Sudden Unexpected Nocturnal Death Syndrome

Since 1977 more than a hundred Southeast Asian immigrants in the United States have died from the mysterious disorder known as sudden unexpected nocturnal death syndrome (SUNDS). SUNDS had an unusually high incidence among recently relocated Laotian Hmong refugees. All but one of the victims were men, the median age was thirty-three, all were apparently healthy, and all died during their sleep. Despite numerous studies of SUNDS, which have taken into account such varied factors as toxicology, heart disease, sleep apnea and other sleep disorders, genetics, metabolism, and nutrition, medical scientists have not been able to determine its exact cause. Medical opinion appears to favor an impairment of the electrical pathways and specialized muscle fibers that contract the heart. It is widely held, however, that some type of intense stressor is likely an additional risk factor.

The medical folklorist Shelley Adler postulates that a supernormal nocturnal experience that is part of Hmong traditional beliefs can trigger the fatal syndrome. The experience is referred to as a "night-mare," not in the modern sense of a bad dream, but rather in its original denotation as the nocturnal visit of an evil being that threatens to press the very life out of its terrified victim. Hmong refugees in the United States experience a culture-specific manifestation of the universal nightmare phenomenon. The Hmong Nightmare (known as dab tsog ) causes cataclysmic psychological stress, which can trigger sudden death. Although the Dab Tsog attack in Laos is related to the worldwide nightmare tradition, the peculiar stresses of Hmong refugee experience transformed its outcome. The power of traditional belief in the nightmare—in the context of the trauma of war, migration, rapid acculturation, and inability to practice traditional healing and ritual—causes cataclysmic psychological stress to male Hmong refugees that can result in SUNDS.

See also: Causes of Death


Adler, Shelley R. "Ethnomedical Pathogenesis and Hmong Immigrants' Sudden Nocturnal Deaths." Culture, Medicine and Psychiatry 18 (1994):23–59.

Hufford, David J. The Terror That Comes in the Night. Philadelphia: University of Pennsylvania Press, 1982.

Parrish, R. Gibson, Myra Tucker, Roy Ing, Carol Encarnacion, and Mark Eberhardt. "Sudden Unexplained Death Syndrome in Southeast Asian Refugees: A Review of CDC Surveillance." Morbidity and Mortality Weekly Review 36 (1987):43–53.


User Contributions:

Can SUND be related to sleep paralysis? A lot of the folklores that I've heard about the "Dab Tsog" it seems to have similiar symptoms as SP. People who claimed to have experienced it said it was like they were awake but could not move their bodies no matter how much they tell themselves too. I accidently stumbled upon this site.. and it got me interested. My mother told me that one of her brother died suddenly in his sleep after they moved to the USA after the Vietnam War. Doctors could not figure out why. He was a healthy man in his 30's, whom was a Dentist back in Laos.
talking about SUNDS. Here in the Philippines, we call it "OROM". many of us here experienced that and we found ways to wake up. SUNDS is like, you are very conscious of what is going on around you. you can here your relatives passing by, youre eyes are closed but you can move your eyeballs and the more you strugle, the lesser the chance of walking up again. when we experience this sunds, there are there parts that we know that we can move. our hands, thumbs of our feet and our mouth. we either move our toe or grasp our hands if its not enough, we bite our tounge. usually people here experience sunds when they are very tired and sleep. a study has been made about rice. it may be another factor because asians eat rice and many say that sunds were only experienced by asian people. hope this little info can help.
I have this and until now thought I was the only one. I am white, healthy and 22 years old. It has been an embarassing thing top talk about, people may think that your talking about alien encounters or something. I have had the dream twice, it doesn't seem like a dream at all, in fact it is very real. I felt and saw a very strong spirit terrify me and put his hand over my mouth, and feeling like he was trying to take my soul. My soul fights back and I win. But I am constantly worried about the next time it comes. Sometimes even afraid to fall asleep. I do not want to die this way, is there any cure??
Hello. I live in Los Angeles, CA, Afro-American, female and I started experiencing similiar things like SUNDS when I was around 33 yrs. old or younger. Now at 42 yrs. old, I still experience this. Whenever I sleep in complete darkness with everything off in my room. I experience something on my chest like a little being. I am conscious but can only move my eyes, my fingers and toes. When I scream, nobody hears me. And I always wakeup before I'm out of breathe. Like something sucking everything out of you while you look at it helplessly. I can never tell what it looks like, because I alway wakeup. Thanks to Spike TV running a show called " How Many Ways You Can Die", I would have never known about SUNDS. HELP! Can this be fixed? That's my question?
Hope this Helps
Wow I wouldn't have known what my condition was until I watched 1000 ways to die the other week on the spike channel. I must admit I am a little tripped out you always think your the only one who has the experience but am glad only to find out a name of the condition that has plaqued me sense early childhood. This might seem crazy but when this happens to me I am totally conscious in my sleep but yet not awake I fell myself stop breathing and no matter how hard I try I cannot breathe I'm totally paralyzed! Even talking to myself telling me to breathe doesn't seem to help. But as soon as I say in my mind one of the two words God and or Jesus. Then as if like a miracle I can breathe again. Many cultures seem to have this phenomenom I have talked to one another person who has this condtion and says god or Jesus worked as well. My ex boyfriend who was Mexician sayed they called "Diablo sleeping on your chest". I'm blessed I'm still here I must have a purpose. For anyone reading this I pray this helps. God Bless
I am 21, chinese american and I have the similar experience. I do not know if it is SUND but i have experienced a reoccurring dream for the past 3 years in which, i dreamt about a ghost (kinda like the girl from the Ring) coming towards me and then my whole body would begin to shake uncontrollably. I would feel that my body is undergoing a black out while i am sleeping. I would also see stars. I screamed but no sound came out. are there cures?
I am a white female...twenty-seven years old......i've experienced this feeling numerous times since i was a teenager.
It's horrible thinking that you're not alone in your dark bedroom, but then not to be able to move or fight back is even worse. People think you're nuts or tell you that you just had a bad dream, but it's so much more than that!
Something similar happened to me for many years. I assumed it was some flashback from the hippy years. I still believe I was awake and see something or someone walking into my room. There is a glow within the object and at times persons. A sense of terror grips me as I follow them to my side of the bed. But I could move and would even throw up my hands to ward off the oncoming attack. I never felt the actual presence of their hands on my throat or the knife that was about to strike my chest or body. Sometimes it wasn't a being but an object that floats into the room but the terror is there as I watch and can't believe what my eyes are seeing. My eyes were open at the time I would "come out" of the "vision" with my heart pumping. I still don't think I was asleep when this would begin -To this day I have believed I wasn't asleep at all. Finally I spoke to a minister who suggested calling on the name of Jesus (my savior) which I started doing. It happened for a few more months but finally stopped. Its probably been 5yrs or more since I had a "vision" Thank the Lord - literally!
Very interesting article on SUNDS. I am a Hmong male, 25 years old, and I have had my fair share of this "dab tsog." One way that I have learn to prevent "dab tsog" from occuring is to not let myself sleep facing upwards (front body facing the celings). Majority of the time, if not all, "dab tsog" occurs when one is sleeping faced upward. In our culture, it's not a wise thing to do because facing upward while sleeping actually resembles that you're dead (the dead lays facing upward) and it allows evil sprits to try and take your soul. It may sound superstious but it's true in our culture.
However, "dab tsog" only occurs while one is dreaming. In each of my experience, what I normally see (in dream) before being paralyze is a black figure. And by the time I know it, I'm already trying to get myself free from the paralyzation. No matter how much I scream, no one could hear me, no matter how much I try to move, I couldn't. Sometimes, it happens so often that when I see this figure (in dream), I already know what's up (kind of like O'shit, brace for impact).
Another thing, family members who have a Hmong Shaman or a Xwm Kab (majority of Hmong family has this, unless they go to church) in their household are more likely to experience "dab tsog." That is because as a Shaman, their Thaj Neeb (Shaman altar) is like a gateway between the dead and the living, allowing the Shaman to trance into the spirit world. However, by having such an altar, it also allows spirits (good and bad) to enter the world of the living. The Xwm Kab is simialr to a Hmong Shaman's Thaj Neeb, but ment for household without a Shaman present (living there).
I can almost gurantee that all the Hmong men who died of SUNDS had either a Thaj Neeb or Xwm Kab present in their home.
Only people who understand our culture will truely understand what I'm talking about.
Suzette Arenas
I'm not sure If this is SUNDS, but since I was a little girl I would have these bad nightmares I would call them..where I could not wake up from my sleep..It was like if I was awake and aware but I could not come out of it. I would try screaming and struggle to wake up and then finally I would come out of it completely scared not wanting to go back to sleep. These kind of nightmares would happen off and on through out my years...I'm now 38 and I still have them once in a great while. However, I had an unusual nightmare unlike the ones I had growing up. I could see the devil near me trying to take me and I was struggling to wake up and I was scared..I managed to wake up as if I was fighting to wake up. Once I did I got up out of bed and got my daughter and put her on the bed with me. My husband works nights and he was working at the time and my son is usually out with his friends..Please help advise me if you would consider this as SUNDS..Thanks A Bunch!!
I had this happen multiple times when I was a child. The worst time was what I associated with a witch (I assume now it was just a female being). I was held down and could not move or scream. I could hear my family in the house but I had no way to tell them to come and wake me up. By the way, this was during the day. I only saw the being in the beginning of this dream and then the rest was just feeling held down with no way to wake myself up. As a child I had discovered I could always wake myself when I knew I was having a nightmare by just opening my eyes. The thing that was so terrifying here was, they were already open.

Twenty something years later, I have yet to have it happen again. Or so bad that I'd never forget it. As someone else mentioned, I try to never sleep on my back. Just like that movie Cats Eye. Little troll demon will come, sit on your chest and suck your breath out.

I also learned about this from the show 1,000 ways to die. Crazy to read other peoples stories and see that we're all affected the same way.
I too am a Hmong male of 29 years old. I have three other brothers all within the same age range and we all at one point have experienced SUNDS. I have been attacked by it the most and still do til this present day. My brothers haven't had it in years, lucky them. I get it so often now that I know when it is coming. I will often wake up before it attacks and pace about the room. As I go back to bed, I can feel its presence waiting for me when I sleep. Whatever this feeling is, it tires me considerably and eventually I'll fall into its grasp. There are times when I don't wake up quickly enough and am trapped. I see this black figure on my chest as I try to breathe in, it will breathe into my mouth preventing me to intake any oxygen. I find myself gasping for whatever little oxygen I can. Usually at this point, I will tell myself that I must wake up. If I do not, I will surely die. I will struggle with every ounce of my body until it releases me. Whether I was able to break out or it released me on its own free-will, I will never know. I always end up gasping for air as I wake. Terrifying experience that I pray no one has to endure.

Funny enough I was told on some tarot card readings that my death will be; suffocation. SCARY!!
SUNDS stands for Sudden Unexplained Nocturnal Death Syndrome. This means that you have to die from it for it to be considered SUNDS; as such, most of you have probably not experienced SUNDS. What you guys are describing is sleep paralysis, SUNDS is most likely an extreme case of sleep paralysis, though this has not been extensively confirmed. From what I've read, sleep paralysis is very common, but if you've experienced it several times, then it may be considered a sleep disorder and usually considered to be a genetic disorder. Fear apparently makes it worse. I've had these experiences myself for quite a while now and have kinda gotten used to them. They usually cause little pain or fear anymore, until recently. Last night, I felt my heart beating heavily during an episode and one time my left chest seemed to start vibrating like hell. Reading that death from SUNDS is due to heart failure sure doesn't matters.
Did anyone notice how all were men but one? Did anyone else think at all that maybe the Americans just made this up because they wanted no immigrants in there country? This was supposedly in the late seventies. like i am only 17 but you don't have to be a genius to make the connection.
Please reply...
I've always had sleeping problems as a kid. I actually didn't sleep by
myself until I was 8. The only way I was able to cope with that
change was to wrap a blanket around my whole body and leave my
mouth out to breath. I would still wake up mulitple times throughout
the night, sometimes somewhat sweaty and feverish.

I'm starting to notice even more that when I'm sleep, a fourth of the
duration I can see what's going on around me while asleep and still
dreaming, or so it seems to be that way. I have recently learned that
it is called ASP. I've been experiencing things that can also be
described as SUNDS every month or so.

I try to convince myself that I'm fully awake during the day, but I know
that I'm not. It's kind of like saying, "It's hot," when it's cold, but you do
it anyways because it was proven to raise your body temperature. I
usually forget my dreams five minutes after waking up, but whether
or not I remember them, they seem to mentally/physically drain me
during the day.

I've done a little research on SUNDS in the past, only to find that it is
fairly typical among men in certain Asian ethnic groups. I'm female,
but I'm partially Filipino and Chinese, so I guess I'm one of the few
exceptions to this common ground. But still, little is known about it,
so I assume that assumption is inconclusive or just wrong. The first
time I had that attack happen was the beginning of last year. It consisted
of a flash of demonic faces, the feeling of suffocation, and I honestly felt
as if I was going to die. Before this happened, I looked at my clock and it
was 11-something pm. I closed my eyes and fell asleep only to think
I was awake during the SUNDS episode. I remember seeing some
part of my room, but with a small mirror on the wall that wasn't
normally placed there, then being suffocated, eyes shut, with no
ability to scream. To be honest, I prayed, but it didn't work. So I relied
on singing a comedic song in my head and I regained
conciousness, only to find that only 10-15 minutes have passed.

I have since lost my fear of putting myself to sleep. The way I did this
was just by not thinking about it too much. Although, I still do wake
up in shock on ocassion with my breathe racing the pace at which
my heart pumps.
im white n lived in the u.s. all my life. ive experienced this back in 2003 in my apt that was haunted my cuz lived downstairs n heed wake up to cubbord doors slamming shut. about a week later it was like 3 or 4 am i woke up not being able to move could hardly breathe i could see everything in my room but my eyes focused to the celing i was on my back i woke my wife she was terrified i remember asking her to healp me wake me but she said it was a diffrent voice ((deamon like)) wich scared me i was 23 then its been going on since every night when i get ready for bed i feel a presence in the room. lateley its been getting worse im 30 yrs old no matter how i sleep it hits me right before i doze off i see something dark enter the room n bam im scared to fall asleep its like something has been following me every apt i moved in a month or so of me living there thats when it starts i dont know what to do i wake up scared n crying i dont wanna die or be scared that this dissorder could kill me please healp
I have experienced it several times before.I am in a deep sleep but i am aware that i am dreaming and unable to move my body,tries to scream but cannot.
I have experienced Sudden Unexpected Nocturnal Death Syndrome - SUNDS,for a few years now and have only now just found this web site. Can anyone tell me if there are differernt forms of SUNDS as i wake up in a panic unable to breath but it feels like i have a blockage in my throat and can only by pinching my adams apple and breathing through my nose do i get air back into my lungs, does this make any sense ??.
But i have to say this happens rare and then just goes away.
I have had sleep issues for many years and I have experienced two out of body experiences in that period of time. My main concern is when I wake up screaming that I am dying or I cannot see and I totally freak out. I have had dreams that my soul was being pulled out of my body a few times. In the past year things have worsen to the point I hate bedtime and I am afraid that I might not wake up. Now I am having an electricty sinsation shooting throughout my body and I am waking up more screaming blood murder and scaring everyone in my house. I hate this and I hate scaring the heck out of my kids! I am looking for answers and praying I find them soon.
I have had so many supernatural happenings in my life since the age of five and I do have to wonder if it has to do with what is happening to me in my slumber? Tired of this, literally!
Sandy hz
I have experienced this several times in my past when it first happened i was sleeping and in the shadows of my ceiling all of a sudden I could see them coming towards me. At first I though I was really tired and tried to blink at away but then I felt as if I was being held down unable to move my body and feel like I was being strangled I prayed and was able to break free. The other times were random but I always prayed my way out and it seemed to work. What helped me the most was when I went to a Christian church and prayed about this crazy feeling since then I have never felt like thr again. I turned to god and for me it worked but I still sleep with light it calms my nurves.
I have never had this experience or anything like this but if you have a demonic presence like that all you have to do is say "in the name of christ get out". If it speaks to you dont listen its lying. I had no idea about this disorder that others were having until watching the show 1000 ways to die. It seemed like people were having demon visits. It was very surprizing that I learned that people world wide have these experiences. Like I said I have never had any kind of super-natural experience but Iam a devoted christian, and I work night shift so Iam up watching Spike TV sometimes on my days off at 3am. If you say you have a demonic experience I will give you the benifit of the doubt and believe you. I would recomend that when this happens you (1) DONT PANNIC- the more you pannic the faster your heart beats and the more oxegen you will need thus the faster you will run out of breath plus pannicing does you no good. (2) Dont listen to it demons will try to decieve you everything they say is a lie (3) all you have to say is "in the name of christ get out". Again and most importantly just say "in the name of christ get out".
I have had a similar experience before...only my family believes it is a HAG that sits on my chest and doesn't allow me to move. I can hear things around me and even feel my heart rate increase, but I can't speak or move. I had someone who is into white magic bless salt for me. This seems to help when I put salt on the floor to the entrance of my bedroom (door way). I spread the salt there and also around my bed. It is suppose to ward off evil spirits... I also have started to smudge my house. I haven't had a problem since I started doing these things...whether it is because I am also a big rice eater...or because it is an evil spirit...The salt seemed to help. In the past I had used regular table salt and that helped for a while. This is an awful experience to go through. I hope this information helps someone.
I must repeat what other posters on here have already stated and that is for those who are posting on here that they have experienced SUNDS, if this were so then you would NOT be posting at all... you would in fact be dead. What in fact you are experiencing is Sleep Paralysis which is an episode that can and has in some cases lead to SUNDS. I have experienced problems breathing but only when I fell asleep on my back. I believe there is a scientific reason for this and it's the same thing that causes sleep apnea and other sleep disorders. You literally stop breathing. And then depending on your religious or philosophical beliefs your subconscious mind will interpret what is happening to you. If you are Christian then calling the name of the Lord Jesus will save you or if you are Hmong, Thai, Chinese or Filipino your spiritual understandings or beliefs will either aid you or fan the flame of fear. I think the common thread is first people who sleep on their back and second maybe an allergy to certain foods mainly rice which is a common food shared among the Asian community. Just throwing out ideas here. But again you have not experienced SUNDS if you are still alive. Sudden Unexpected DEATH Syndrome.
SUNDS stands for sudden unexpected nocturnal DEATH syndrome right? how is it possible to suffer death and still be able to post on a website? while i feel compassion for these people I wish they would put a little thought into what they are saying.
I usually see them right before I go to sleep and have varied in shapes. The one that was most defined was one night I was falling asleep in my room, and my day had gone normal, so nothing traumatic had happened, and I wasn't even aware of their existence at the time. Anyways my bed faces three windows in my room, and the other window is next to it in the far right corner of the room. In front of the far right corner window was a high-boy dresser. The window itself led to my front porch with my amber light always on at night. One night the light started dimming, and it was naturally making me sleepy. I was relieved actually at first because, I needed my rest because I had to be up early for work. The middle window out of the three in front of me disappeared, where there was no frame, blinds, or glass for that matter. I could not see the outside it was pitch black. The only thing I remember seeing that still is embedded in my memory to this day is a giant phantom hand reaching in towards me. On another occasion, about 3 weeks ago, was I was trying to fall asleep in my room, and I looked down in the dark by my bed where I have a glass-top coffee table, and there was a black orb that was the size of a watermelon. Other than that they usually come out of the corner of my eye, even during the day, but more so at night. Ive also seen them on my TV after I turn it off. I thought it was my dead grandfather finally coming home to have his chair that I was sitting in, but it vanished.
My youngest sister used to tell me she would see these shadows of people and then they would disappear. She would rarely sleep but when she did sleep it was usually during the daytime. She did complain a few times about feeling like something was on or around her when she was almost or half asleep and it affected her breathing. After reading up on this I am not sure what to think. My sister passed away in her sleep Oct. 2013
She was 21
I am a 45 year old white female. I experienced sleep paralysis with the feeling of an evil presence many times between the age of 17 and 22. I usually felt a presence prior to sleep along with a humming in my ears. The first time this happened I seamed to awaken from a regular dream to a different state between sleep and conciousness to a male shadowy person that laid across me on my chest. After the first time I didn't see him any more but he laughed at me while I invoke the name of Christ. I always came to complete conciosness by moving my fingers while I prayed. During this time I always slept on my back until I had an injury that made it more confortable to sleep on my side. I have not experienced this again since sleeping on my side. Until reading here I never associated the cessation of the phenomenon with the change in sleep position.

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