MANILA — Heart specialists debunked on Friday the myth that nightmares are the root cause of sudden unexplained nocturnal death syndrome (SUNDS), locally known as ‘bangungot.’ In the ‘Usapang Puso sa Puso’ episode of the Philippine Heart Association (PHA) on May 9, electrophysiologist Dr. Giselle Gervacio, along with PHA Director Dr. Luigi Pierre Segundo, clarified that bangungot is triggered by a heart disorder known as arrhythmia — the irregular heartbeat that occurs when the electrical signals do not work properly and may potentially lead to sudden cardiac arrest. “Nag-lead iyon sa conclusion na baka arrhythmia kasi ‘yung arrhythmia ay abnormal na tibok ng puso na pwedeng nakakamatay kasi masyadong biglaan” Gervacio explained, citing their 2014 study on SUNDS. According to PHA, SUNDS or bangungot is a syndrome characterized by the unexplained death of a healthy individual during sleep. This condition mostly affects young adults in the Asian region.
Bangungot has long been recorded in the Philippines, stemming from century-old Philippine folklore and myths portraying it as a deadly curse brought on by evil spirits during sleep. Segundo explained that the word bangungot came from two Visayan words: bangun (to wake up) and ungol (to moan), which describes the sounds victims make in their sleep before they pass—hence it is often attributed to nightmares. She also emphasized the need for people to know the scientific facts about bangungot to end theories and misconceptions surrounding it. Gervacio said that, in the 1950s, the U.S. Centers for Disease Control (CDC) observed a sudden rise in mysterious deaths among Southeast Asian migrant workers, with autopsies revealing no clear cause. This same pattern was later observed in the country, where victims face sudden death at sleep without any warning. Early research pointed to pancreatitis as the primary cause of these unexplained deaths, a theory that soon became widespread.
However, in 2014, Gervacio and her research team in the University of the Philippines—Philippine General Hospital (UP-PGH) alongside PHA members, ruled out this theory in their study and proved that pancreatitis does not lead to bangungot. By process of elimination, they concluded that arrhythmia, which causes the heart to beat irregularly or stop altogether, is the reason that such an unexplained death common to young adults. According to Gervacio, this syndrome is around 20 to 30 percent hereditary and is more common among healthy, young male adults. Gervacio also refuted other notions associated with bangungot, including work of evil spirits, deadly dreams, and excessive consumption of fish sauce. She added that stress and heavy eating and alcohol consumption before bedtime are also not direct causes of bangungot, but may act as potential triggers for episodes.
‘Brugada Syndrome’ Moreover, Gervacio also encouraged the public to know ‘Brugada Syndrome,’ a serious but treatable heart condition that could be connected to sudden unexplained deaths, which is often considered the “Western counterpart” to bangungot. According to her, bangungot and Brugada can both lead to sudden cardiac death. However, their key difference is that Brugada can be treated through life-saving interventions as it is detectable through a unique pattern on an electrocardiogram (ECG). Following are some of the warning symptoms of Brugada, according to Gervacio: -Frequent fainting or sudden black out -Seizures
-Palpitations (Irregular or rapid heartbeat) -ECG patterns Preventive Measures Gervacio and Segundo noted that while Brugada and bangungot are fatally alarming, there are some measures to prevent its risks, including the Implantable Cardioverter Defibrillator (ICD). ICD is a small device placed under the skin that monitors heart beat and delivers an electric shock to restore normal rhythm if it senses arrhythmia. “Itong ICD na ito ay life-saving kasi sa pamamagitan nito, napipick-up kung nagkakaroon ng arrhythmia or irregular heartbeat na delikado sa pasyente, at nagdedeliver ito ng life-saving shock,” she explained.
Avoiding factors that trigger arrhythmia — such as high fevers, stress, and poor lifestyle and eating habits —c an also help prevent the risk of bangungot and Brugada, Gervacio advised. In the Philippines, several programs and initiatives have been launched to better understand, manage, and prevent the mysterious deaths associated with bangungot and Brugada syndrome. “Ang maganda rito ay mayroon na tayong ginagawa na paraan para makatulong sa mga kababayan natin para ma-link natin sa possible treatment na ginagawa naman sa Pilipinas,” Segundo said. In 2023, UP Philippine General Hospital (PGH), along with other health agencies and organizations, established the Philippine Bangungut Program, aimed to further study and address these conditions. Under this program are two research initiatives, the Bangungut Project and Brugada Project, which both aim to identify genetic mutations responsible for the condition and develop a genetic test kit tailored to Filipinos.
“‘Pag nakita natin ano ito (genetic mutations), pwede tayong mag-design ng special Filipino-specific genetic kit para ‘pag may namatay in the future of bangungut, pwede i-screen ‘yung pamilya, at ‘pag may na-diagnose ng Brugada, pwede silang ma-manage using the genetic results,” Gervacio stated. Gervacio also called on government health agencies and the public to collaborate in further strengthening the program for more practical application and purposes in the future.
