishing a differential diagnosis or predicting disease flare-ups. Understanding these symptoms can help reduce patients’ hesitance to report them and seek appropriate medical care.
In conclusion, the study emphasized the importance of recognizing neuropsychiatric symptoms in autoimmune diseases like lupus, as they could be early warning signs of impending flare-ups. More research and medical understanding in this area could help patients feel more confident in reporting these symptoms and receiving timely intervention. While the study focused on lupus, similar neuropsychiatric symptoms may also be present in other autoimmune rheumatic diseases, highlighting the need for increased awareness and support for individuals experiencing these symptoms.
