Nightmares and Their Link to Inflammatory Arthritis

Authors of a study published in Brain and Behavior in March 2019 reported an unexpected discovery. Researchers were originally investigating the link between inflammatory arthritis, like ankylosing spondylitis, and an uncommon sleep disorder known as REM behavior disorder.

In the process, they identified an increased for people with inflammatory arthritis to experience a different sleep condition known as nightmare disorder.¹ The researchers found that more than 20% of their test subjects had active nightmare disorder. The general population has a prevalence of between 2% and 8%, by comparison.

What is nightmare disorder?

Most of us have had an occasional nightmare, which is a scary or vivid, alarming dream. However, nightmare disorder describes a condition in which one has frequent and persistent nightmares.

If they occur repeatedly over time, these nightmares can cause psychological distress, leading to sleep loss and insomnia. This can result in excessive daytime sleepiness and potential anxiety at bedtime.²

Does this mean that nightmares are a symptom of ankylosing spondylitis?

No. Anyone can have nightmares, for any number of reasons. Anxiety, medication side effects, PTSD, trauma, and sleep deprivation are common reasons that some people have nightmares. However, remember, an occasional nightmare is not the same thing as having nightmare disorder. Nightmare disorder is a formal sleep disorder that’s rare and may or may not be linked to any forms of inflammatory arthritis.

The study was slightly limited

The researchers of the Brain and Behavior study acknowledge the study was small and was not intended to examine nightmares or nightmare disorder as a potential symptom of rheumatological illness. They essentially suggest that while REM behavior disorder is as prevalent in inflammatory arthritis as it is in the general population, nightmare disorder emerged as a surprising potential link that will need further research if any link is to be confirmed.

Should people with arthritis be concerned?

If you have an occasional nightmare, and you have inflammatory arthritis, it’s not something to worry about. Nightmares are considered part of a wide spectrum of normal sleep behavior in people of all ages. However, anyone having frequent nightmares should discuss this development with their physician regardless of their health status. Fortunately, nightmare disorder is treatable.

Also, if you or a loved one tends to act out dreams on a regular basis, this should prompt a visit with the doctor as any suspected cases of REM behavior disorder need to be diagnosed as treated promptly.

What is inflammatory arthritis, anyway?

According to the Arthritis Foundation⁴, “Inflammatory arthritis is a group of diseases characterized by inflammation of the joints and often other tissues,” which include, among other conditions: