As someone approaches death, their body begins to exhibit symptoms. The breathing patterns change and can create a rattling sound. This sound is known as the death rattle, and it is a part of the dying process.

A death rattle can occur when a person who is dying is no longer able to swallow, cough, or otherwise clear saliva and mucus from the back of the throat, and because secretions in the respiratory tract may be increased.

The sound varies. It may be a crackling, wet noise that is amplified as the person breathes. In other cases, it may sound like a soft moaning with each breath, or a very loud gurgling or snoring.

While the sound may be unpleasant, the person emitting the death rattle usually feels no pain or discomfort.

The death rattle signals that death is very near. On average, a person usually lives for around 25 hours after the death rattle and the dying process begins.

Woman holding hand of dying partner in hospice bed to demonstrate death rattle.Share on Pinterest
A person nearing death may be unable to clear secretions from the back of their throat, causing the death rattle. Image credit: Photographee.eu/Shutterstock

The death rattle happens because the person can no longer remove secretions, such as saliva and phlegm, from the back of the throat.

People normally clear these secretions without any trouble, but a person nearing death may not have the strength.

Breathing patterns change as someone nears death and breaths may alternate from quiet to very loud.

A dying person may draw a sharp breath, then not breathe for several moments. This labored breathing may amplify the death rattle.

The death rattle is a sign that a person is approaching death. With each breath, a person may make a moaning, snoring, or rattling sound.

The following can also occur as a person nears death:

  • confusion
  • lung congestion
  • incontinence
  • a change in the pattern of breathing or difficulty breathing
  • a difference in the odor of a person
  • dark bruising
  • cold and bluish extremities
  • agitation
  • sleepiness
  • drifting in and out of consciousness
  • mottled skin

The death rattle can sound like the person is choking. However, no evidence suggests that the dying person is aware of the sound or experiences any related pain or unease.

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A nurse or medical professional can provide advice on easing the sound of a death rattle. Image credit: SDI Productions/iStock

The death rattle is not painful. However, it may be upsetting for the dying person’s loved ones. A nurse may do the following to ease the sound:

  • turn the person on their side
  • raise the head so the secretions can drain
  • moisten the mouth with damp swabs
  • use suction to drain secretions from the mouth
  • limit fluid intake
  • administer medication to clear the secretions

Proposed treatments are unlikely to prevent a death rattle, emphasizing that it is a natural stage of dying.

Medical professionals caring for a dying person will explain the noise to any loved ones present.

Addressing the grief and needs of loved ones may help everyone to be more comfortable during the dying process.

The amount of time that a person lives after the death rattle begins can vary based on many different factors.

However, one study found that the dying process lasted around 25 hours on average and was characterized by symptoms like death rattle, restlessness, and confusion.

According to the study, the dying process lasts slightly longer for individuals in hospice care than for those in the hospital. Additionally, the death rattle doesn’t occur for everyone.

In fact, the death rattle was only reported in about 40% of people during the dying phase and in about 35% of people during the last 24 hours of life.

The death rattle is a natural part of the dying process in many people who are terminally ill.

The noisy breathing can be distressing to family and other loved ones witnessing the death, but there is no evidence that the dying person experiences pain or discomfort.

While there is no way to prevent a death rattle, there are several steps that a nurse or clinician can take to reduce the sound and make the process more comfortable.