nightmare death syndrome

Nightmare death syndrome



Folktales abound of deadly visions that visit us in our sleep. David Hambling reports on the real-life medical phenomenon.
Text: David Hambling / Images: Xavier Lemmens February 2006

A man who goes to bed fit and healthy is heard to cry out in his sleep, and the next morning is found dead. The same scene is repeated again and again. The doctors cannot find any physical cause for the mysterious deaths, but people mutter darkly about dæmonic beings and deadly dreams. The 11 victims were all Filipino sailors, and the case was investigated by Dr Gonzalo Aponte of the US Naval Hospital in Guam in 1960. The autopsies turned up nothing, but Dr Aponte found that sudden night deaths were well known in the Filipino community. In fact they have been recorded across the entire Far East. According to folklore, the sleeper is attacked by a nocturnal dæmon that squats on his chest and suffocates him. Witness reports bear this out, describing “choking, gasping, groaning, gurgling, frothing at the mouth, laboured breathing without wheezing or stridor, screaming, and other signs of terror.”

In the English-speaking world, we talk about the Night Hag and similar apparitions (see pp38–40). These terrifying beings are glimpsed in the darkness of nightmare, pressing down on their victims and preventing them from breathing. Their attacks, though scary, are generally harmless, whereas the nightmare demons of the Far East can be lethal. In Japan, this type of death is known as pok-kuri; the Filipinos call it bangungot or batibat; and the Hmong people of Vietnam and Laos call it tsob tsuang. In Thailand, the being to fear is the phi am or ‘widow ghost’ who comes to steal away the souls of young men. Some men defend themselves from phi am by wearing lipstick at night, so that the ghost mistakes them for women and leaves them alone.

Although he discovered references to the condition in Filipino medical literature as far back as 1917, Dr Aponte could draw no conclusions about the nightmare deaths. The same condition was later documented among refugees from South-East Asia, and in 1981 some 38 victims had been recorded in the US, most of them Hmong. The term Nightmare Death Syndrome was coined, which was later changed to Sudden Unexplained Nocturnal Death (SUND) or Sudden Unexplained Death Syndrome (SUDS) (see FT48:25, 55:15). The immediate cause of death was cardiac arrest. But why had the men’s hearts failed when there was seemingly nothing wrong with them? The breakthrough fi nally came from this side of the Atlantic. In 1986, Spanish-born Dr Pedro Brugada came across an unusual pattern on an electrocardiogram, which shows the electrical activity in the heart. The patient suffered from an irregularity in his heartbeat, and he had an ECG trace that looked like a shark’s fin.

The same unusual pattern turned up in two further patients, both men in their forties who had suffered from sudden collapses. Dr Brugada collected several more cases and by 1992 he was certain. The shark-fin ECG pattern, now known as the Brugada Sign, represents an irregularity in the rhythm of the heart. This irregularity can cause fibrillation, when the chambers of the heart pump out of sequence. The circulation of the blood ceases, and if the heart is not stimulated with an electric shock or similar treatment, the results are fatal. This condition – “sudden death with structurally normal heart” – became known as Brugada Syndrome.

Brugada deaths are different from those caused by other cardiac conditions because they are associated with periods of slow heartbeat. Deaths generally occur at night, or when the victim is sitting peacefully, not during strenuous exercise. “The typical patient is 40 years old, in the best moment of his life, very active, very productive, with no previous history of anything, and all of a sudden one night he never wakes up,” says Dr Brugada. SUDS patients showed the same telltale ECG pattern and it was confi rmed that SUDS and Brugada Syndrome are essentially the same condition. 1 In Southeast Asia and Japan it is alarmingly common; in Thailand, Brugada Syndrome (known locally as Lai Tai) is second only to road accidents as a cause of death of men under 40. Although rarer in Europe, it is more evenly distributed among the sexes, whereas in Asia it mainly affects men. An investigation into the genetic basis of the condition identified a mutation in a gene called SCN5a, which controls the flow of sodium ions into heart cells. The regularity of heartbeat is controlled by electrical fi elds generated by this fl ow of ions, and as soon as it fails the heart fi brillates. 2 This mutated gene is characteristic of Brugada patients.

Now we can assess whether patients are at risk from an ECG, and an electrical implant is available for those who are in greatest danger. Drug treatments are also being explored, and one day gene therapy may be available. Modern science seems to have defeated the ancient nightmare demons at last. However, things are not necessarily so simple. In Japan, thousands of elderly people visit the Buddhist temple at Kichidenji, the best known of the pokkuri-dera or ‘temples of sudden death’. What they pray for is to die “suddenly, unexpectedly, without having to suffer from prolonged illness and staying healthy until just before death takes place.” 3 The Japanese are the longest-lived nation in the world, and the prospect of extended illness in old age is not an appealing one. These days, some people see a sudden death in the night as a blessing rather than a curse.

So, really there were no nightmare monsters or whatever and it's really just a genetic condition of the heart? And now there are people in Asia wearing lipstick for absolutely no reason, and when they finally die they're going to look like a complete tit?

what i believe is that people can believe so hard in things that it can cause the mind to create or reinact such incidences casuing the effects of the so called 'nightmare death syndrome'

let me also point out that in many cases it would be even simpler to point out the explaination of a normal heart attack - they hurt like a biatch and I can imagine they would easily wake someone up - and cause them to cry out in pain before they died.

Well actually... people tend not to wake up when having either heart-attacks or strokes for that matter. If, in the unlikely circumstances that they happen to wake up, heart attacks cause laboured breathing and so any cries would be impossible.

Not impossible, I've been with people who are suffering a major heart attack or angina attacks, and yes they have laboured breathing but they're able to cry out in some form - usually more like a yelp or loud groan or something similar

The accounts given in the report do not mention any groaning, or yelps, saying whether or not they happened, so how are we to know they didn't?
Besides, the report also said that it was a simple genetic disorder, meaning that the 'daemons' were just hallucinations, a coincidence, even.

i know it's a genetic thing, but i'm trying to say it could happen to others who haven't got the genetic condition, in theory.

Theoretically... but it hasn't XD
Besides, it still means that there's no oogley googley monsters killing people in their sleep.

damn! was looking forward to seeing some kewl monstarrs... *sniffles*

You still can. Just whack yourself on the head with a frying pan a few times and hope you his the right part. If I knew much about Neurology I'd be able to tell you where to hit, but until then you'll just have to wallop and drool.

Or you could have night-terrors