Answer to Question 1
Unique to Southeast Asians in the United States is the unexplained condition known as sudden unexpected nocturnal death syndrome (SUNDS), when a seemingly healthy person dies in his or her sleep. It is especially prevalent among Cambodians, Laotians, and Hmong, although it may occur in other immigrants from the mainland as well. It was a leading cause of death among Hmong men aged twenty-five to forty who were the earliest immigrants to the United States. Although biomedical hypotheses have been proposed to account for the fatal syndrome, such as heart irregularities or sleep apnea, none has been proven. It is now believed the phenomenon known as sleep paralysis is involved. Some researchers believe that death is caused within the cultural context of the nightmare experience. Specifically, the nightmare spirit, dab tsog, enters the room at night and the victim wakes to the sensation of the spirit sitting on his or her chest; he or she is unable to move and is terrified. Although many immigrants report having experienced nightmares in Southeast Asia, the attack by the spirit does not usually result in death. Cultural disruptions are believed to have intensified the episodes. Guilt and depression create increased vulnerability to fatal nightmare experiences. Posttraumatic stress disorder, panic attacks, exposure to chemical warfare agents, or blood electrolyte imbalances may be other risk factors.
Answer to Question 2
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