Nightmares might serve as an early warning system for the onset of autoimmune disorders in the brain, according to new research. Melanie Sloan, a public health researcher at the University of Cambridge, led a study revealing that bad dreams are a common early sign of a lupus flare-up.
In an online survey of 676 lupus patients—technically known as systemic lupus erythematosus (SLE)—about a third reported experiencing disrupted dreams in the year before other disease symptoms appeared. This finding supports anecdotal reports linking the brain's immune system to dream patterns.
Neurologist and study author Guy Leschziner from Guy's and St Thomas' Hospitals in London explained, "We have long known that changes in dreaming can signify shifts in physical, neurological, and mental health and may indicate early disease. However, this is the first evidence suggesting that nightmares might help monitor a serious autoimmune condition like lupus."
SLE is a lifelong autoimmune disease typically beginning between ages 15 and 45, causing intermittent flare-ups every few years, marked by painful joints, fever, chest pain, fatigue, or hair loss. While not all SLE patients develop neuropsychiatric symptoms during flares, about 40 percent do. Diagnosing and treating these symptoms can be challenging, as they are subjective and patients are often hesitant to discuss them.
People with brain-related autoimmune diseases frequently experience vivid, emotionally charged dreams. However, these cognitive symptoms often go unnoticed. Recent studies have shown that individuals who later develop Parkinson's disease, which is linked to autoimmune issues, experience distressing dreams up to a decade before diagnosis. Nightmares may also predict dementia, another condition linked to the immune system, and some multiple sclerosis patients report unpleasant dreams before flare-ups.
The study included personal interviews with 69 people with systemic autoimmune rheumatic diseases, including lupus. One participant described their nightmares during a lupus flare as so "horrific" that they saw "skin coming off people." Another theorized, "I came to the conclusion that [the nightmares are] probably me fighting my own system."
Researchers also gently introduced the topic of hallucinations by asking about 'daymares.' One participant immediately understood, describing the experience as feeling "really disorientated" and akin to being "Alice in Wonderland." The online survey found that over 60 percent of respondents reported increasingly disrupted night-time dreaming before experiencing daymares.
These findings align with clinical observations by Sloan and rheumatologist David D'Cruz from Kings College London. D'Cruz noted, "For many years, I have discussed nightmares with my lupus patients and thought there was a link with their disease activity. This research provides evidence of this, and we strongly encourage more doctors to ask about nightmares and other neuropsychiatric symptoms."
The study also surveyed clinicians about their understanding of lupus. Only one rheumatologist had considered dreams potentially related to lupus flares, but most experts were open to asking patients about their nightmares to detect and treat flares earlier.
Our dreams could indeed be telling us something significant, even as scientists continue to explore these links.
