Some Nightmares Are Real — the Mysterious Deaths that Inspired “A Nightmare On Elm Street”
The Nightmare
“First, I was surprised but right away, I got real scared. I was lying in bed.
A dark shadow in the night.
I was so tired, because I was working very hard then.
I wanted to go to school, but I had no money.
I kept waking up, because I was thinking so much about my problems. I heard a noise, but when I turned-tried-I could not move.
My bedroom looked the same, but I could see-in the corner, a dark shape was coming to me.
It came to the bed, over my feet, my legs. It was very heavy, like a heavy weight over my whole body, my legs, my chest.
My chest was frozen-like I was drowning, I had no air.
I tried to yell so someone sleeping very close to me will hear. I tried to move-using a force that I can-a strength that I can have.
I thought, “What if I die?”
After a long time, it went away it just left. I got up and turned all the lights on.
I was afraid to sleep again.”
- Account from a 33 year old Hmong immigrant (from “Refugee Stress and Folk Belief: Hmong Sudden Deaths” by Shelley Adler [3])
Introduction
Some of the greatest stories are often inspired by real life events. When I was a child I loved watching horror films and one of the big horror film franchises of the time was the “Nightmare on Elm Street” Series.
Although the movies eventually turned into horror comedy as the sequels progressed, the original film was a much more serious affair that was considered a horror classic.
One of the reasons that I think the original resonated so much with audiences was that it spoke to an archetypal fear — that of being attacked during sleep — a time when we are all at our most vulnerable.
What I didn’t realise then was that it was actually inspired by a bizarre series of real life deaths amongst an immigrant community in the United States.
Wes Craven’s Inspiration for the Movies
In an October 2014 interview with Vulture.com — Wes Craven (the creator of Nightmare on Elm Street) recounted [1]:
“I’d read an article in the L.A. Times about a family who had escaped the Killing Fields in Cambodia and managed to get to the U.S.
Things were fine, and then suddenly the young son was having very disturbing nightmares.
He told his parents he was afraid that if he slept, the thing chasing him would get him, so he tried to stay awake for days at a time.
When he finally fell asleep, his parents thought this crisis was over. Then they heard screams in the middle of the night.
By the time they got to him, he was dead.
He died in the middle of a nightmare.
Here was a youngster having a vision of a horror that everyone older was denying.
That became the central line of Nightmare on Elm Street.”
This seems to be one example of a spate of deaths that became known as Sudden Nocturnal Death Syndrome (SUNDS).
They occurred amongst East Asian immigrants in the late 1970s/early 1980s (primarily affecting a group known as the Hmong).
LA Times Article
I wasn’t able to access the LA Times archives for the original article that Craven read (as it is behind a paywall) but I did find a later article which contained the following summary [2]:
“In 1981, the Centers for Disease Control began tracking a mysterious rash of sudden unexplained nocturnal deaths occurring in apparently healthy, male immigrants from Vietnam, Laos and Cambodia.
The problem, unknown in other ethnic groups, has now claimed more than 104 men, averaging 33 years of age, and one woman, according to Dr. Gib Parrish, a CDC medical epidemiologist.
Ninety-eight percent of the deaths occurred between 10 p.m. and 8 a.m.
In 1981, the peak year of these deaths, 26 men, often Hmong refugees from the highlands of northern Laos, died in their sleep.
Usually victims were simply found dead, but when medics arrived quickly, the men’s hearts were fibrillating or contracting wildly, a symptom Parrish said may result from numerous possible causes.”
Hmong Immigrants
The Hmong were people of Laotian origin who had fought for the Americans (via CIA funding) during the Vietnam war.
It is estimated that as many as ten times more Hmong died during the Vietnam war than American soldiers [3].
When the US left they were abandoned to fend for themselves.
As the Laotian government fell under communist rule, the Hmong became targets of the regime.
This forced them to flee under risk of death (or worse if they were imprisoned in re-education camps).
Some of those who fled ended up in the United States (many in California).
Sudden Nocturnal Death Syndrome
The main features in the Hmong cases were:
- Almost all the dead were men — just one woman died.
- Aged 25–44, median age was 33.
- They were recent arrivals (median time 17 months).
- They all died or at least become seriously unwell during sleep.
- No obvious abnormalities were found on autopsy.
The basic theory behind SUNDS was (and still is) that the Hmong men were dying as a result of an extreme stress response during episodes of sleep paralysis.
Sleep Disorder or Something More?
Sleep Paralysis
Sleep paralysis is a sleep disturbance where people become unable to move whilst falling asleep or (more often) waking up [4].
It is quite common and seems to result from the natural paralysis that occurs during REM (dream sleep) spilling over into a more wakeful conscious state.
It is almost like the brain is stuck midway between dreaming and being awake.
One of the known triggers is stress.
The paralysis is quite terrifying in itself and is often accompanied by visual, auditory and other types of sensory hallucinations.
One of the common experiences is of being attacked or suffocated by an evil entity — often referred to as the “Old Hag” in Western countries.
Having experienced it myself many times I can attest to how terrifying the experience actually is.
The interesting thing is that sleep paralysis is very common and other than the fear it induces it does not (normally) cause any harm.
If this was just sleep paralysis why were these young men dying?
Stress & Cardiac Abnormalities?
It appears in the case of the Hmong something more was occurring. The struggles and difficulties of fleeing persecution to come to a new country should not be underestimated:
“Hmong refugees have experienced a host of hardships including language and employment problems, changing generational and gender roles , survivor guilt and trauma-induced emotional and psychological disorders. These changes can affect all Hmong immigrants in varying degrees,but Hmong men, in particular, have had their roles dramatically altered.”
It has long been believed and even recorded in the medical literature that extreme stress can cause sudden death — this is sometimes referred to as the nocebo effect.
Excessive production of stress hormones can in certain cases cause death — most likely by their effect on the heart.
For example Tako-Tsubo syndrome (which I wrote about here) is a type of stress induced cardiomyopathy that can cause sudden death.
Whilst Tako-Tsubo seems to predominantly affect women, there may well be a particular subset that affects men more.
Perhaps the Hmong have a particular predisposition towards something like Tako-Tsubo or some form of heart conduction abnormality which can be triggered by extreme stress.
The presence of fibrillation (basically an unproductive flailing of the heart) in the victims (as stated in the LA Times article) is consistent with this.
Sleep Avoidance
Further as word spread of such deaths in the community the Hmong men started to do things which may have made the situation worse.
There were reports that some of them were using alarm clocks to wake them up regularly during the night so that they would not sleep too deeply, — some were even trying to avoid sleep altogether.
This likely resulted in sleep deprivation, a known factor that increases the risk of sleep paralysis, enhances the release of stress hormones and generally puts more strain on the body (including the heart).
Paradoxically by trying to reduce their risk of dying these men may have actually increased their probability of suffering sleep paralysis and succumbing to SUNDS.
Cultural Factors
Shelley Adler [3] presents some interesting cultural context which may help to explain (at least partly) why the Hmong may have had a more extreme response to sleep paralysis type phenomenon.
The traditional Hmong spiritual beliefs contained a form of spiritual panpsychism — the idea that all things have a consciousness or spirit.
On leaving their homeland the Hmong felt that they had been cut off from their ancestral spirits, who would previously be able to protect them from attack from evil spirits:
“In interviews with refugees, it became clear that many Hmong feared that the ancestor spirits who protected them from harm in Laos would be unable to travel across the ocean to the United States and thus could not shield them from spiritual dangers.
Solace was taken, however, in the conviction that the myriad evil spirits who challenged Hmong well-being in Laos would also be prevented from following the Hmong to their new home.
Among these evil spirits assumed to have been left behind was the nocturnal pressing spirit dub tsog (pronounced ‘da cho’) .
It soon became frighteningly apparent, however, that this notorious evil spirit had made the journey to America as well.”
In their native country the Hmong would traditionally make sacrifices to feed and placate such evil spirits (which were also known as tsog tsuam).
This practice stopped when they moved to America as one Hmong immigrant told Adler:
“At least once a year those evil spirits must be fed. If someone forgets to feed them, then they will come back and disturb you.
If you have tsog tsuam, the ancestor spirit is supposed to protect you.
If you feed the ancestors regularly, then whenever you have tsog tsuam, the ancestor spirits will protect you”
It seems that the Hmongs’ belief in the “dub tsog” and “tsog tsuam” may have made them interpret sleep paralysis as being an attack by such an evil spirit.
This, combined with the belief that they were no longer under ancestral spiritual protection may have left them more prone to excessive fear and hence an extreme, potentially fatal fear response.
Adler also provides a cultural explanation for why the toll may have been predominantly on men:
“Although Hmong women do experience nightmare attacks and are aware of the roles of both spirits and the absence of traditional religious practices m SUNDS deaths, they also know that dab tsog seek out their husbands, fathers or brothers as the individuals held accountable.”
Conclusion
The mystery of SUNDS in the Hmong population during the 1970s-1980s is a fascinating one.
Although we have a strong idea of the likely contributory factors — this particular mystery has never been conclusively solved.
It is likely that it was caused by a combination of factors e.g. genetics, cultural beliefs, PTSD, and the acute stress of being a new immigrant.
It is also of interest that the cases peaked in the early eighties — perhaps the belief in the Dub Tsog died out and hence removed one of the principal components which caused the syndrome.
There may have been some sort of environmental trigger (e.g. dietary deficiency) which resolved as the immigrants spent more time in the US.
It is also possible that modern cardiology is able to detect and treat more subtle heart abnormalities in childhood (potentially eliminating cardiac factors that may have been contributory).
Ultimately it is likely that the combination of news of the deaths with the Hmong spiritual beliefs created a compelling and frightening narrative which resulted in behaviours which may have made the situation worse.
It also inspired multiple newspaper headlines, drew the attention of the CDC and led to the creation of one of the great horror film franchises of contemporary times.
- It seems some nightmares are real.
Thank you for reading
References
- Marks, Craig, and Rob Tannenbaum. 2014. “Freddy Lives: An Oral History of A Nightmare on Elm Street.” Vulture. October 20. http://www.vulture.com/2014/10/nightmare-on-elm-street-oral-history.html.
- LA Times. 1988. “Deaths of Asians in Sleep Still a Mystery,” April 24. http://articles.latimes.com/1988-04-24/local/me-2575_1_southeast-asian-refugees.
- Adler, S. R. 1995. “Refugee Stress and Folk Belief: Hmong Sudden Deaths.” Social Science & Medicine 40 (12): 1623–29.
- Sá, José F. R. de, and Sérgio A. Mota-Rolim. 2016. “Sleep Paralysis in Brazilian Folklore and Other Cultures: A Brief Review.” Frontiers in Psychology 7 (September): 1294.
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