If someone in your family died suddenly in their sleep—especially at a young age—you could be at risk too.
The Philippine Heart Association (PHA) urged Filipino families to take “bangungut”—medically known as Sudden Unexplained Nocturnal Death Syndrome (SUDS)—seriously, as new findings reveal that many cases are not caused by superstition, bad dreams, or overeating, but by an inherited heart rhythm disorder.
In the PHA 5th Annual Convention and Scientific Meeting, electrophysiologgist and Primary Investigator of the Philippine Bangungut and Brugada Programs, Dr. Giselle Gervacio said that “bangungut “ is strongly linked to Brugada Syndrome (BrS).
BrS is genetic disorder that disrupts the heart’s electrical system, often without warning. It disproportionately affects young, healthy males, especially in Southeast Asia, and has been linked to fatal arrhythmias during sleep.
A look at the Science
The term “bangungut” comes from the Filipino words “bangun” (to rise) and “ungul” (to moan), echoing the tragic and sudden nature of these deaths. The condition first gained medical attention in 1917, when Paz Mendoza Guazon reported a series of unexplained sleep deaths. For years, the cause remained uncertain, with theories pointing to acute hemorrhagic pancreatitis—a claim now widely debunked.
Modern autopsy findings and international studies—including those by the US Centers for Disease Control (CDC)—have ruled out pancreatitis in most cases.
Instead, they point to arrhythmias triggered by Brugada Syndrome, which is often caused by mutations in the SCN5A gene. This gene controls sodium channels in the heart, and its malfunction can lead to irregular, often deadly, rhythms during sleep.
In the Philippines, the incidence of SUDS is 0.043%, and the prevalence of Brugada ECG patterns in Asians ranges from 0.2% to 2.23%. Most patients show no prior symptoms, and their heart structure appears normal—even during autopsy. This makes the condition difficult to detect without specialized testing.
Why families should act now
The risk of Brugada Syndrome is hereditary, and familial clustering of sudden cardiac death (SCD) before age 45 is a key red flag. Symptoms—when they occur—may include fainting, seizures, or gasping during sleep (known as nocturnal agonal respiration).
It’s a call for families to act, especially those with a known history of sudden sleep deaths.
Philippine Bangungut and Brugada projects
The Bangungut and Brugada Project is a nationwide initiative designed to confront SUDS.
The PHA and UP-PGH collaborated for the program that integrates clinical, genetic, and cultural research to identify and protect at-risk individuals.
It includes the establishment of a national registry, genetic testing for 70 percent of high-risk families, annual electrocardiogram (ECG) screening in barangays, and Cardiopulmonary Resuscitation (CPR) training for local communities.
Through functional studies, it also seeks to build a Filipino Brugada genetic database and reclassify uncertain genetic variants to improve risk prediction and treatment strategies.
The program encourages early detection, family screening, and referral to specialized clinics.
Dr. Giselle Gervacio
Fr. L: Drs. Luigi Pierre Segundo, Richard Henry Tiongco II, Aurora Gamponia, Giselle Gervacio (Dr. Ramiro De Guia Memorial Lecturer), Rodney Jimenez and Walid Amil
