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Ronald B. Melles; Barrett Katz, MD
University of California at San Diego School of Medicine La Jolla

JAMA. 1987;257(21):2918-2919.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

We read with great interest the recent correspondence suggesting sleep apnea as a possible explanation for the sudden, unexplained nocturnal death syndrome (SUNDS).^1,2 We would like to offer a different pathophysiological mechanism that we suspect is behind many of these deaths.

The SUNDS occurs largely in young, previously healthy Asian men and includes Bangungut in the Philippines, Pokkuri in Japan, and sudden, unexplained nocturnal deaths among Southeast Asians in the United States. Ventricular fibrillation is thought to be the common physiological mechanism of these deaths.³ Special postmortem cardiac studies reported by Kirschner et al² and previously by others^4,5 have documented abnormalities of the cardiac conduction system and cardiomegaly in victims of SUNDS. These cardiac defects are not manifest during the victim's life, and the event that provokes the fatal arrhythmia has never been explained.

Our review of the clinical descriptions of the victims . . . [Full Text PDF of this Article]

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