Sudden Unexplained Nocturnal Death Syndrome (SUNDS)

Unraveling Hmong mystery
When Hmong people first moved from Southeast Asia to the Twin Cities a generation ago, they had a saying:

"Every Hmong housewife must know CPR and sleep lightly beside her husband."

That's because Hmong men in America were dying -- mysteriously -- in their beds, at night, in their sleep. Apparently healthy, most between the ages of 25 and 44, these men would be sleeping peacefully. They would gasp or gurgle and be dead in only a minute or two. Sometimes the deaths were witnessed by family members, but most victims were found unresponsive and could not be revived.

Some Hmong men set their alarms to ring every half-hour during the night, just to be sure they were still alive.

A 30-year-old St. Paul man named Ma Thao told a reporter in 1983 that he was too terrified to sleep. He spoke in simple English, slowly, quietly and with dignity. He had seen much fighting when he was a truck driver for the U.S. Army in Laos, he said. Yet there he could cope, and he slept hard through the night.

But, in America, he said, "I worry, and I cannot make my body to sleep." He forced himself to stay awake as late as he could, usually waking up in a sweat after only three or four hours. Fear of dying in his sleep was ruining his life, he said.

In the 1980s, at least 117 apparently healthy Southeast Asian refugees to the United States died mysteriously of what became known as SUNDS -- Sudden Unexplained Nocturnal Death Syndrome. But giving it a name didn't answer the question:

Why were apparently healthy Hmong men in America dying in their sleep?

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Sudden Unexplained Nocturnal Death Syndrome

Sudden Unexplained Nocturnal Death Syndrome
This is the sudden unexplained death of a young adult during sleep. Autopsy and clinical findings are both unable to determine the cause of death. The person will likely suffer from labored breathing, choking and gasping, but the problem is not sleep apnea. Sometimes the heart muscle has been detected to go into fibrillation (or spasm). Southeast Asian men ages 25 to 44 are most likely to suffer from this problem, but it is unknown if this disease has a genetic basis. Many Asian languages have words for this problem.

This disorder is in the group known as other parasomnias.

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