Mortal Nightmare

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The Nightmare by Henry Fuseli

The Nightmare by Henry Fuseli

Folk and fairy tales tells of deadly visions that visit us in our sleep. The example that comes into mind is a healthy man who goes to bed and is heard to cry out during his sleep, the next morning he is dead. The same example is seen repeatedly elsewhere. Can you imagine what it is to die in one’s sleep? No wonder folklore, mythology and the like took the matter quite descriptively. We find more background via a most curious article in the Fortean Times :

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?

In folklore, a “mare” or “nightmare” is not an awful dream, but rather a supernatural being that crushes a sleeper’s body by sitting on it. Another related term is hag-riding which implies a frightening feeling of being held immobile in bed, often as if by a heavy weight pressing on one’s stomach or chest and it is said that it might be accompanied by the sense of an alien presence, and by visual hallucinations. In folklore, it was thought of as a magical attack, whether it was a demonic incubus, ghost, harmful fairy, or witch depending on culture and time period.

Folktales told us about nightmare deaths and sudden night deaths which had a higher incidence in healthy young men from Southeastern Asia, Pacific Rim countries and Polynesian populations. In Philippines the Sudden Unexplained Death Syndrome was attributed to bangungot (“bangon”- Tagalog root word of to rise; and “ungol” to moan). The risk profile was that one of a young male, aged in between 25 and 44 years old, usually preceded of a heavy meal, alcohol use, presumably healthy with no prior heart problems, history of fainting and family history of unexpected death. Dr. Stuart writes a nice synthesis in “Bangungot: The Folklore and the Science”, he tells us some of the folklore remedies:

Move an extremity, a leg, or wiggling the big toe or thumb will drive the batibat away or snap him out of the ‘paralysis.’

Drinking several glasses of water before sleeping.

Lying on the left side.

Not going to bed too soon after a big meal (especially one washed down with lots of alcohol).

Avoid balut as pulutan when drinking beer.

Bedtime prayers.

Put on lipstick, paint the nails, or wear women’s nightclothes to bed at night to fool the pontianak, the lady ghoul.

But as strange as all this sounds, there is actually a scientific explanation in medical literature to these tales. I’m talking here about the Brugada Syndrome, named after the research of doctors Josep, Pedro and Ramón Brugada. This syndrome was described in 1992 and it involved the discovery of a certain electrocardiogram pattern related with sudden death or syncope in a person whose heart is structurally normal.

Dr. Brugada found an unusual pattern on the electrocardiogram (ECG), which shows the electrical activity in the heart. The patient had an irregular heartbeat, and his ECG trace looked like a shark’s fin. The shark-fin ECG pattern, now named the “Brugada Sign”, represents an irregularity in the rhythm of the heart which can cause fibrillation which doesn’t allow for a proper pumping mechanism of the heart, hence there is no blood flow coming out from the heart and if no electric shock or resuscitation maneuvers are given in time, it can result in death. This condition – “sudden death with structurally normal heart” – became known as Brugada Syndrome.

Continuing with The Fortean Times, more science is described:

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 confirmed that SUDS and Brugada Syndrome are essentially the same condition. 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 fields generated by this flow of ions, and as soon as it fails the heart fibrillates. This mutated gene is characteristic of Brugada patients.

Evil fairies, demons or else, it all sound certainly creepy!! Hopefully the research about Brugada Syndrome will help the afflicted sleep peacefully.

Recommended link:

http://www.brugada.org/

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Comments

  1. Arthur Williams  May 28, 2016

    This reminds me of an article I was just reading about German New Medicine where they have linked emotions to particular types of cancer

    reply
    • Gabriela Segura, MD  May 29, 2016

      Yes, the link between psyche and disease can be fascinating and quite a learning experience.

      reply

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