Why does a dying person's breathing suddenly change?
Breathing can change suddenly near death because the brain, muscles and circulation no longer control breathing in a steady way.
Breathing can change suddenly near death because the brain, muscles and circulation no longer control breathing in a steady way. Breathing may become fast, slow, shallow, deep, noisy, irregular, or pause for periods.
These changes can be distressing to watch. They do not always mean the person is suffering, especially if the person is deeply asleep or unconscious. Ask the care team to assess the person if you are worried.
General information: This page gives general information for people in Australia. It cannot tell you exactly what is happening in one person's situation. If you have concerns about a symptom, medicine, treatment decision or change in someone's condition, contact their doctor, palliative care team, nurse or other treating health professional.
What breathing changes can look like
You may notice:
- long pauses between breaths
- shallow breathing
- deep breaths followed by lighter breaths
- noisy, wet or rattly breathing
- faster breathing
- jaw movement with each breath
- breathing through an open mouth
- a final pattern where breaths become further apart.
Some changes come and go. Others continue until death.
Why it happens
Near death, the body has less energy. The muscles used for breathing become weaker. The brain's breathing control becomes less regular. Secretions may collect in the throat because the person is too weak to cough or swallow.
This can happen even when comfort care is good. It is part of the physical process of dying for many people.
How to tell whether they are distressed
Look at the whole person, not only the breathing pattern. The person may be comfortable if their face is relaxed, body is loose, and they are not trying to sit up or pull at things.
Ask for review if they look frightened, tense, panicked, blue around the lips with distress, moaning, grimacing, or repeatedly restless.
What may help
Ask the nurse or palliative care team about positioning. A slight turn to the side, raising the head of the bed, or adjusting pillows may help some people. A fan or moving air can help breathlessness if the person is awake enough to feel it.
Mouth care can help with dryness. Medicines may help if the person has pain, breathlessness, anxiety or noisy secretions. Follow the person's own plan.
Do not force food, drink or tablets into the mouth if the person is too sleepy or unable to swallow.
When to get help now
Contact the palliative care team, GP, nurse or aged care staff urgently if breathing looks distressing, changes suddenly in a way you were not prepared for, or comes with choking, severe pain, agitation, blue lips with distress, fever or seizure.
Call 000 if this is a sudden life-threatening breathing problem in someone who is not expected to be dying, or if there is no end-of-life plan and you need emergency help.
You may also want to read
- What is Cheyne-Stokes breathing?
- How long can pauses between breaths last when someone is dying?
- What is the death rattle?
- Are they suffering when breathing becomes noisy, irregular or stops for periods?