How Many People Die in Their Sleep and Why?

A staggering 1 in 8 people die in their sleep and it is estimated that between 25,000 and 45,000 people worldwide die in their sleep every day. This is not necessarily a bad thing, as it is the way most of us would like to go! However, a premature or preventable death is sad. This article explores some of the most common causes of dying at night and how this might be prevented.

Unsurprisingly, sudden cardiac death is the leading cause of these deaths, with cardiovascular issues, strokes, and sleep apnoea being significant contributors. Some people also suffered from carbon monoxide poisoning.

• Sudden Cardiac Death: This is responsible for 15-20% of all deaths across the World, with 30% occurring at night.
• Stroke: Approximately 25% of strokes happen when people are asleep.
• Sleep Apnoea: This condition causes people to struggle to breathe at night and increases the risk of sudden cardiac death and stroke as it reduces the oxygen levels to the brain. If you continually wake up tired and are a noisy night-time breather, it is definitely worth you asking your GP to refer you to a sleep apnoea specialist.

Cardiac Causes of Night Time Death

The most common cause of sleep-related deaths is due to some form of cardiovascular problem. The two leading causes of death globally are due to cardiovascular (problems with the heart) and cerebrovascular (issues in the brain) events. Studies show that between 17% and 41% of Sudden Cardiac Deaths occur during the nighttime hours of 10 p.m. to 6 a.m. According to the Sudden Cardiac Arrest Foundation, around 30% of these deaths occur at night and for some reason, women are more likely to experience this than men. Other heart-related issues such as arrhythmias and congestive heart failure may also be contributing factors. Regular check-ups and heart health monitoring are essential in mitigating these risks.

Many Strokes Happen at Night

Strokes also frequently occur at night. Some people suffer from “wake-up strokes,” these are strokes that have occurred whilst they are asleep. These are estimated to account for 15% to 25% of all stroke cases.

Conditions like sleep apnoea hugely increase the risk as the regular interruptions in breathing result in dramatically lower oxygen levels. People with high blood pressure are also at a greater risk of strokes.

It is important to get regular check ups and get prompt treatment if you experience sleep apnoea or have raised blood pressure.

The American Academy of Sleep Medicine states that severe sleep apnoea increases the likelihood of premature death by 46%.

Common Risk Factors for Sleep-Related Deaths

I think as a fundamental point, many people would be quite happy to die peacefully in their sleep at the end of a long, happy, healthy and fulfilled life. However, it is helpful to identify specific risk factors in order to try and stay healthy and reduce the likelihood of dying early in your sleep.

Type 1 Diabetes

People with type 1 Diabetes need to be particularly careful to monitor their blood sugar before bed. If their blood glucose is particularly low they should ensure they have eaten sufficient complex carbohydrates to sustain them through the night.  Sadly people with Diabetes are more likely to experience unexplained nocturnal deaths due to hypoglycemia.

Head Injuries, Hypothermia, Drugs and Alcohol

Medicines and other Drugs

Some medicines can supress the respiratory system, particularly if someone takes more than the recommended dose or mixes them with alcohol. Always read the label and talk to your Pharmacist about possible side effects. Key substances and medications to be aware of include:

• Amphetamines
• Benzodiazepines
• Cocaine
• Opiates
• Sedatives

Head Injuries

Severe head injuries can cause swelling in the brain. The effects of drugs and alcohol can make it harder for those caring for the injured person to recognise early signs of brain trauma. It is important to treat a traumatic brain injury swiftly and if it is not spotted, it could result in someone losing consciousness and slipping away in their sleep.

Hypothermia

Hypothermia can also cause someone to lose consciousness and die in their sleep. Severe hypothermia can cause confusion and unconsciousness and it also affects the ability of the blood to clot and the stability of the heart. Hypothermia dramatically increases the likelihood of someone experiencing a cardiac arrest in their sleep.

SUDEP – Sudden Unexpected Death in Epilepsy

SUDEP is the term used when someone with epilepsy dies suddenly and unexpectedly for no known reason, during or after a seizure. It’s important to remember that SUDEP is rare – it affects around 1 in 1,000 people with epilepsy each year. SUDEP can affect people of any age.

Risk factors for epilepsy-related death, including SUDEP, include:

• Having uncontrolled tonic-clonic seizures, especially at night
• Having a type of genetic epilepsy that’s difficult to control
• Not taking anti-seizure medication regularly or correctly – missed doses can raise SUDEP risk
• having seizures from a young age
• living with epilepsy for many years
• being male
• having seizures during sleep
• for some women, the risk of seizures may be greater at times during their menstrual cycle.

How to reduce the risk of SUDEP

• Taking prescribed anti-seizure medication regularly and correctly to help keep seizures under control.
• Ensuring friends and family know first aid for a seizure and when to phone an ambulance.
• Avoiding specific seizure triggers, such as stress, lack of sleep, missing meals, drinking too much alcohol or taking drugs.
• Introducing or increasing night-time supervision, for example, a parent or carer of a child with epilepsy,  may want to use a night monitor. This may be particularly helpful if their child has a history of having seizures during their sleep or is considered to be at a higher risk of epilepsy-related death. 
• It is suggested that sleeping on the back or side may help prevent SUDEP.

Preventative Measures and Tips for Staying Healthy

Being proactive can significantly reduce the chances of sleep-related deaths. Here are effective strategies:

Regular Health Check-Ups

Annual physicals are vital for monitoring cardiovascular health and other risks. Through these visits, healthcare providers will evaluate key health metrics, helping you stay informed.

Healthy Weight and Lifestyle Choices

Adopting a balanced and healthy lifestyle is a sensible approach to achieving a healthy life:

Maintaining a healthy weight is also critical. People with a raised BMI are far more likely to experience other health conditions.

• Diet: Aim for a nutritious, balanced and healthy diet
• Sleep Quality: Ensure you’re getting sufficient, quality and restorative sleep.
• Stress Management: Prolonged stress and raised cortisol levels have been shown to increase the likelihood of increased blood pressure and cardiac stress.
• Physical Activity: Regular exercise is incredibly important and has been shown to improve both cardiovascular health and sleep quality.

Ensure You Have a Safe Sleep Environment

It is vital to regularly check smoke detectors, and carbon monoxide monitors.

What To Do If You Find Someone Unresponsive and Not Breathing In Bed

The advice used to be, that if you find someone unresponsive and not breathing and they are in bed, that you should try and get them onto the floor. The advice used to be to use the sheets to try and lower the person onto a firm surface. However, most people found that trying to do this, was just too difficult. It was also taking too much time.

Consequently the advice has been updated to explain how someone might be able to give the best possible CPR on the soft surface of a bed.

If someone has collapsed and is unresponsive and not breathing and they are in bed. Remove the pillows. Kneel beside the casualty on the side of the bed to counter the effect of the soft mattress. Push down even harder on their chest, increasing the pressure to account for the absorption affect of the soft mattress.

If you are able to swiftly and safely remove the person onto the floor and give CPR on a firm surface. That will enable you to give quality CPR.

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Author: Emma Hammett