Somebody said it was a peaceful death. Dying in your sleep is a peaceful death? How ironic! How can something so unexpected be called peaceful? Families are devastated from their sudden loss.
Just recently, a seemingly very healthy young father I know died in his sleep. Last week, a young woman friend in her mid-20s also died in her sleep. A year ago, three people who were related to my friends all died in their sleep.
According to their families, these people were generally known to be healthy. No history of any severe ailments like a heart disease or a bad heart condition,; no respiratory problems whatsoever like asthma or bronchitis; all were non-smokers; and all were only occasional light drinkers, and not to be categorized as alcoholics.
Their common denominator was they were all physically tired (coming from physically exhausting work) and all had heavy meals before sleeping. Because of exhaustion, they felt sleepy immediately after eating. The much-wanted rest…
They never woke up. By sunrise, they were discovered lifeless. What happened during the night?
Myths, superstitions and folklores provided answers in the form of terrifying nightmares like falling into a deep abyss, falling off a mountain, being attacked by a creature in the dark standing by the bedside, or a fat female demon who sits on the chest or face of the sleeping person, others linked death in sleep to eating rice cakes, or the phi am or “widow ghost” who usually forages in the night for healthy young men. We could only guess if they are merely generic ingredients to culture-flavored nightmares.
However, medical examiners declared the deaths mentioned above as SUNDS, or Sudden Unexpected Nocturnal Death Syndrome, caused by acute pancreatitis or acute hemorrhagic pancreatitis, wherein in layman’s words would refer to sudden inflammation of pancreas during sleep. Would that mean that heavy meal and exhaustion plus immediate sleep kept the pancreas from functioning properly? Heavy intake of carbohydrates (like ricecakes and noodles) and fats were also pointed as culprits to pancreatitis.
SUNDS is more common in Asian countries whose culture includes eating a lot of rice, being their staple food. Even drinking sessions include a lot of eating. Doctors believe that high carbo diet triggers it. Those who died of SUNDS were in the age bracket 25-45; and mostly male.
Another diagnosis pointed to Sleep paralysis, a common and ancient sleeping disorder which was attributed to demons and malevolent spirits, characterized by a feeling of immobility, like being pinned down by an invisible force which makes a person unable to move and scream for help. It inevitably goes back to creatures of superstition and culture. It is said that sleep paralysis occurs at the threshold of being awake and sleeping; termed as hypnagogic when one is falling asleep and hypnopompic when one is waking up, It is said that sleep paralysis is accompanied by sensations of falling, pressure on the chest and seeing shadowy creatures; And that sleep paralysis usually happen during the dreaming state or in REM (Rapid Eye Movement) states (after about 2 hours of sleep). Nightmares are said to occur during REM sleep and sleep terrors or pavor nocturnus occurs on the following hours therein.
There are other studies on SUNDS which linked to different factors like sleep apnea and other sleep disorders, to heart disease, toxicology, genetics, nutrition and metabolism; the latest being on impairment of the electrical pathways and muscle fibers that contract the heart. But presently, the medical field has not been able to really determine the exact cause of SUNDS yet. However, it is broadly believed that some type of intense stressors poses additional risk factors.
How to avoid, or minimize the risk of SUNDS:
- Avoid eating heavy meals at night, especially when you are too exhausted. And don’t sleep right away after dinner or a heavy meal.
- Avoid eating food rich in fats and carbohydrates like rice cakes and noodles, boiled eggs, butter and red meat at night. Food that are not easily digestible should also be avoided.
- Avoid drinking alcoholic drinks after heavy meals.
- Drink sufficient water before you sleep.
- It is best to sleep on your side instead of sleeping flat on your back.
- Be quick to notice when a sleeping person starts to moan in his/her sleep. Gently wake the person and make the person sit for a while, knees towards chest; to calm down and breathe deeply. Get him out of his nightmare.
- If you cannot make the person wake up and he remains moaning and groaning in his sleep, old wives suggest wiggling (or pulling) the toes to snap him out of sleep paralysis. If he still fails to wake up, take him to the nearest hospital immediately.
Somehow, science has made amazing progress into uncovering the mysteries of unexpected sleep-deaths; such that some unexplained sleep deaths have been attributed to genetic peculiarities which cause the heart’s electrical system to go crazy. The Brugada Syndrome is a genetic disease characterised by abnormal electrocardiogram (ECG) findings and poses an increased risk of sudden cardiac death. We are learning more and more about sleep related deaths.
However, a truly healthy lifestyle is still the best preventive measure to combat unexpected sleep-deaths.