Do People Actually Die in Their Sleep ... Without Ever Waking?

October 25, 2004 7:50 AM

Can people actually die in their sleep, without first waking up with the pain or surprise of the sudden crisis that lead to their death? What are the chances? [More inside.]

I'm aware that died in his/her sleep is often a euphemism but is it always so? Imagine a fully conscious human being, not drugged beyond a sleeping pill or two. Is it possible to go to sleep and die without waking up? My totally ignorant and unmedical hunch is that whatever kills you is important enough to jolt you into wakefulness, if only for a moment. Many thanks for any informed advise or less scientifically unsupported opinions.

posted by MiguelCardoso to science & nature (23 comments total)

I have anecdotal evidence only. When my great-grandmother died in her sleep at the age of 95, my great aunt went in to wake her up and only discovered that she had died when she went to nudge her to wake her up. My feeling is that if there was some sort of shock of impending death, my great grandmother would have had some sort of "oh hell, this is it!" look on her face and not have appeared to be peacefully sleeping.
posted by jessamyn at 7:59 AM on October 25, 2004

When I had my heart attack last year, I slept through the first four hours of it. I know this because when it first started, I mistook it for a cold coming on, and I took a nap. When I woke up, the pain had steadily grown so intense that 12 units of morphine couldn't touch it.

YMMV. ;-P
posted by mischief at 8:01 AM on October 25, 2004

I'm sure it happens all the time. One of my best frients died in his sleep of a blood clot a few years ago. His wife slept on next to him, and was unaware until rising the next morning (I can think of few things more horrible). The only consolation is that the doctors told us that it was probably quick---his brain stopped receiving oxygen and he simply faded in his sleep, probably without pain. Were they telling us what we wanted to hear? I don't know.
posted by bonehead at 8:03 AM on October 25, 2004

Imagine a fully conscious human being
If you're close to death, chances are you may not be a fully conscious human being. There's no reason something has to "kill" you for you to die... sometimes you just stop living.
posted by 4easypayments at 8:03 AM on October 25, 2004

Unfortunately the people with the best answers are dead.
posted by smackfu at 8:03 AM on October 25, 2004

Miguel--you're assuming that most of your body is well-innervated with nerves; most organs are not. Most organs are lined only with a layer of connective tissue (visceral) that is not well innervated; you only get localized, stronger pain when the outer layer (parietal) is disrupted.

If you took out a chunk from the middle of most organs, not disrupting the surface, I don't think you'd be able to tell.
posted by gramcracker at 8:10 AM on October 25, 2004

Aside from the heart attack/blood clot stuff people have described, if you're very old, you often die in your sleep due to your body just "winding down". Sleep is inherently a state of lessened body activity- if you are already frail, your body may lack the strength to "wake back up" and just continue its descent.

Personally, I knew a guy who this happened to, out of the blue. He was a hardcore party guy, just shy of 30, and he died unexpectedly in his sleep- his body just decided to punt.
posted by mkultra at 8:45 AM on October 25, 2004

I cracked my head badly enough to leave me unconscious for several minutes, and then passed in and out of consciousness during the next couple hours during the ambulance ride and hospital admittance. I then slept very, very heavily the next few days while in a private IC room and a gawdawful IV drip of purest bone-chilling antibiotic poisons.

I could have kicked the bucket at most any time and I'd never, ever have realized it.

It was greatly reassuring: death isn't necessarily a fearful thing. It can be completely... natural, I suppose. Graceful, perhaps.

I conclude that one's brain kicks into a nice self-protection mode, in which it lets you die without undue mental stress.
posted by five fresh fish at 9:06 AM on October 25, 2004

My 40-something neighbor died this way. His wife woke up the next morning and found he had died sometime in the night. She was lying next to him, so you would think if he was in any distress, she would have noticed. There was no prior medical history.

The writer Shirley Jackson also died this way, a heart attack in her sleep at age 48. If I remember right, I think she was taking a nap.
posted by Secret Life of Gravy at 9:29 AM on October 25, 2004

I conclude that one's brain kicks into a nice self-protection mode, in which it lets you die without undue mental stress.

I'm not convinced, when you're ill sometimes you can go out catastrophically but other times it seems to me more like your body is trying to hang on but has diminishing resources to do so and systems gradually fade out, until eventually it packs in. You can still have a final rapid drop off but by that stage you're too gone to really be around for it anymore.

My mother also spent a fair bit of time in hospitals overnight and it was pretty frequent that old ladies would slip away in the night without anyone in the ward being disturbed. I would venture to say that some where 'natural' deaths but that some where chemically assisted.
posted by biffa at 9:59 AM on October 25, 2004

My 80-something grandmother was found dead in exactly the same position she fell asleep. Her heart failed.

I see exactly where you're coming from with this question, but I think you're ignoring one thing: that moment of wakefulness, that "oh shit, I'm dying!" reaction would be an alert self-preservation response from a working body. An aged or ill person whose body finally gives out may or may not have the strength of body or quickness of nerve to wake up for that final gasp. If they did, they might not die at all.

I think some people really do slip away.
posted by scarabic at 9:59 AM on October 25, 2004

My wife and I both promised each other that neither of us would die while asleep, just because of how inconsiderate it would be for the one who wakes up.
posted by jasper411 at 10:12 AM on October 25, 2004

I had a stroke in my sleep when I was 28. I did eventually wake up, but there was no "Oh shit!" moment. It didn't even really hurt. I was mostly confused. I knew something was horribly wrong but I wasn't sure just what was going on. The people looking at me were more frightened than I was. I could definitely have slept through the whole thing.
posted by astruc at 10:37 AM on October 25, 2004

Given that our brains can do some pretty creative things with external and internal phenomena while we sleep (I'm sure most people have experienced things like incorporating the alarm's beeping into a dream so they don't wake up, or dreaming that your arm falls off, only to wake up lying on it), I expect even if people do perceive whatever it is that's killing them in their sleep (assuming it's something catastrophic like a stroke, clot or sudden heart attack and not something more gradual like stopping breathing and subsequent anoxia, which seems unlikely to be perceived), it could well not be perceived as what it actually is. I read an account of someone who almost died from a heroin overdose, and one of the things that really stuck with me was that they were aware enough to know that they weren't breathing, but didn't care enough to do anything about it (from the euphoria) - perhaps dying in your sleep is something like that.

Either way, people do seem to die while sleeping without waking up during the process.
posted by biscotti at 10:57 AM on October 25, 2004

my grandma too, like scarabic. I think it's very common --your heart stops, or a blood clot bursts or something, and you just go.
posted by amberglow at 12:01 PM on October 25, 2004

On a slightly related note, my dad had a tree fall on his head a few years ago. It knocked him out cold, and when he came to a while later, he had to piece together what had happened from the evidence surrounding him: tree, broken hard-hat, headache.

Whenever he tells the story of "the time a tree fell on my head and knocked me out" he always finishes up by saying that he had always thought that the moment before something like that happens you might realize it and panic, but in his experience there was no "oh shit, I'm about to die!" moment, just lights on. lights off. The end.

Sort of comforting, really.
posted by bonheur at 6:28 PM on October 25, 2004

I read once that someone who gets shot in the head feels no more than slight tap. I have no way of verifying this however.

On a related note, is a death spasm more intense for a violent death than for a peaceful death?
posted by mischief at 7:17 PM on October 25, 2004

I have seen people who died and didn't look like they had woken up from sleep. I was with an aunt of mine during her last waking hours, when she was delirious but seemingly aware that she was dying--after a couple of hours, they gave her some medication that sent her to sleep and sent us home, and according to the nursing home staff she just "never woke up". Her expression was certainly that of someone who was sleeping.

You might think that it's scary to be with someone who's dying, and it is, but on the other hand it's pretty easy to figure out what to do--you hold their hand and tell them you love them over and over. And pray, if that's something they do.

Now I am a little sad thinking of this.
posted by Sidhedevil at 10:03 PM on October 25, 2004

My grandmother "died in her sleep" last year. Upon taking her final breath, she was surrounded by her surviving sister, her surviving children (my father, two uncles and two aunts), one of her grandchildren (me) and my uncle's partner. Just along the hall was my partner with her yet-to-be-born great-grandchild and a priest from her parish.

She had been deteriorating for a long time. Dementia takes its time and whereas at the start of the last decade it crept slowly into her life and manifested itself mildly, it soon gathered pace and had accelerated at terrifying speed about a month before her death.

A week before she passed away, she had a massive stroke. She was taken to hospital and given a private room on an NHS ward. In the UK, this is a pretty sure sign that death is imminent, so two days later and with no change to her condition, the call went out for family to gather.

An aunt set off to the UK from Australia, an uncle from Spain and other close relatives from across the UK made their way to Yorkshire. I commuted over the Pennines a couple of times before camping out at a family friend's in York.

We kept a vigil over the course of three days. A member of her family was with her at all times. My aunt arrived from Australia and got to the hospital. My father, my partner and I were milling around outside talking to her when I got a call on my mobile to say that my grandmother's breathing was becoming more laboured. Not 5 minutes after her arrival from the other side of the planet, we made our way to the ward.

We entered the room together. There were eight of us gathered around. My grandmother's breathing was very ragged, her skin taught and pale. Hair that since time immemorial had crowned her head in regimented sweeps lay bedraggled on her shoulder.

My aunt removed the oxygen mask from my grandmother's face and held her left hand. My Uncle held her right. We all held hands in a semi circle in between them. We each prayed for her in our own way.

Her breathing continued in a laboured fashion for a few minutes. Without warning, my grandmother's eyes flashed open. With what seemed like remarkable clarity in her eyes, she surveyed the room. She squeezed her children’s hands.

She took a sharp intake of breath, closed her eyes and let out a cry.

It is very difficult to describe that moment. A full and complex range of emotions were expressed in no more than a matter of seconds. At first, she looked so terribly pained at the effort of living. Suddenly, the grimace evaporated in an expression of shock and her cry was cut short, as if caught in her throat.

After a moment, she let go.

With an unending sigh, a look of serene calmness spread through her. Her grip relaxed and her hands fell limp.

Had she been asleep? Had she been awake? Was she "conscious", was she "unconscious"?

I don't and can't know.
posted by davehat at 6:48 AM on October 26, 2004

My mother died while awake and playing cards with my father. She'd always had a bad heart, and it finally just gave out. Dad said she suddenly leaned over onto the bed she'd been sitting on, still with a smile on her face. She obviously had no "this is it" awareness; she just... went. If that's possible when you're awake, it's obviously possible while you're asleep.
posted by languagehat at 8:02 AM on October 26, 2004

davehat: thank you.
posted by iffley at 2:31 PM on October 26, 2004

You can certainly die in your sleep even if your brain is fully operational at the time.

Many of my patients who have died in their sleep told me they felt no -- er, wait a minute. Seriously: I have seen lots of people die in a very calm, peaceful state, but they were not otherwise healthy - they were dying, in a hospital.

The experience of death remains a mystery to us; no one comes back to explain it. However, people have died in various stages of sleep with EEGs and polysomnograms on; they do not always revert to a waking state.

The 13 year old girl who died of acute blood loss after a car accident, surrounded by her JW relatives, seemed to me to go very peacefully.
posted by ikkyu2 at 4:13 PM on October 26, 2004

My first stepfather died in his sleep, of a massive heart attack. He looked absolutely peaceful and normal when my mother tried to wake him the next morning. It happens.
posted by stavrosthewonderchicken at 4:27 PM on October 26, 2004