The story behind ‘A Nightmare on Elm Street’

Spooky season is knocking on your door in time for the horror movie marathon to begin! Did you know that A Nightmare on Elm Street was inspired by an article from the L.A. Times regarding the death of a young Asian male refugee? The refugee did not want to sleep out of fear of being attacked in his dream and unable to wake up. One night he fell asleep, his parents heard him scream and  found him dead. There have been many reports of young Southeastern Asian males who experienced stressors and passed away. The mysterious circumstances of their deaths has been referred to as Sudden Unexplained Nocturnal Death Syndrome (Morgan, 2018).

A perplexing part of Sudden Nocturnal Death Syndrome is that many of the affected individuals appear healthy and show no histopathological changes (Srettabunjong et al., 2019). Approximately 75% of reports by Centers for Disease Controls and Prevention involve individuals between the ages of 25 to 44 years old. Sudden Unexplained Nocturnal Death Syndrome (SUNDS) is related to structural heart disease such as coronary heart disease and cardiomyopathies (Zheng et al., 2018). SUNDS is also known as bangungut in the Philippines, Lai Tai in Thailand, and  Pokkuri Death Syndrome in Japan. The causes of SUNDS appears to be multifactorial.

Primary arrhythmia like Brugada Syndrome, potassium deficiency, night terrors, acidosis from hypoventilation and hypoxemia , and coronary artery vasospasm related to remnant lipoproteins have all been speculated as  causes for SUNDS.  There have been mutations involving the calcium channel, potassium channel and connexosome that have been linked with SUNDS (Zheng et al., 2018). Molecular genetic studies have indicated a correlation with a gene mutation in SCN5A which encodes for a sodium channel in the heart. A recent postmortem genetic analysis of 12 Thai SUNDS cases showed 12 variants of SCN5A present (Srettabunjong et al., 2019). Further genetics studies are needed to define the pathological cause of Sudden Unexplained Nocturnal Death Syndrome. In the meantime, though, SUNDS continues to be an inspiration for horror films. 


Morgan, T. (2018, October 30). How a terrifying wave of unexplained deaths led to ‘a nightmare on elm street’. Retrieved March 29, 2021, from

Srettabunjong, S., Eakkunnathum, D., Thongnoppakhun, W., & Sripichai, O. (2019). Association between SCN5A and sudden Unexplained NOCTURNAL death syndrome in Thai Decedents: A case–control study. Egyptian Journal of Forensic Sciences, 9(1). doi:10.1186/s41935-019-0145-3

Zheng, J., Zheng, D., Su, T., & Cheng, J. (2018). Sudden unexplained NOCTURNAL Death syndrome: The hundred YEARS’ ENIGMA. Journal of the American Heart Association, 7(5). doi:10.1161/jaha.117.007837

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