Ondine’s Curse—and Other Sleeping Sicknesses

Abstract

The “central hypoventilation syndrome,” or “Ondine’s curse,” was first recognized in the mid 1950’s. It is a disorder which does not exist during waking hours, while conscious control over breathing patterns holds sway. Instead, it appears that with sleep, or the loss of consciousness, the breathing that we all take for granted does not continue, presumably because of a faulty element in the automatic, nonconscious breathing control mechanisms that reside in the brainstem. Sufferers of “Ondine’s curse” “forget” to breathe, so to speak, when they sleep. The neurological “automatic pilot,” which is supposed to take over control of respiration during sleep, does not respond to the oxygen needs of the body. Normally, much of the brain can sleep while select centers of nervous activity, like night watchmen in a power generating plant watch, adjust and fine-tune activities according to the maintenance needs of the system. But in the individual with Ondine’s curse, the night watchman sleeps too. Usually, the syndrome can be identified within a few hours of birth, when the affected child takes on a peculiar bluish tinge, known as cyanosis (a reflection of poor oxygenation of the blood), and exhibits periods of greatly reduced if not totally absent respiratory movements during periods of slumber. Not to be confused with voluntary breath-holding of the 1- or 2-year old, or the swimmer’s suppression of his breathing by voluntary hyperventilation just prior to diving underwater, “Ondine’s curse” refers to a deficiency in the brain’s control of automatic breathing—in other words, a defect in the central control mechanisms of breathing.

The water nymph, Ondine, even though an immortal, was smitten by an ordinary bloke, a knight, and married him. He, however, did not remain faithful to her. The enraged nymph took her revenge . . . by cursing him with death if he were ever to sleep.