PHANTOM DEATH - Page 2
© Kerrin Leon White
A movie called The Elephant Man (1980), based on his life, madesthe point that he always slept sitting up because, if he lay down to sleep, he would stop breathing. This amounts to postural sleep apnea, understandable in view of his great masses of extraneous tissue, as well as his misshapen jaws.
The movie takes a fanciful step further, for dramatic effect. It attributes his death, not to accident, but to a deliberate act of self-destruction, lying supine to sleep. This might be motivated in part by despair, in part by his wish to become like a “normal” person in his sleep, and in part by his sense that he had now achieved as much fulfillment as possible in his life.
Perhaps this was not how it happened. Another source states “his massive skull was too heavy to be easily supported, and during his sleep his head fell backward, dislocating his neck.” (http://www.bullseyedesigns.com/sideshow/... However, it seems dubious that the most proximal cause of death lay in a dislocated—or even broken—neck, as opposed to cessation of breathing.
Rightly, the various accounts of John Merrick’s life and death show scant concern with sleep apnea—scarcely known of in his time—in deference to the overwhelming ramifications of his disease, which included severe impediments to speech, crippling of one arm and one leg, inability to exhibit facial expression, and grotesque deformities.
John Merrick's case is, no doubt, extreme, indeed almost unique. It merely serves to illustrate the possibility that a person could, conceivably, die during sleep of a prolonged apneic episode.
People do die during their sleep, and in most cases it is impossible to say exactly why without an autopsy. Even then, should an autopsy demonstrate, for example, a myocardial infarction, or should lack of such a finding lead to a default diagnosis of a fatal cardiac arrhythmia, the question must remain unanswered whether the cardiac event resulted from an apneic trigger.
Having just made a statement that might well terrify people who know they have sleep apnea, I must at once qualify my meaning. Innumerable instances of prolonged apnea during sleep have been recorded in the laboratory without requiring cardiopulmonary resuscitation to avert death. This leads me to conclude that, while such an event may happen, the risk is very low.
I plead guilty to deliberate use of shock value in an effort to break through the protective fog of inattentiveness and unconcern that keeps too many people ignorant of the danger of undiagnosed and untreated sleep apnea. Those who have been diagnosed, and are being treated, often harbor secret fears that one more episode of awakening choking and struggling for breath might be their last; these people need fear less—for they are at less risk than the remaining millions who have it and don’t know.
