Scary Nightmares and 'Daymares' Associated with Autoimmune Conditions

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"There's a serial killer after me," a Canadian patient shared, "and it's been the same one for the last few years." "I feel like he's targeting my legs because I can still feel something on them even when I'm awake."

Man in bed in the morning

Man in bed in the morning

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One English patient shared experiencing nightmares where they felt like they couldn't breathe and someone was sitting on their chest. Another patient talked about having violent visions in their sleep, describing them as "really nasty."

An Irish patient described their nightmares as "horrific," mentioning seeing murders and skin coming off people. They believed that the intensity of their dreams was linked to feeling overwhelmed, possibly due to their lupus acting up. The patient thought that the more stress their body was under, the more vivid and disturbing their dreams became.

Nightmares and “daymares,” dreamlike hallucinations that occur while awake, could be early signs of lupus and other autoimmune diseases, like rheumatoid arthritis. This information comes from a recent study published in the journal eClinicalMedicine.

According to the lead researcher, Melanie Sloan from the University of Cambridge in the United Kingdom, experiencing these unusual symptoms could also indicate that an existing disease is about to worsen significantly, known as a “flare-up,” requiring medical attention.

Human karotype, 23 pairs of chromosomes, Bottom right, the pair of sex chromosomes XY or XX determines the sex. (Photo by: BSIP/Universal Images Group via Getty Images)

Human karotype, 23 pairs of chromosomes, Bottom right, the pair of sex chromosomes XY or XX determines the sex. (Photo by: BSIP/Universal Images Group via Getty Images)

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“This is especially seen in diseases such as lupus, known for impacting various organs including the brain. However, similar symptom patterns were also observed in other rheumatological conditions like rheumatoid arthritis, Sjogren’s syndrome, and systemic sclerosis,” Sloan mentioned in an email.

Lupus is a chronic condition where the immune system attacks healthy tissue, leading to inflammation and pain in various parts of the body like blood cells, brain, heart, joints, muscles, kidneys, liver, and lungs.

According to a study, cognitive issues and other neuropsychiatric symptoms linked to lupus can greatly impact people's daily lives, work performance, social interactions, and overall quality of life.

These symptoms may not be easily seen or tested, but they are still crucial to address and provide treatment and support for.

Jennifer Mundt, an assistant professor at Northwestern University's Feinberg School of Medicine in Chicago, who specializes in sleep medicine, psychiatry, and behavioral sciences, expressed her satisfaction with the study's emphasis on nightmares in an email.

Vivid, disturbing nightmares may be a sign of a newly developing autoimmune disorder or an upcoming flare of existing disease, experts say.

Vivid, disturbing nightmares may be a sign of a newly developing autoimmune disorder or an upcoming flare of existing disease, experts say.

Nightmares are a common issue in various medical and psychiatric conditions, but they are often only discussed in relation to PTSD (post-traumatic stress syndrome), according to Mundt.

Doctors and patients need to know that a recent study revealed that 18% of individuals with long-COVID experience frequent nightmares. This is significantly higher than the general population prevalence of about 5%. According to the researcher, hearing the patient perspective is crucial in guiding research and clinical care to prioritize what is most important to patients themselves.

Research in the field is relatively new, but a study from March 2019 revealed that patients with inflammatory arthritis and other autoimmune and inflammatory diseases may also experience nightmares and other REM sleep disorders like sleep paralysis. REM stands for rapid eye movement, the stage of sleep where dreams occur and information is processed and stored in memory.

In this particular study, a 57-year-old man shared that he had nightmares about being threatened by wild birds, while a 70-year-old woman dreamed that her nephew was in serious trouble but she was unable to help him.

The study involved 400 doctors and 676 individuals with lupus. Additionally, 50 clinicians and 69 people with systemic autoimmune rheumatic diseases, including lupus, were interviewed in detail.

Soft focus of jar with sleeping pills and glass of water placed on bedside table near sleeping female in morning at home.

Soft focus of jar with sleeping pills and glass of water placed on bedside table near sleeping female in morning at home.

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Researchers discovered that a majority of lupus patients, as well as a significant number of patients with other rheumatology-related diseases, experienced intense and disturbing nightmares leading up to their hallucinations. These nightmares frequently featured themes of falling, being attacked, feeling trapped, being crushed, or even committing violent acts.

One patient from England shared, "I would dream of riding a horse, cutting people with my sword. In one dream, someone attacked me and I ended up slitting their throat."

I don't have a violent bone in my body. I wouldn't even harm an insect," the patient explained. "I've come to realize that it might actually be my own immune system that I'm battling. It seems like I could be attacking myself, and that's the only explanation that makes sense to me.

Autoimmune diseases that affect the entire body often come with warning signs known as prodromes. These symptoms can indicate a sudden and potentially serious worsening of the condition. For instance, in the case of lupus, common prodromes include headaches, increased fatigue, painful and swollen joints, skin rashes, dizziness, and unexplained fever.

Recognizing these warning signs is crucial, according to Sloan. This is because early detection can lead to timely treatment of flares, some of which can cause organ damage or even be fatal for lupus patients.

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However, unique warning symptoms like nightmares and daymares are not part of the diagnostic criteria for lupus or other diseases, according to Sloan. The study revealed that doctors rarely inquire about these experiences, and patients often hesitate to discuss them with their physicians.

Senior study author David D’Cruz, a consultant rheumatologist at Guy’s Hospital and Kings College London, emphasized the importance of doctors asking about nightmares and other neuropsychiatric symptoms. These symptoms, although considered uncommon, are actually quite prevalent in systemic autoimmunity. Detecting these symptoms earlier can help in identifying disease flares sooner.

When autoimmune diseases like lupus affect the brain, it may seem logical to expect neurological symptoms such as nightmares to occur, according to Sloan. However, the study revealed something different.

Sloan shared via email that they discovered something interesting. They found that lupus patients, who were categorized as experiencing organ issues like kidneys or lungs, also frequently experienced various neuropsychiatric symptoms before their kidney/lung flare.

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Many patients may benefit from monitoring symptoms like nightmares, changing mood, rashes, and protein in the urine. These symptoms can help in detecting flare-ups earlier, not just in patients with major brain involvement.

However, sleep disorder specialist Dr. Carlos Schenck, a professor and senior staff psychiatrist at the Hennepin County Medical Center at the University of Minnesota in Minneapolis, reassures that there is no need for people with occasional nightmares or daytime dreams to worry about having an inflammatory autoimmune disease.

In an email, Schenck explains that having nightmares or hallucinations, which are considered "nonspecific symptoms" by doctors, should not immediately lead to concerns about having lupus or a related autoimmune disorder. These symptoms can be attributed to a variety of conditions, both medical and psychiatric.

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It is completely normal to experience occasional nightmares and daymares, as well as hallucinations, which are more common than we realize, according to Sloan.

However, if these experiences are intense, distressing, and accompanied by symptoms like extreme fatigue, headaches, or other signs of autoimmune disorders, it is important to talk to a doctor, as advised by Sloan.

"It's important for people to feel comfortable discussing these symptoms," she mentioned. "By speaking up about them early on, even if they may seem odd or unrelated, it can help the doctor connect the dots and diagnose an autoimmune disease."

Editor's P/S:

The article highlights the potential role of nightmares and daymares as early warning signs of lupus and other autoimmune diseases. These intense and often terrifying experiences can provide valuable insights into disease activity and impending flares. However, it's crucial to note that nightmares and daymares alone do not definitively indicate an autoimmune condition. Other symptoms and risk factors should be considered for a comprehensive diagnosis.

If you are experiencing frequent or severe nightmares and daymares, especially in conjunction with other concerning symptoms, it is advisable to consult a healthcare professional. Early detection and treatment of autoimmune diseases can significantly improve outcomes and prevent potential complications. By raising awareness of these unique warning signs, the article empowers individuals to take proactive steps towards their health and well-being.