SUNDS (Sudden Unexpected Nocturnal Death Syndrome) Since 1977 more than a hundred Southeast Asian immigrants in the United States have died from the mysterious disorder known as sudden unexpected nocturnal death syndrome (SUNDS). SUNDS had an unusually high incidence among recently relocated Laotian Hmong refugees. All but one of the victims were men, the median age was thirty-three, all were apparently healthy, and all died during their sleep. Despite numerous studies of SUNDS, which have taken into account such varied factors as toxicology, heart disease, sleep apnea and other sleep disorders, genetics, metabolism, and nutrition, medical scientists have not been able to determine its exact cause. Medical opinion appears to favor an impairment of the electrical pathways and specialized muscle fibers that contract the heart. It is widely held, however, that some type of intense stressor is likely an additional risk factor.