What ‘Dying in Your Sleep’ Actually Means

Everyone’s heard the phrase “dying in your sleep.”Ā But what does dying in your sleep feel like? Is it really peaceful, likeĀ Grandma’sĀ obituaryĀ said? What actually happens when someone dies in their sleep?

What dying in your sleep is actually likeā€”i.e., what happens to theĀ body, since we have no firsthand accountsā€”depends on the true cause of death, of which there are many. Science tells us that, yes, it is actually possible to die a seemingly painless death while remaining asleep.

But what areĀ the factsĀ behind the obituaries? What can actually cause you to die in your sleep?Ā Read on to learn what the phraseĀ reallyĀ means.

You Died of Cardiac Arrhythmia

Elizabeth Simpson, health reporter forĀ The Virginian-Pilot, decided toĀ investigateĀ the phrase ā€œdied peacefully in his sleepā€ before including the phrase in her own fatherā€™s obituary in 2011. Simpson discovered that there is one condition that is most commonly the cause of someone dying in their sleepā€”and it turned out to be what technically killed her father.

Hereā€™s what Dr. Simone Gold, an ER doctor from California, told Simpson: “If a patient simply dies, without any symptoms, which of course we don’t know unless it is witnessed, but when that is what occurs, absolutely and without question the most common reason would be aĀ cardiac arrhythmia, specificallyĀ ventricular fibrillation or pulse-less ventricular tachycardia.ā€ Basically, your heart starts to beat differently than it usually does, which leads to death.

You Died of Carbon Monoxide Poisoning

Hearing that someone ā€œdied in their sleepā€ might also mean carbon monoxide poisoning. Itā€™s called theĀ silent killerĀ for a reason: an entire family can fall asleep in a house with a carbon monoxide leak andĀ just never wake up.

TheĀ CDC saysĀ more than 400 Americans die this way each year. It warns that those who are ā€œsleeping or drunkā€ can die before experiencing a single symptom of CO poisoning.

You Were Electrocuted

Hereā€™s a weird one: you could ā€œdie in your sleepā€ after being electrocuted. How? Dr. Patrick Lantz, a professor of pathology at Wake Forest University School of MedicineĀ saysĀ the conditions would have to be just right. Letā€™s say thereā€™s a faulty wire in a hairdryer.

Lantz says touching that hairdryer in the bathroom late at night before going to bed could give off a shock, but an irregular heartbeat caused by that shock may not start that second:

“It may give them enough time to lie down on the bed and fall asleep or fall down on the bed. They might not be found right next to the device that caused the electrocution.”

You Died of Central Sleep Apnea

Researchers at UCLA think a condition called ā€œcentral sleep apneaā€ might be behind a lot of cases of elderly people dying inĀ their sleep.Ā Itā€™s so sneaky it can go totally undetected, leading examiners to attribute heart failure as the cause of death instead.

Central sleep apnea typically affects people older than 65Ā and is caused by losing brain cells that help control your breathing. Older folks with already weak hearts and lungs stop breathing during sleep because of a lack of those cells. Theyā€™re unable to rouse themselves naturally and they die from lack of oxygen.

You Died of Sudden Unexpected Nocturnal Death Syndrome

Sudden Unexpected Nocturnal Death Syndrome, or SUNDS, is an obscure genetic condition that leads to cardiac arrhythmia. It strikes otherwise healthy people while they sleepā€”some in their early 30sā€”and it is prevalent in Southeast Asia. At one point in the early ā€˜80s, in fact, it was in the top five natural causes of death among theĀ HmongĀ people, many of who resettled in the USĀ after the Vietnam War.

Dr. Shelley Adler, author ofĀ Sleep Paralysis: Night-mares, Nocebos, and the Mind-Body Connection, makes the controversial claim that the Hmong died in their sleep because of their belief in night spirits:

It is my contention that in the context of severe and ongoing stress related to cultural disruption and national resettlement (exacerbated by intense feelings of powerlessness about existence in the United States), and from the perspective of a belief system in which evil spirits have the power to kill men who do not fulfill their religious obligations, the solitary Hmong man confronted by the numinous terror of the night-mare (and aware of its murderous intent) can die of SUNDS.

You Died of a Stroke

A massive stroke can sometimes be the cause of ā€œdying in your sleep,ā€ butĀ accordingĀ to Dr. Leah Bush, former chief medical examiner of the state of Virginia, you usually would have experienced headaches or other nagging painĀ beforeĀ you went to sleep. AboutĀ one in seven strokesĀ happen while youā€™re asleep, but theyā€™re not all so-called ā€œwake-upā€ strokes and are virtually indistinguishable from strokes experienced while awake.

Elizabeth Simpson shared an anonymous journalistā€™s story about their mother dying of a stroke in her sleep at 82 inĀ The Virginian-PilotĀ in 2011:

She was physically active and mentally alert up until her final moment. She most likely thought warmly about her granddaughter’s upcoming wedding when she went to bed that night. The TV in her bedroom was still on when her body was discovered the next morning. She was in bed leaning back against a pillow. The remote control was still in her hand.

You Died of a Brain Aneurysm

Massive bleeding from a brain aneurysm is linked to sudden death during sleep,Ā according to Dr. Patrick Lantz. Thatā€™s what killed 22-year-oldĀ Aminah Jennifa Ahmed, who didnā€™t wake up from a nap the day she graduated from the University of Texas in 2015. She vomited on campus after receiving her diploma and once again on the ride home, but her parents chalked it up to stress.

As the director of the schoolā€™s Islamic Learning Foundation put it, her poor parents saw ā€œtheir daughter graduate literally hours before she was declared completely brain dead.ā€

You Died of Enterovirus D68

A New Jersey preschooler with no known health problems and no signs of infectionĀ died in his sleepafter being infected with Enterovirus D68 in 2014. Eli Waller, 4, went to sleep the night of September 24 showing no symptoms whatsoever, but his family found him dead the next morning. The next day, health authorities determined it was D68.

Enterovirus D68 is spread through ā€œrespiratory secretions and excrementsā€ and presents itself as a mild to severe respiratory illness when (or if) symptoms emerge. The CDCĀ saysĀ there is no specific antiviral medication available to fight the virus, which most commonly infects kids.

You Died Peacefully

If someone truly does die in their sleepā€”meaning no symptoms roused them from their slumberā€”then doctors agree that they did actually die peacefully. Dr. Simone GoldĀ saysĀ dying in your sleep of cardiac arrhythmiaā€”ventricular fibrillation, specificallyā€”is ideal: ā€œIf you have to die, this is a great way to go.ā€ Ventricular fibrillation is not a heart attack, she explains, but rather a ā€œshort-circuit of the electricityā€ of the heart, which would cut the flow of blood to your brain, rendering you unconscious.

Compare this to the so-called ā€œagonal respirationā€ of a patient desperately clinging for life. This breathing can sometimes last for hours, and is a sign of the body struggling to die. This struggle can even occur in a patientĀ technicallyĀ asleep and medicated with morphine.

It Was Just a Euphemism

Thereā€™s also a possibility that ā€œdying in your sleepā€ is just a euphemism for a household tragedy (such as carbon monoxide poisoning) or suicide. One anonymous journalist shared the story of their grandfatherā€™s death at 87 with Elizabeth Simpson ofĀ The Virginian-Pilot. They were told their entire adult life that their grandfather ā€œdied in his sleep,ā€ but thatā€™s not what happened at all:

I was 17 and decided that was how I wanted to go. Twenty-five years later, when my mother was dying of cancer, I learned that, in fact, he had committed suicide. He had cancer and did not want to be a burden to his family. That’s what he wrote on the note that he left for my grandmother and mother, pinned to his pajamas. He was a doctor and evidently had stowed away enough pills for when the time came.