THE RECENT death of a Psychology freshman in his sleep raised questions about the science of “bangungut.”

Bangungut—from the Tagalog root words “bangon” (to rise) and “ungol” (to moan)—was first referred in the country in 1915 as Sudden Unexplained Nocturnal Death Syndrome (Sunds), a disorder common in Southeast Asian countries.

However in the Philippines, bangungut deaths are now widely attributed by health experts to acute hemorrhagic pancreatitis.

Pancreatitis is a sudden inflammation of the pancreas caused mostly by too much intake of alcohol and highly salty food.

According to a research by Dr. Godofredo Stuart Jr., Sunds could happen with the combination of excessive alcohol and overeating before sleeping.

But even if pancreatitis is associated by Philippine doctors with bangungut deaths, other causes are also being considered.

Stuart said attacks of acute pancreatitis have numerous symptoms and will not explain the many cases of bangungut deaths in the apparent "peaceful" scenes of dying.

Munger’s and Booton’s study titled “Bangungut in Manila: Sudden and Unexplained Death in Sleep of Adult Filipinos" classified the causes of bangungut as myocardial infarction, rheumatic heart disease, and other ill-defined heart diseases—in short, heart-related. They said 48 percent of reports of sudden deaths were unexplained after autopsy.

Another condition, the Brugada syndrome, was first described in 1992 in a clinical article describing Sunds.

Stuart said Brugada syndrome is a hereditary gene defect involving the coding of protein components in the sodium channels in heart cells. The defect causes abnormal electrical conduction in the heart which may lead to ventricular fibrillation causing death.

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Ventricular fibrillation is the uncoordinated contraction of heart muscles of the ventricles, making them tremble rather than contract properly.

In another study titled "Unraveling the Enigma of Bangungut," clinical findings in the Philippines strongly suggested that Sunds and Brugada syndrome have common underlying mechanisms. It was conducted by Doctors Albert Gaw, Byron Lee, Giselle Gervacio-Domingo, Charles Antzelevitch, Romeo Divinagracia, and Felipe Jocano, Jr.

The pattern in which Sunds occurs almost only among Southeast Asians also suggests that Brugada syndrome is the closest possible cause given that it is genetic.

Despite numerous studies, medical scientists have yet to discover the exact cause of Sunds. Common medical opinions, however, suggest heredity and stress as likely causes.

After decades of studying the causes behind mysterious sleep-deaths, science has discovered a way of preventing them.

Gaw said an implantable cardioverter defibrillator or ICD is the only Sunds treatment proven to be effective.

While studies suggest that Sunds or bangungut can be prevented by implanting ICD, there's still no substitute to a healthy, stress-free life. JAN EVA MARI P. DE VERA

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