Bangungut: A silent killer, not just a bad dream

For generations, bangungut has haunted the Filipino psyche. Told in whispered folklore, it was a phenomenon feared but poorly understood: a person, usually young and seemingly healthy, goes to bed and never wakes up. Some say it’s a bad dream. Others say it’s a curse. But science is here to set the record straight.

In a recent “Usapang Puso sa Puso” talk hosted online by the Philippine Heart Association (PHA), Dr. Luigi Pierre Segundo sat down with Dr. Giselle Gervacio, Associate Professor at the UP College of Medicine and primary investigator of the Philippine Bangungut and Brugada Projects, to dissect the myths and truths behind this deadly condition.

Folklore and fear

“For many, bangungut is a mysterious phenomenon,” Dr. Segundo opened. “We've all heard stories — someone young and healthy dies suddenly in their sleep, and people say it’s bangungut.”

He offered a linguistic trivia: “The word ‘bangungut’ comes from the Visayan words bangon (to wake up) and ungol (to moan), likely describing the sounds victims make in their sleep before they pass.”

Early Filipino folklore blamed angry female spirits targeting men. Later, blame shifted to food and lifestyle — fish sauce (patis), alcohol, even nightmares. But none of these theories have held up under scientific scrutiny.

“In the early 20th century, it was thought to be caused by evil spirits. Then people speculated it was because of patis or alcohol. But all of those have been disproven,” Dr. Gervacio said in Filipino.

A silent killer

The breakthrough, she explained, came in 2014 when Filipino researchers definitively ruled out another popular but mistaken theory: pancreatitis. Though autopsies consistently showed normal organs, some doctors had previously focused on the pancreas because of its pink color. But microscopic examinations at the UP College of Medicine found no inflammation.

“So if it’s not pancreatitis,” Dr. Gervacio continued, “and the autopsy is normal, and the death is sudden — then by deduction it lead to arrhythmia.”

Lethal arrhythmias: the abnormal heart rhythms that can stop the heart in an instant.

“In the 1950s,” she said, “the U.S. Centers for Disease Control reported increased incidence in sudden unexplained deaths in migrant workers from Southeast Asia, especially from Laos."

Is it hereditary?

While bangungut can strike without warning, it may run in families. “Not all, but in about 20 to 30 percent of cases are possibly genetic,” Dr. Gervacio explained in Filipino.

In such cases, family members are encouraged to undergo ECG screenings, which may reveal subtle abnormalities linked to sudden cardiac death. For survivors — those rare individuals who suffered an episode and were revived — treatment options include implantable cardioverter defibrillators (ICDs), devices placed under the skin that shock the heart back into rhythm.

The PHA is also pushing for Automated External Defibrillators (AEDs) to be available in malls and airports — public spaces where emergency response can save lives.

Is there a cure?

While there is no cure mentioned, there are ways to manage the risk. One medication, Quinidine, a sodium channel blocker, has shown promise in combination with ICDs. But prevention is key — and that starts with awareness, early detection, and targeted screening.

To that end, the Philippine Bangungut Program was launched in 2023. Partnering with PGH, the Department of Health, Philippine Heart Center, the PNP Crime Laboratory, and LGUs, the initiative includes two major studies: the Bangungut Project and the Brugada Project. Both aim to identify genetic mutations responsible for the condition and develop a Filipino-specific genetic test kit.

The Brugada syndrome

Often considered the “Western counterpart” to bangungut, Brugada Syndrome shares several features: it occurs in young, healthy males, leads to sudden cardiac death, and shows no structural heart issues in autopsies. But Brugada has a defining characteristic: it shows up on an ECG.

“Brugada has a distinct ECG pattern,” Dr. Gervacio said. “That’s why doctors can diagnose it before symptoms occur."

Families of bangungut victims may be eligible to participate in the national study. If a victim dies, the Bangungut Project Team must be contacted immediately — either at the hospital or barangay — so they can collect samples for genetic testing. Qualified participants receive genetic counseling and, if found at risk, are referred for advanced cardiac screening and possible ICD implantation.

As for Brugada Syndrome, diagnosis starts with an ECG. Once identified, patients are referred for the same genetic screening under the Brugada Project.

If your family has experienced a sudden unexplained death during sleep, contact the Philippine Bangungut Program through PGH or the Department of Health for screening and support.