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SUND-ay terror

I’m a big fan of House, not only because the lead character is someone we all (or maybe just me) wish we could be (someone so brilliant that he can get away with saying and doing just about anything), but because of their use of bizarre medical cases showing off some of the extreme things that one’s body is capable of when sick.

While SUND (Sudden Unexplained Nocturnal Death) will probably never show up on House (given the sudden, inexplicable death of the patient preventing House and company from being able to do or say much of anything), it is definitely one example of an extremely bizarre condition which doctors still don’t have a good handle on.

I first read about it in an article on Forbes covering bizarre sleep disorders. The craziest thing about this “condition” is that it seems the victims die of nightmares!?:

Since 1977, more than a hundred Southeast Asian immigrants in the U.S., primarily ethnic Hmong from Laos, have died from a mysterious disorder known as Sudden Unexpected Nocturnal Death Syndrome, according to reports by the U.S. Center for Disease Control. The victims were mostly imagemen in their 30s or older, who were apparently in good health when they died in their sleep for no apparent reason.

“The victim has no known antecedent illnesses, and there are no factors  that might precipitate cardiac arrest,” the Cambridge History of Disease notes. “At autopsy, no cause of death can be identified in the heart, lung or brain. Postmortem toxicologic screening tests reveal no poisons.”

Shelley Adler, a professor of integrative medicine at the University of San Francisco, California School of Medicine, speculates that the cataclysmic psychological stress caused by war, migration and rapid acculturation created such wrenching nightmares among Hmong refugees that they died. In other words, nightmares killed them.

Doing some additional research on Wikipedia reveals that the current operating hypothesis appears to be cardiovascular – mainly that SUNDS victims could all have potentially died of ventricular fibrillation (a lethal heart arrhythmia where the heart ceases to pump normally). There’s even a syndrome named for this – Brugada syndrome – with 6 associated genes which show a higher risk for the condition.

Now, in all honesty, I’m not sure how you diagnose a patient who’s already dead (esp. when autopsies and histories reveal nothing significant), but that leads us to the prognosis:

  1. If no one you know died suddenly in their sleep, you probably won’t either (it’s at least partially genetic)
  2. If someone you know did die suddenly in their sleep, go bulk up on Thiamine (Vitamin B-1), get routine heart monitoring, and maybe get a cardiac defibrillator implanted into your chest.

On that note, happy holidays everyone!

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