Patient Referral

As a patient nears death, it is common for their breathing patterns to change. These end-of-life breathing patterns can happen very quickly, or it can occur over many hours or even days. This is a normal part of the dying process as the body begins to slowly shut down. Families may choose to use this time to maintain a calm, supportive presence for their loved one, sitting with them quietly or speaking to them, saying prayers, or playing soft music.

How do breathing patterns change near death?

In the days and hours before a patient passes away, it is common for their breathing to become irregular. The time between breaths can begin to stretch out with many seconds or even minutes passing between breaths.

Breathing patterns before death may also become louder as they are no longer able to swallow or clear away secretions in their throat. These secretions gather in the throat, causing a gurgling sound commonly referred to as “the death rattle.” This sound causes no pain to the individual, but can be difficult for families to hear. A change in the patient’s position or administering medication to dry the secretions can help to reduce the sound, but may not completely eradicate it.

What is Cheyne-Stokes breathing?

Cheyne-Stokes breathing is an abnormal pattern of breathing commonly seen as patients approach death. It is named for the physicians John Cheyne and William Stokes, who first described the pattern in the early 1800s.

Patients who experience Cheyne-Stokes breathing will take several breaths followed by a long pause before regular breathing resumes. These cycles of breathing will become increasingly deeper and can be difficult for family members as they wait for the final breath to come.

What are some of the other signs that death is imminent?

In addition to end-of-life breathing patterns, there are several other end-of-life signs to be aware of. Although no one can predict the exact moment of death, knowing the signs and symptoms that indicate death is coming can help family members prepare. These symptoms include:

  • Blood pressure begins to lower.
  • The patient may experience confusion or be unable to identify family and friends.
  • Extremities may become mottled and cool to the touch.
  • The patient spends more time sleeping or becomes unresponsive.
  • The patient may experience incontinence or a decrease in urine output.
  • The patient’s need for food and fluid decreases.
  • The patient may experience terminal restlessness or agitation.

In the final few moments, the individual may continue to have some physical reactions caused by the chemical imbalance in their body. Muscles may twitch or they may sigh deeply. Once the patient has passed away, their hospice nurse will pronounce death.

Interested in learning more about breathing patterns near death and other signs at the end of life? You can download a free guide to end-of-life signs and symptoms by completing the form on this page.

End-of-Life signs by disease.

Learn about the specific end-of-life signs of common diseases and illnesses:

More end-of-life resources.