What Is a Death Rattle?

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What is the death rattle? If you care for a loved one in the last days of life, you might be upset after learning about the “death rattle” or other alarming breath sounds that you may hear when death is near.

This article will go over what the death rattle means, why the death rattle is a common symptom of impending death, and what you should know if you’re caring for a loved one at the end of their life.

Woman on oxygen in a hospital bed with man in the background looking at her
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What Death Rattle Means

Since a dying person can no longer swallow or cough, phlegm and saliva can build up in the back of the throat and upper airways. The "death rattle" is the name for the sound the fluid makes a sound as air passes through it."

The death rattle appears to be slightly more common in females but can appear in people of any age dying of any cause. 

Studies have shown that the death rattle is heard to some degree in roughly half of dying people.

Science has shown that dying is an active process. There are steps in how the body shuts down, just as there were steps at birth, during the teen years, and in other stages of life. The death rattle is one of those steps and one that means death is near. 

Is It Uncomfortable?

The death rattle can be very hard for a dying person’s loved ones to hear but it is a normal end-of-life event that is not uncomfortable for the person who is dying, even if they are partially awake as it’s happening. 

The death rattle does not mean the person is "drowning" or having a "bad" death.

People with a death rattle while dying do not have any more trouble breathing than those who do not have one.

Likewise, the quality of the death rattle sounds you hear—how loud they are, for example—is not a measure of how much breathing distress there is. Even some treatments for a death rattle won't necessarily change the sounds.

The death rattle can be very upsetting for loved ones and caregivers. One study found that at least 66% of loved ones of a dying person found listening to the death rattle highly distressing.

Death rattle sounds can be noisy, but keep in mind that they are not upsetting to the person who is dying.

Is There a Treatment?

There are ways to dry up excess fluid that causes a death rattle, but remember that it is a normal and common step in dying. Your loved one does not feel like they are suffocating because they are breathing this way.

You can try a few things if the death rattle makes you anxious. They include:

  • Medications for fluid buildup: If you have a hospice comfort kit, it likely has a medication for drying up the fluids. This is usually either atropine or scopolamine.
  • Changing your loved one's position: The death rattle may seem worse when someone lies flat on their back. Simply rolling your loved one over a bit may help. You can also try placing your loved one's head higher than their body and turning it to one side to help the fluids drain.

How Near Is Death?

Many people wonder how long it will be until death when a loved one develops a death rattle. 

The timing varies from person to person, making it hard to predict exactly what the rattle means about impending death.

At the end of life, a person may seem agitated and confused. Others become unexpectedly calm during this time. Providers refer to these changes at the end of life as terminal restlessness and it is a normal part of the dying process.

It’s not uncommon for a dying person to speak of seeing loved ones who have died, which is often comforting and may even make them smile.

Try to resist correcting your dying loved one during this time and instead, just focus on being present with them.

Being Present

Being with your loved one while they are dying is hard, but it is a loving gesture. When people talk about their greatest fears, they often fear that they will die alone. Your presence is the greatest gift you can ever give to someone you love who is going through the dying process.

Don't stop talking to your loved one, even if you do not think they are aware of what’s happening around them. It's thought that hearing is the last sense to disappear, and even if they seem unconscious, your loved one may still sense your presence and be able to hear what you are saying.

At the same time, you must take care of yourself during this process. Take a break when you need to and make sure that you are tending to your own needs.

Summary

The "death rattle" is a sign that a person may die soon, maybe even in a matter of hours. The sound of the death rattle is very common when someone dies.

The gurgling sound is caused by fluid your loved one can no longer swallow. It is hard to hear, but knowing it does not hurt or harm your loved one can provide you with some reassurance and help you stay present with your loved one at the end of their life.

Frequently Asked Questions

  • Is gurgling the same as a death rattle?

    Gurgling most often describes the sound of fluid in the lungs. It can occur as part of the death process. "Death rattle" usually refers to the noise of phlegm or saliva pooling in the back of the throat.

  • How can you tell a loved one is near death?

    Cold skin, noisy breathing, and loss of consciousness are among the signs that death may be near.

    Not everyone will show all of them, but it's good to know them so you can support your loved one without showing fear or alarm.

  • How long will a person live once they develop a death rattle?

    Typically, a death rattle will begin when a person is hours away from dying, although some people may continue to live for a day or two.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. Shimizu Y, Miyashita M, Morita T, Sato K, Tsuneto S, Shima Y. Care strategy for death rattle in terminally ill cancer patients and their family members: recommendations from a cross-sectional nationwide survey of bereaved family members’ perceptionsJournal of Pain and Symptom Management. 2014;48(1):2-12. doi:10.1016/j.jpainsymman.2013.07.010

  4. Boland JW, Boland EG. Noisy upper respiratory tract secretions: pharmacological managementBMJ Supportive & Palliative Care. 2020;10(3):304-305. doi:10.1136/bmjspcare-2019-001791

  5. Palliative Care Network of Wisconsin. Death rattle and oral secretions.

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Additional Reading

By Lynne Eldridge, MD
 Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time."