Clinical Manifestations and Pathology

The victims whose deaths were witnessed by relatives appeared to be asleep prior to death or were just falling asleep. None of them had complained of illness or symptoms before going to bed, and all were considered by family members to have been in good health.

Witnesses of SUDS deaths become aware of abnormal breathing sounds, in some cases preceded by a brief groan. Victims cannot be aroused. Terminal respirations are said to be labored and deep, irregular and without wheezing or stridor. The victims remain flaccid during these events, although a few are described as having tonic rigidity. Some of the victims are incontinent of urine or feces. Witnesses recall no signs of pain or terrifying dreams. A few of the victims who are still alive when paramedics reach them are found to be in ventricular fibrillation.

Interviews with family members yield no clues as to why the victims have died. Spouses have not noted symptoms consistent with sleep apnea syndrome.

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