Depending on the cause of a person's demise, what it sounds like when someone takes their final breath can take a couple of forms. It can be silent and peaceful, like slipping into a dream, or it can sound like a nightmare full of sporadic gasps, moans, and gurgles. The latter is known as agonal breathing, and it is just as terrifying as it sounds. Sometimes mentioned alongside the term "death rattle," this type of gasping can be scarring for anyone who witnesses it. It's not pretty, it's not always quick, and it's genuinely horrifying.
Most people have probably had this morbid thought: What does it sound like what someone is dying? This type of breathing sounds desperate and pained, and it can go on for minutes or longer, even after the rest of your body is gone. It can happen after a heart attack, and can even happen while you're passing in your sleep. Beyond that, there are some agonal breathing facts that are likely to leave you breathing a little heavier, and perhaps feeling a little nauseated. This list contains videos of agonal breathing, which can be very distressing.
For those who have never seen agonal breathing before, watch the above video with caution; it is an incredibly unnerving experience. There are several aspects of this phenomenon that make it particularly startling. When a person experiences agonal breathing, they may convulse slightly, and their face may contort even if they're not conscious. They will gasp for air, and their mouth may open and close as they gasp.
Watching it happen - especially to someone you know - can leave you feeling helpless and afraid. Their breaths may gurgle, snort, and they even moan at times. When this happens to someone who is already effectively deceased, it can seem otherworldly. Even medical personnel can be pretty shaken by agonal breathing before they have experience with it. Redditor/u/bombaybicyclecub recalls how terrified they were to experience this sort of breathing:
My first code was during my second semester of nursing school. He had coded about 20 minutes before I was able to get to his room, and they had pretty much already decided they couldn't save him. So, they were letting all the students have a round of performing compressions. Afterwards, the doctor had called it and the students were leaving. As I was walking around the bed, he started violently gasping for air. I didn't know what agonal breathing was and it was the scariest thing I've ever seen. I immediately burst into tears.
Although these gasps may seem like a person is breathing - frantically or sporadically so - what is happening is not really breathing. The normal rate of respiration is between 15 and 20 breaths per minute. Agonal breathing rates - when it happens more than once - can be as low as three to four breaths per minute.
Agonal breathing also happens sporadically rather than in any sort of regular rhythm. Most important to remember, however, is agonal breathing isn't bringing oxygen to the body the way that normal breathing does. While it is the body's attempt to get oxygen to the organs, it is not sufficient to keep a person alive and is a sign they are quickly on their way out.
While agonal breathing can be occasional and may happen only once or twice as a person's final breaths, that is not always the case. Depending on the cause of agonal breathing, it can go on for just a few minutes, or it can go on for multiple hours at a time. For the most part, agonal breathing comes on at the very end of a person's life and will occur naturally without any prompting or provocation from outside sources.
However, in the case of treatment withdrawal or when a person is taken off of a ventilator, these actions can bring on prolonged agonal breathing. These gasps may continue on and off for a longer period of time than if a person is in the final stages or is experiencing a sudden stroke or cardiac arrest. Even when they happen for a long time, though, they are still normally a sign the end is near.
So why exactly does the body do this? To put it simply, a person's brain is trying to save their life. Agonal breathing is the body's final attempt to get oxygen to organs, even if it's not a very effective means of doing so.
When the heart stops pumping blood or isn't pumping enough blood, the brain doesn't get the oxygen it needs. As the brain starves for oxygen, it reaches a state of ischemia, and it turns on a reflexive type of breathing in order to stay alive. This is meant to keep the body alive as long as possible and is an attempt to restart breathing and regulate heart rhythm. In short, it makes the person gasp.
In order to make the body do this, the brainstem tells the diaphragm and the muscles in the jaw to spasm. This jerks air into the lungs in irregular intervals.