The Mechanism of Dead-in-Bed Syndrome and Other Sudden Unexplained Nocturnal Deaths

Author(s): B. Parekh.

Journal Name: Current Diabetes Reviews

Volume 5 , Issue 4 , 2009

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Abstract:

The mechanism of dead-in-bed syndrome (DBS), a rare but devastating condition that mainly affects young type 1 diabetes patients, remains mysterious. A new theory is proposed to explain this syndrome. This theory suggests that repeated episodes of hypoglycaemia-induced adaptation in orexin-A neurons cause (i) defective awakening and (ii) hypotonia of upper airway muscles during sleep. Consequently, due to the combined effect of these factors, long-term exposure of intermittent hypoxia occurs, leading to a combination of factors - such as depression of ventilation, increase in sympathetic tone, fluctuations in intrathoracic pressure and cardiac arrhythmias - these in conjunction with an underlying cardiovascular pathology (genetically inherited or acquired) cause cardio-respiratory failure and thus sudden death during sleep. This mechanism can be generalized to explain other cases of sudden unexplained nocturnal deaths including sudden infant deaths (SIDs).

Keywords: Hypoglycaemia, Glucose, Orexin, Arousal, Sleep apnoea, Sudden death

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Article Details

VOLUME: 5
ISSUE: 4
Year: 2009
Page: [210 - 215]
Pages: 6
DOI: 10.2174/157339909789804387
Price: $58

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