Bangungot: Nightmares

by M. L. Tan

The stories are familiar -- a relative or a friend, usually a male, dies suddenly in his sleep, without any history of illness. Relatives or companions in the house will recall hearing the victim moan that fateful night, and friends will nod their heads as they agree on a postmortem diagnosis: bangungot.

This nightmare syndrome is also found in other cultures, dubbed lai tai by the Thais and tsob tsuang by the Hmong of Vietnam. The Tagalog term bangungot is derived from bangon (to rise) and ungol (to moan). In daily colloquial use, bangungot often refers to nightmares in general, and do not necessarily end fatally; nevertheless, there is a real fear that the nightmare might become more dangerous and deadly.

These nightmare deaths have caught the attention of medical researchers. There was a report on bangungot in a local medical journal as early as 1917. In the 1950s, sudden deaths among Filipino sailors in the US Navy led to more reports in American medical journals. In the late 1970s, the Americans coined the term Sudden Unexplained Noctural Death (SUND) to describe mysterious deaths among Southeast Asian refugees, mainly from the Hmong of Vietnam. In 1990, a series of articles appeared in the British journal, The Lancet, reporting on such deaths among Thai construction workers in Singapore. Through the years, there have been other sporadic reports in the journals of deaths among Cambodian and Lao men in north America as well as refugee camps in Thailand.

Filipinos attribute bangungot to going to bed right after a very full meal. The medical researchers have their own crop of theories. The earliest investigations, based on autopsies of Filipino victims, suggested pancreatitis as the cause of death, with speculation that our high salt diet of bagoong and patis. In the 1980s, doctors at the University of the East proposed the victims had coongenital problems in their heart's anatomical structure. The deaths among Thai workers in Singapore led researchers to zero in once again on dietary factors, with suggestions that the problem was associated with nutritional deficiencies - some suggested thiamine, others potassium.

These diverse explanations underscore the need to expand our perspectives on illnesses. Problems like bangungot - as well as many other health problems -- cannot be explained as having just one cause.

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