When we think about our own mortality, dying in old age often seems to be the least frightening and probably painless way for many of us.
But dying in sleep can happen at any age, often a huge shock to friends and family, and many questions remain unanswered.
So why exactly do people die in their sleep? Is such a death preventable?
Research suggests that too much or too little sleep is associated with an overall higher risk of mortality, but there is no clear evidence that the amount of sleep contributes to dying in sleep.
Most people who die in their sleep do so due to general health problems, experts say, and in some cases it is possible to reduce our risk of dying overnight.
“Dying in sleep is usually related to the heart, lungs or brain,” said Dr. Milind Sovani, respiratory medicine consultant (pulmonologist) from Nottingham University Hospitals NHS Trust in the United Kingdom news week. “People with diabetes can sometimes die of low glucose levels while they sleep.”
Sometimes more complicated conditions are a factor, Sovani said, adding that a 30-year-old young man recently died in his sleep of Pompe disease, a glucose storage disorder that causes muscle weakness and difficulty breathing.
More often, however, conditions that lead to nocturnal deaths can be treated to reduce the risk.
Risk factors and health maintenance
The supine position, which many people expect when asleep, can affect lung volume, Sovani says, adding that nocturnal breathing is also affected by conditions such as diaphragmatic paralysis – the muscle that controls breathing.
Neurological diseases such as epilepsy may also be at risk.
People with refractory epilepsy are more prone to a syndrome called Sudden Unexpected Death In Epilepsy (SUDEP), which is thought to be caused by seizures that affect the body’s respiratory, cardiac and electrocerebral functions.
Research results published in 2018 in Frontiers in neurology found that SUDEP is more common at night or in the early morning.
Likewise, uncontrolled high blood pressure can increase the risk of stroke, which can be fatal and occurs during sleep.
Other conditions that tend to worsen at night include heart failure and sleep apnea, which cause breathing to begin and stop during sleep.
According to a Cleveland Clinic study from 2017, people with obstructive sleep apnea, in the form of this condition, are more than 2.5 times more likely to have sudden cardiac death between midnight and 6:00.
The study also found that people over the age of 60 were at the highest risk of sudden cardiac death.
Although mild forms of the disease do not always require treatment, more severe cases can be treated using a device known as a CPAP machine, which pumps air into a mask that the sleeper wears at night through his mouth or nose.
Other heart conditions, such as arrhythmias or abnormal heart rhythms, can also be dangerous if left untreated, says Sovani. People with these disorders are often equipped with pacemakers or implantable defibrillators; The first uses pulses to keep the heart beating at a normal rate, while the second monitors the heart rhythm and provides shock if it detects a dangerous one.
Chronic conditions such as high blood pressure, diabetes and obesity can contribute to overall ill health and increase the likelihood of complications. Managing these conditions and maintaining a healthy lifestyle can help reduce risks.