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Evening Standard
Evening Standard
World
Maryam Kara

Increase in nightmares could be early warning sign of autoimmune disease, study says

An increase in nightmares could be a warning sign of certain diseases, according to a new study.

Researchers at Kings College London and the University of Cambridge have flagged than an increase in both nightmares and hallucinations could herald the onset of some autoimmune diseases.

They have called for doctors to ask about nightmares in the hope it could flag the onset of some diseases in patients earlier.

For the study, published in eClinicialMedicine, researchers surveyed 676 people living with lupus and 400 clinicians. Detailed interviews were conducted with 69 people living with systemic autoimmune rheumatic diseases.

Patients were asked about the timing of 29 neurological and mental health symptoms such as depression, hallucinations and loss of balance, and were requested to list them in the order they appeared when the disease was flaring.One of the most common symptoms was disrupted dream sleep, experienced by three in five patients. A third of them said the symptom appeared a year before the onset of Lupus which Lupus UK believes 50,000 people in the UK currently have.

Lupus is a condition that affects the immune system. It can cause problems with your skin, joints, kidneys and other organs.

The study’s senior author Professor David D’Cruz from Kings College London said: “For many years, I have discussed nightmares with my lupus patients and thought that there was a link with their disease activity. This research provides evidence of this, and we are strongly encouraging more doctors to ask about nightmares and other neuropsychiatric symptoms – thought to be unusual, but actually very common in systemic autoimmunity – to help us detect disease flares earlier.”

Another symptom, which just one in four study participants reported was hallucinations, or ‘daymares’. 85 per cent of these symptoms did not appear until around the onset of the disease or later.

The study found that using the word ‘daymare’ was more effective for patients. One from England told an interviewer: “As you said [daymare] it just made sense, it’s like not necessarily scary, it’s just like you’ve had a dream … it’s like feeling really disorientated, the nearest thing I can think of is that I feel like I’m Alice in Wonderland.”

Lead author Dr Melanie Sloan from the Department of Public Health and Primary Care at the University of Cambridge said: “It’s important that clinicians talk to their patients about these types of symptoms (nightmares and hallucinations) and spend time writing down each patient’s individual progression of symptoms.

“Patients often know which symptoms are a bad sign that their disease is about to flare, but both patients and doctors can be reluctant to discuss mental health and neurological symptoms, particularly if they don’t realise that these can be a part of autoimmune diseases.” 

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