Sudden unexplained nocturnal death syndrome

Oriana Sanchez MD (Dr. Sanchez of Northwestern University has no relevant financial relationships to disclose.)
Hrayr P Attarian MD (

Dr. Attarian, Director of the Northwestern University Sleep Disorders Program, received honorariums from Eisai and Insights for consulting work.

Antonio Culebras MD, editor. (

Dr. Culebras of SUNY Upstate Medical University at Syracuse received an honorarium from Jazz Pharmaceuticals for a speaking engagement.

Originally released September 9, 1993; last updated June 17, 2018; expires June 17, 2021

This article includes discussion of sudden unexplained nocturnal death syndrome, bangungut, laitai, nonlaitai, Pokkuri, sudden unexplained death syndrome, SUDS, and SUNDS. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.


In this article, the authors discuss sudden unexplained nocturnal death syndrome. Often fatal, it is a disorder that occurs in young adult Southeast Asian men who are otherwise healthy. This article includes new information on novel mutations associated with channelopathies that may lead to disorders of cardiac muscle electric coupling as well as new epidemiological information about sudden unexplained nocturnal death syndrome in Thailand.

Key points


• Sudden unexpected nocturnal death syndrome is the most serious of sleep disorders as it affects otherwise healthy people, mostly young Asian men.


• There is an etiologic relationship between sudden unexpected nocturnal death syndrome and other conditions that can cause sudden cardiac death.


• Prevention is possible, as in the implantation of a defibrillator in near-miss cases.

Historical note and terminology

The Centers for Disease Control in the United States applied the term “sudden unexplained nocturnal death syndrome” to the syndrome first recognized in 1915 in the Philippines, originally called bangungut ("to arise and moan," the word for "nightmare") in the Tagalog language. In Japan, the syndrome was identified and named pokkuri ("sudden death") in 1959. In Thailand, sudden unexplained nocturnal death syndrome is called laitai ("sleep death"); in Laos it is called non-laitai ("sleep death"), and in Hawaii it is called “dream disease.” Sudden unexplained nocturnal death syndrome has been identified in Southeast Asian male refugees, primarily the Hmong people, settling in the United States since 1975 and was the chief cause of death among these male refugees in the early 1980s, which was the peak time of Southeast Asian immigration to the United States (Nakajima et al 2011).

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