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of the "Nightmare"
Author(s): Shelley R. Adler
Source: The Journal of American Folklore, Vol. 104, No. 411 (Winter, 1991), pp. 54-71
Published by: American Folklore Society
Stable URL: http://www.jstor.org/stable/541133
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SHELLEY R. ADLER
SuddenUnexpectedNocturnalDeath
SyndromeamongHmong Immigrants
Examiningthe Role of the "Nightmare"
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Adler, SuddenDeathamongHmongImmigrants 55
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56 Journalof AmericanFolklore104(1991)
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Adler, SuddenDeathamongHmongImmigrants 57
when I went hunting ... I slept in the jungle and an old man wearing a cloak came to me and
told me that "Oh, now you aregetting, you're getting stronger. I want to see, I want to try how
strong you are." Then he, he simply squeezedmy neck very hard, and I could not do anything.
Finally,my friendwho slept next to me turnedover and touched me. That's why I was able to
move my arm, my legs Before that, I couldn't move, couldn't breathe.I think most of the
....
people who die in their sleep might have a similarnightmare. [CT]
The first night he woke suddenly, short of breath, from a dreamin which a cat was sitting on
his chest. The second night, the room suddenly grew darker,and a figure, like a largeblackdog,
came to his bed and sat on his chest. He could not push the dog off and he grew quickly and
dangerouslyshort of breath. The third night, a tall, white-skinned female spirit came into his
bedroom from the kitchen and lay on top of him. Her weight made it increasinglydifficult for
him to breathe. .. . He attemptedto turn onto his side, but found he was pinned down. After
fifteen minutes, the spiritleft him. [Tobin and Friedman1983:440]
This description offers another example of how the seemingly unique Hmong
experience is actually a culture-specific manifestation of the universally expe-
rienced physiological state that produces the "traditional" Nightmare attack.
In interpreting the account, Tobin and Friedman make the plausible deduction
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58 Journalof AmericanFolklore104(1991)
persons who fit the demographiccharacteristicsof SUNDS and who have transientnocturnal
events with the following symptoms:
1) a sense of panic or extreme fear
2) paralysis(partialor complete)
3) a sense of pressureon the chest
4) a sense that there is an alien being (animal,human, or spirit) in the room
5) a disturbancein sensation (auditory,visual, or tactile). [Holtan et al. 1984:11]
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Adler, SuddenDeathamongHmongImmigrants 59
Hmongtraditioninsistson maintainingcertainreligiouspractices,includ-
ing spirit-feedingrituals(usuallyinvolvingthe sacrificeof a chicken,pig, or
cow); violatingthese normscan incurthe wrathof spirits(Chindarsi1976;
Quincy1988).Ancestorspiritsmaydemandretributionthemselvesor simply
desertthenegligentperson,who is thenleft opento anevil spiritattackin the
formof a nightmare:"Um, the peoplewho, uh, diedin theirsleephadeither
oneor two timesof nightmareduringtheirlifetime,andif it happenagainand
nobodyhelpthe person,they die"(CT).
The symptomsof the Hmong evil spiritattackparallelthoseof the night-
mare.The peculiarimpressionof semiwakefulnessis describedby a male
Hmongrefugeein SantaAnawho hasexperiencedthenocturnalattackas the
feelingof being"kindof half-asleepandhalf-awake"(LV).The senseof im-
mobilityand the panicor extremefeartypicalof Nightmareattacksis also
evidentin Hmong descriptionsof nocturnalencounterswith evil spirits.
Lastly,the featureof the nightmareoccurringwhen the victimis in a supine
position is evident in this Hmong explanation: "[old people] told us that evil
spirits can easily get to your body if you sleep on your back, so we are in-
structed to sleep on our sides only" (CT).
Both Hmong SUNDS and the nightmare are better understood with the
assistance of concepts from laboratory sleep research. As DavidJ. Hufford de-
scribes in The Terror That Comes in the Night (1982), current scientific thought
on sleep phenomena also offers one explanation for the pervasiveness of the
nightmare through history and across cultures.
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60 Journalof AmericanFolklore104(1991)
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Adler, SuddenDeathamongHmongImmigrants 61
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62 Journalof AmericanFolklore104(1991)
In our old country, whatever we had was made or brought in by our own hands We are
....
not born on earthto have somebody give us food. Here, I'm sure we're going to starve, because
since our arrivalthereis no penny I can get that is money I earnfrom work. I've been trying very
hardto learnEnglish, and at the same time look for ajob. But no matterwhat kind ofjob, even
ajob to clean people's toilets, still people don't trust you or offer you such work. I'm not even
worth as much as a dog's stool. Talking about this, I want to die right here so I won't see my
future.[Whitman1987:18]
We arejust like the baby birds who stay in their nests, opening their mouths, waiting only for
the mother bird to bring the worms. When the government doesn't send the cash on time, we
even fearwe'll starve. I used to be a real man like any other man, but not any longer. The work
I used to do, I can't do here. I feel like a thing which drops in the fire but won't burn and drops
in the river but won't flow. [Whitman1987:19]
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Adler, SuddenDeathamongHmongImmigrants 63
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64 Journalof AmericanFolklore104(1991)
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Adler, SuddenDeathamongHmongImmigrants 65
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66 JournalofAmericanFolklore104(1991)
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Adler, SuddenDeathamongHmongImmigrants 67
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68 Journal of American Folklore 104(1991)
forfolkloriststo investigate.Manyfolkloristicconcepts,suchaslegends,per-
sonalexperiencenarratives,traditions,andsymboliccommunication,aredi-
rectlyrelevantto studiesthatseek to investigatenew andemergingconcep-
tualizationsof theway humanbeingsactin illnessandhealth.Folkloristicshas
muchto offerotherfieldsof inquiry,includingbiomedicine,thatwill contrib-
ute to the advancement of knowledgeandunderstanding of humanbehavior.
Notes
The hypothesisset forth in this articlerepresentsthe culminationof preliminaryresearchinto the Night-
mare, as it is known in folk tradition,and its relationto Hmong SUNDS. Portions of an earlierversion of
this articlewere presentedat the 1988 AmericanFolkloreSociety meeting in Cambridge,Massachusetts,and
the 1989 SouthernCaliforniaAcademy of Sciences meeting in Pomona, California. I would like to thank
Donald Wardfor his initialinspirationand continuedassistance,MichaelOwenJones for his ongoing creative
insights and encouragement,and Carole Browner, Yoram Bilu, and David Hufford for their enthusiasmas
well as comments on earlierversions of this article. Specialthanks are due to the Hmong men and women
who spoke with candorand trust on the painfulsubjectof SUNDS.
'The disorderis also known by the acronym SUDS, Sudden Unexplained Death Syndrome. I feel that
both the unpredictablenatureof the syndrome and the fact that 98% of the deaths occurredbetween 10:00
P.M.and8:00A.M.(Parrishet al. 1987)warrantthe inclusionof both the words "unexpected"and "nocturnal"
in the label. Thus, Sudden UnexpectedNocturnalDeath Syndrome is a more accuratedescriptionof the dis-
order. My use of the term SUNDS is consistent with that of the SUNDS Planning Project at Saint Paul-
RamseyMedicalCenter.
2Autopsieshave revealedonly irregularitiesassociatedwith acuteheartfailure.Certainspecialpostmortem
cardiacstudieshave revealedother cardiacdefects (conductionsystem abnormalitiesand cardiomegaly[Kir-
schner,Eckner,and Baron 1986;Otto et al. 1984]). These cardiacdefectsarenot manifestduringthe victims'
lives, however, and "the event which provokes the fatal arrhythmiahas never been explained"(Melles and
Katz 1988).
3Theword mara,from which "nightmare"is derived, can be tracedto a proto-Indo-Europeanroot that
most likely referredto a nocturnalpressing spirit (Kluge 1960). The Old English nihtmara,which is the an-
tecedentto the modernword "nightmare,"andthe GermanMahr(m.) or Mahre(f.) (Old High GermanMara)
arerelatedexamplesof this root (Hoops 1916:172;Kluge 1960:454).
41am indebtedto David J. Hufford for his characterizationof the nightmarein The TerrorThatComesin
theNight(1982). Although I have alteredhis configurationslightly (basedon the resultsof my own fieldwork
in Jerusalem[1987-88] and Los Angeles [1986-87]), Hufford's criteria,which are unique in the literatureon
the subject, remain the foundation of the minimal requirementsfor the nightmare experienceas I present
them.
5Theinterviews cited in the text were conducted during the months ofJanuary throughJune of 1987 in
Hmong communities in Orange County, California. (Additional fieldwork has subsequentlybeen under-
takenamong Hmong living in Stockton, Sacramento,and Fresno, California.)In order to protect the ano-
nymity of the informants,all quotationsfrom these interviews are followed by the initialsof the informant
in parentheses.
6Althoughin the biomedicalliteraturesleep paralysisis commonly associatedwith victims of narcolepsy,
this phase of sleep has a significantrate of occurrenceamong nonnarcolepticsas well, as has recently been
convincinglydemonstrated(Hishikawa1976;Hufford 1976, 1982;Ness 1978).
7Thereare only two publishedreports to date on the possibility of SUNDS in SoutheastAsia; both are
basedon interviews with Hmong in the Ban Vinai refugee camp in Thailandand are written by Ronald G.
Munger(1986, 1987). My preliminaryreview of the materialindicatesthatthe 16 reporteddeathsmay indeed
have been instancesof SUNDS, but, due to the vaguenesswith which victim's "sleep disturbances"are de-
scribed,it is difficultto assess the relevanceof Munger'sfindings to my own research.Although (out of 16
incidentsof sudden unexpecteddeath during sleep in which the victim was not previously ill) Mungerpro-
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Adler, SuddenDeathamongHmongImmigrants 69
vides detailedinformationon only four cases. The discussionof one of these casescontainsuseful information
on what appearsto be a Nightmare attack. The wife of one victim describes"dreams"her husbandhad had
previouslyin which a female spirit, known as poj ntxoog,would appear:"The subjecttold his wife that the
poj ntxoogwould sometimes visit during sleep and sit on his chest. Breathingduring these episodes was very
difficult .. ." (1986:388).Interviewsconductedwith Hmong in Ban Vinai confirmedthe characterizationof
poj ntxoog as an evil spirit who may take away the souls of the living, thus causing illness and death, and
whose evil must be protectedagainstby the performanceof shamanisticceremonies.
8Bliatout'sstatedintentin conductinghis investigation"was to open avenuesfor alternatetypes of research
on the subject of Hmong Sudden Unexpected Nocturnal Death Syndrome" (1982:v). Although Bliatout
states that, based on this investigation, he was unable to prove definitively that his hypothesis regarding
Hmong religiousbeliefsis correct,he did find "manyindicationsthata fairlylargegroup of Hmong, probably
both Christianand non-Christian, have anxieties caused by not performing traditionalreligious practices.
This probablycontributedto raisingthe stresslevel in many of the suddennocturnaldeathcases" (1982:92).
Bliatoutconcludesthat he did indeedfind supportfor his hypothesisthat seriousreligiousconcernscan affect
Hmong individualsby greatlyraisingthe level of stressand triggering"mentalhealthproblems, healthprob-
lems, and suddennocturnaldeath"(1982:93).
9Onlyone Hmong woman has died of SUNDS to date. A Hmong informanthypothesizedthat she might
have been the headof her householdand hence the one held accountableby the spirits (CT).
'oHmongSUNDS and other disorderswhich appearto be forms of nightmaredeath are reminiscentof
what is frequentlyreferredto as "voodoo death." In 1942, WalterCanon publisheda paper describingin-
stancesof mysterious,sudden,apparentlypsychogenicdeath,from manypartsof the world. He suggests that
intenseemotionalstresscreatessympathicoadrenaloverdrive, which canresultin suddendeath. The unifying
featurein all of the caseshe describesis the elementof beliefonthe partof the victims (Cannon1942). Hmong
SUNDS may be relatedto Cannon's voodoo deathinsofaras belief is capableof affectingthe state of health
or illness of the humanbody.
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