Recently there have been quite a few different days in which the press reported US president Donald Trump "falling asleep" during televised events in the White House. In the typical event that has occurred, Trump will be seen sitting at a desk, and behind him will be various people talking. As someone else talks, Trump will close his eyes for quite a few consecutive seconds. Incidents of this type have reportedly occurred quite a few times. The March 24 article here claims that there have been 13 such events. There have been multiple reports of Trump falling asleep at official events in the weeks since March 24.The latest report has a headline of "Trump, 79, Falls Asleep Seconds After Speaking in White House Event."
The press seems to have been uniform in its coverage of these events, describing them as cases of Trump "napping" or "falling asleep." But let me suggest a novel hypothesis about the cause of these events, one I have not read anyone else suggest. These events may be something more serious. Rather than mere napping, these events may be short events of fainting, caused by a drop in blood pressure. Syncope is the medical term for fainting. There is a type of problem called cardiogenic syncope, and the older a person is, the more likely it is to occur. When cardiogenic syncope occurs, blood pressure may undergo a sharp temporary drop because of some malfunction in the heart, often a heart arrythmia or a temporary deviation from the heart's normal sinus rhythm, or some heart pumping problem. The drop in blood flowing to the brain results in a state called cerebral hypoperfusion, which results in fainting or loss of consciousness.
The infographic visual below (modified from one generated by Google Gemini) explains how cardiogenic syncope involves a short-lasting dip in the flow of blood to the brain.
If a person is standing and has an episode of cardiogenic syncope, the result may be a very noticeable collapse. But a person sitting and having such an episode may merely appear to be napping for a short time. I asked Google this: "Can cardiogenic syncope look like napping?" I get this answer from an AI overview: "Yes, cardiogenic syncope (fainting caused by a heart condition) can sometimes look like someone is 'napping,' dazed, or in a deep sleep, particularly if the episode is very brief or occurs while they are already sitting or lying down."
By itself a tendency towards cardiogenic syncope does not have any very grave short-term prognosis. Typically the fainting episodes are brief, and do not cause any permanent brain damage. An old person with such a tendency may well continue to live for years, and may function well. But his chance of sudden cardiac death or heart failure death during those years will tend to be much higher. Whether such a person can continue to do a job well depends on the frequency of the episodes, and what type of job the person does.
If a very old president were to be having occasional episodes of cardiogenic syncope (fainting uncontrollably now and then), he might well be able to get by without people noticing, particularly if he was careful to avoid events involving prolonged standing, and instead mainly did Oval Office events while seated. Such a president might be able to do his job well on most days. The problem would be that the cardiogenic syncope would tend to create rare days in which the president was pretty much incapacitated, and incapable of doing his job well.
In Caucasian people cardiogenic syncope involving cerebral hypoperfusion tends to temporarily create a rather white-looking face, a pale face color. The word for that is pallor. If you do a Google image search for photos of Trump sleeping in the Oval Office, you will not typically see a pale-looking face. But that does not discredit the possibility discussed here, simply because it is widely believed that Trump applies colored makeup all over his face, often leaving his face with a rather orange-looking or bronze-looking appearance. If Trump ever fails to apply that makeup, and there arises TV footage of him "napping" in the Oval Office while having a pale-looking face, that will tend to corroborate the hypothesis suggested in this post.
Quite a few articles claim to show pictures in which Trump appears to have swollen ankles. Swollen ankles involving edema are a symptom of heart failure, and cardiogenic syncope and heart failure are strongly associated. I asked Google this: "Is cardiogenic syncope associated with heart failure?" I get this answer from an AI overview:
"Yes, cardiogenic syncope is strongly associated with heart failure. It is a dangerous form of fainting caused by heart-related issues, such as severe arrhythmias or impaired pumping function, and is a major, independent predictor of sudden death in patients with advanced heart failure."
The latest report with a headline of "Trump, 79, Falls Asleep Seconds After Speaking in White House Event" may be particularly suggestive of the hypothesis I here propose. The likelihood of falling asleep is inversely related to a person's alertness and state of mental interest or engagement, with the act of falling asleep much more likely to occur in someone bored or not doing anything important. So it seems very unlikely that a person would ever fall asleep "seconds after" publicly speaking. Conversely, cardiogenic syncope occurs unpredictably, with its timing having no connection to a person's level of alertness or how socially engaged he was in the past minute.
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