{"id":72,"date":"2021-01-25T20:57:22","date_gmt":"2021-01-25T20:57:22","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/suny-hvcc-healthpsychology\/?post_type=chapter&p=72"},"modified":"2021-01-29T16:26:01","modified_gmt":"2021-01-29T16:26:01","slug":"the-biopsychosocial-model-the-case-history-of-nightmare-deaths","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/suny-hvcc-healthpsychology\/chapter\/the-biopsychosocial-model-the-case-history-of-nightmare-deaths\/","title":{"raw":"The Biopsychosocial Model: The Case History of Nightmare Deaths","rendered":"The Biopsychosocial Model: The Case History of Nightmare Deaths"},"content":{"raw":"[caption id=\"\" align=\"aligncenter\" width=\"500\"]\r\n
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\"Figure Triple\u2010risk hypothesis of SUNDS. We propose that SUNDS occurs when 3 factors coincide: a vulnerable young person carrying susceptible variants; stressors caused by environmental or social factors; and finally a disturbance in action potential production and propagation in nocturnal sleep[\/caption]\r\n

Sudden Unexplained Nocturnal Death Syndrome: The Hundred Years' Enigma<\/h1>\r\nSudden arrhythmic death syndrome is rare in most areas around the world. This syndrome occurs in populations that are culturally and genetically distinct and people who leave the population carry with them the vulnerability to die suddenly during sleep. Sudden unexplained death syndrome was first noted in 1977 among southeast Asian\u00a0Hmong<\/a>\u00a0refugees in the United States and Canada.[4]<\/a><\/sup>[5]<\/a><\/sup>\r\n\r\nLaotian Hmongs were chosen for the study because they had one of the highest sudden death rates while sleeping in the United States. They were originally from Southern China and the highlands of North Vietnam, Laos, and Thailand. The location that was picked for this study was in\u00a0Ban Vinai<\/a>\u00a0in the\u00a0Loei Province<\/a>, which is approximately 15 kilometers from the Lao border. This study took place between October 1982 and June 1983 as this syndrome became more of a relevant pressing issue. Ban Vinai was the location chosen because it had 33,000 refugees in 1982, which was the largest population of victims.[11]<\/a><\/sup>\u00a0Because this syndrome was occurring most commonly in those particular men, researchers found it most beneficial and effective to study the population in which they migrated from instead of studying victims and populations in the U.S. Because of religious limitations the Hmong men in Ban Vinai were not allowed to receive autopsies. Therefore, the only results and research obtained were victims outside of their religion or geographical area. An interview was arranged with the next of kin who lived with the victim, witnessed the death, or found the body. The interviews were open ended and allowed the person who was next of kin to describe what they witnessed and what preceding events they thought were relevant to the victim's death. The interviewers also collected information such as illness history, the circumstances of the death, demographic background, and history of any sleep disturbances. A genealogy was then created which included all the relatives and their vital status and circumstances of death.[11]<\/a><\/sup>\r\n

Society and culture<\/span><\/h2>\r\nIn a medical journal, the author suggested that the Hmong who died were killed by their own beliefs in the spiritual world, otherwise known as\u00a0Nocturnal pressing spirit attacks<\/i>. In Indonesia it is called\u00a0digeuton<\/i>, which translates to \"pressed on\" in English.[12]<\/a><\/sup>\u00a0In China it is called\u00a0b\u00e8i gu\u01d0 y\u0101<\/i>\u00a0(traditional Chinese<\/a>:\u00a0\u88ab\u9b3c\u58d3<\/span>;\u00a0simplified Chinese<\/a>:\u00a0\u88ab\u9b3c\u538b<\/span>) which translates to \"crushed by a ghost\" in English.[12]<\/a><\/sup>\u00a0The Dutch call the presence a\u00a0nachtmerrie<\/i>, the night-mare.[12]<\/a><\/sup>\u00a0The \"merrie\" comes from the\u00a0Middle Dutch<\/a>\u00a0mare<\/i>, an\u00a0incubus<\/a>\u00a0who \"lies on people's chests, suffocating them\". This phenomenon is known among the Hmong people of Laos,[16]<\/a><\/sup>\u00a0who ascribe these deaths to a malign spirit,\u00a0dab tsuam<\/i>\u00a0(pronounced \"dah chua\"), said to take the form of a jealous woman.\r\n\r\nDuring the 1970s and 1980s, when an outbreak of this syndrome began, many of the Southeast Asians were not able to worship properly due to the guerrilla war against the government of Laos with the United States. Hmong people believe that when they do not worship properly, do not perform religious ritual properly or forget to sacrifice, the ancestor spirits or the village spirits do not protect them, thus allowing the evil spirit to reach them. These attacks induce a nightmare that leads to sleep paralysis when the victim is conscious and experiencing pressure on the chest.[12]<\/a><\/sup>\u00a0It is also common to have a\u00a0REM<\/a>\u00a0state that is out of sequence where there is a mix of brain states that are normally held separate.[12]<\/a><\/sup>\u00a0After the war, the United States government scattered the Hmong across the country to 53 different cities.[12]<\/a><\/sup>\u00a0Once these nightmare visitations began, a shaman was recommended for psychic protection from the spirits of their sleep.[12]<\/a><\/sup>\u00a0However, scattered across 53 different cities, these victims had no access to any or the right shaman to protect them from this syndrome.\r\n\r\nHmong people believed that rejecting the role of becoming a\u00a0shaman<\/a>, they are taken into the spirit world.\r\n\r\nBangungot<\/i>\u00a0is depicted in the Philippines as a mythological creature called\u00a0batibat<\/a><\/i>\u00a0or\u00a0bangungot<\/i>. This\u00a0hag<\/a>-like creature sits on the victim's face or chest so as to immobilize and suffocate him. When this occurs, the victim usually experiences paralysis.\r\n

English names<\/span><\/h3>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<\/tfoot>\r\n<\/table>\r\n

Names in other languages<\/span><\/h3>\r\n

Name<\/th>\r\nAcronym<\/th>\r\nNotes<\/th>\r\n<\/tr>\r\n<\/thead>\r\n
sudden unexpected death syndrome<\/td>\r\nSUDS<\/td>\r\n<\/td>\r\n<\/tr>\r\n
sudden unexplained death syndrome<\/td>\r\nSUDS<\/td>\r\n<\/td>\r\n<\/tr>\r\n
sudden unexpected nocturnal death syndrome<\/td>\r\nSUNDS<\/td>\r\n<\/td>\r\n<\/tr>\r\n
sudden unexplained nocturnal death syndrome<\/td>\r\nSUNDS<\/td>\r\n<\/td>\r\n<\/tr>\r\n
sudden adult death syndrome<\/td>\r\nSADS<\/td>\r\n(parallel in form with\u00a0SIDS<\/a>)<\/td>\r\n<\/tr>\r\n
sudden arrhythmia death syndrome<\/td>\r\nSADS<\/td>\r\n<\/td>\r\n<\/tr>\r\n
sudden arrhythmic death syndrome<\/td>\r\nSADS<\/td>\r\n<\/td>\r\n<\/tr>\r\n
sudden arrhythmic cardiac death syndrome<\/td>\r\n\u2014<\/td>\r\n<\/td>\r\n<\/tr>\r\n
bed death<\/td>\r\n\u2014<\/td>\r\n<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n
\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Term<\/th>\r\nLanguage<\/th>\r\nNotes<\/th>\r\n<\/tr>\r\n<\/thead>\r\n
bangungot<\/i>\u00a0or\u00a0urom<\/i><\/td>\r\nFilipino[17]<\/a><\/sup><\/td>\r\nThe term originated from the\u00a0Tagalog<\/a>\u00a0word meaning \"to rise and moan in sleep\".[18]<\/a><\/sup>\u00a0It is also the Tagalog word for\u00a0nightmare<\/a>.<\/td>\r\n<\/tr>\r\n
dab tsog<\/i><\/td>\r\nHmong[16]<\/a><\/sup><\/td>\r\ndab tsog means 'ghost<\/a>\"<\/td>\r\n<\/tr>\r\n
lai tai<\/i><\/td>\r\nThai<\/td>\r\n(Thai<\/a>:\u00a0\u0e43\u0e2b\u0e25\u0e15\u0e32\u0e22<\/span>; meaning \"sleep and die\")[14]<\/a><\/sup>[19]<\/a><\/sup><\/td>\r\n<\/tr>\r\n
dolyeonsa<\/i><\/td>\r\nKorean<\/td>\r\n<\/td>\r\n<\/tr>\r\n
pokkuri<\/i>\u00a0disease<\/td>\r\nJapanese[20]<\/a><\/sup><\/td>\r\n<\/td>\r\n<\/tr>\r\n
ya thoom<\/i>[citation needed<\/span><\/a><\/i>]<\/sup><\/td>\r\nArabic<\/td>\r\n<\/td>\r\n<\/tr>\r\n
albarsty<\/i>\u00a0(Kyrgyz<\/a>:\u00a0\u0430\u043b\u0431\u0430\u0440\u0441\u0442\u044b<\/span>)<\/td>\r\nKyrgyz<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n \r\n\r\n<\/div>\r\n <\/dt>\r\n<\/dl>\r\n<\/div>","rendered":"
\"Figure<\/p>\n

Triple\u2010risk hypothesis of SUNDS. We propose that SUNDS occurs when 3 factors coincide: a vulnerable young person carrying susceptible variants; stressors caused by environmental or social factors; and finally a disturbance in action potential production and propagation in nocturnal sleep<\/p>\n<\/div>\n<\/dt>\n<\/dl>\n<\/div>\n

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Candela Citations<\/h3>\n\t\t\t\t\t
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CC licensed content, Specific attribution<\/div>