Monday, January 22, 2007

Snoring Can Portend Death

Snoring is NOT a good thing. It came up again this morning while we were discussing cases in conference.

Time and again the story is that the individual is heard to be snoring shortly before their death. People lying on the floor snoring. People lying on the couch snoring. People lying on their bed snoring. People snoring really loudly. Most often the snoring is unusual for that individual or seems inordinately loud, it is “remarkable” snoring.

These snoring preceding death in these cases almost invariably involve individuals impaired by alcohol and drugs. The snoring is due to the fact that their airway is way too relaxed and they are not getting enough air (oxygen). Do not allow them to continue to lie there and snore. They are going to die. Chances are that they are not “going to sleep it off”.

Yes, some people snore every night, but if they are snoring loudly after drinking or using drugs (licit or illicit) the snoring is a sign of impending death. Get them medical help (911).

Consider this yet another of Coroner Keller’s Axioms, like no cocaine after 50 and get a doctor’s clearance if over 45 and participating in certain “extra-curricular” activities.


cheryl1054 said...

Hi in light of the recent death of a teen snowmobiler, I was wondering if you could discuss these accidents that happen at least once or twice a year in this county. Short of NOT going out on thin ice--how does one save themselves once you've gone thru? How quickly does hypothermia set in? What can we do to prevent these types of accidents?

Dr. Richard Keller said...

See my next post.

Anonymous said...
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Anonymous said...

My husband died from esophageal cancer. About 45 minutes to an hour before he died he started snoring loudly and very fast, his heart was beating extremely fast, he was sweating and in a stiff posture. I tried to wake him but there was no response. He was on morphine and I had put a morphine patch on him about 2 hours before he died. I thought his death would be peaceful but it was not. What was happening to him? Why did those things occur? There was no autopsy done. Please reply...I am haunted by what he went through.

Dr. Richard Keller said...

His snoring was likely due to his airway being relaxed to the point of noisy breathing or an abnormal breathing pattern that often precedes death.

The symptoms you describe (fast heart, sweating) are normal physiologic activities of the autonomic/automatic nervous system. One would expect more restlessness and movement if there was pain or suffering at his end.

Anonymous said...

Thanks for your does help. I've often wondered if the morphine patch was leaking and that hastened his death. It's been three years now so I'll never no the answer to that.

Would it have been at all possible for my dying husband to hear me talking to him? Would he have been aware of what was happening? He had said that he felt "good" that night and then several hours later he died. Just what does the cancer do to eventually cause death? He had mets in liver, gastric outlet,(mesh stent was placed there) and heaven only knows where else. There was no outward sign that he could have been bleeding internally.

Dr. Richard Keller said...

I do believe that those near death and seemingly unresponsive can hear us when we talk to them and sense or presence as comforting (I have been there and done that with loved ones and others)

With those mets, etc death is caused by metabolic causes: substances normally cleared by a healthy body and chemical changes in the body. These depress the heart and brain and breathing ability, resulting in death.

Anonymous said...

7 weeks ago I was getting ready for work and hear my husband snoring loud, short snores, he usually did not snore like that. I woke him for a brief minute, I just thought he was in a deep sleep, he responded and went back to sleep, I left for work, I was gone 12 hours and came home and my husband was DEAD, his feet were still tucked into the covers on the bed and he was lying with his head on the floor on a pillow, I started screaming and turned him over, he was cold and blue and hard, it was HORRIBLE, I called 911 but the shock and the death of my husband at 44 is KILLING ME, I am in such shock over this. He was seeing his doctor and she had recently put him on 5 medications for hiugh blood pressure....why did he DIE....I MISS HIM SO BAD!!!

Anonymous said...

My father was a very healthy, very active 60 year old, with great b.p and cholesterol, on no medications and he had annual check ups/ekg's b/c he was a responder in NYC on 9/11. He woke up one morning, did some laundry then laid in bed to watch a movie, almost immediately started snoring (according to his g/f) she woke him, he jumped and yelled "what" then laid down and died. She immediately did CPR and called 911 (she is a Medic) but they could not get him back. I wish I had done an autopsy, but obviously wasn't in my right mind when the Dr asked and she assured me that it was likely an acute heart attack. Do you have any insight on this, it's so hard to believe.

Dr. Richard Keller said...

My condolences.

Medicine's ability to screen for heart disease with any of the tests your father had done is extremely limited. Many individual's first indication that they have heart disease is a heart attack and for many the first symptom of a heart attack is cardiac arrest.

It is not at all unusual for an individual with normal EKGs ( a incredibly ineffective screening test for heart attack risk, even when an individual is in the midst of a heart attack 50% have normal EKGs) to have a heart attack. Normal BP and normal cholesterol are also no guarantee of low cardiac disease risk.

It is very likely that your father died of a heart attack, likely there is very little that could have been done to know ahead of time that this was going to happen with any usual screening.

Life is indeed precious and is often much shorter than we hope.

James said...

Thanks for your information. It's very useful.