Saturday, June 26, 2004

Peaceful Sleep

When people are asked, how do you want to die? You rarely hear an answer of plane crashes, car accidents, heart attacks, drowning, or cancer. The most frequent response I have heard is "I want to die peacefully in my sleep." This response, however, has come from people who are relatively healthy.

I've recently had two patients who are terminally ill whom have an intensely real fear of dying in their sleep. One patient, each time she enters the hypnopompic state - the transitional state of semiconsciousness between sleeping and waking - she goes into a panic attack. "Help me! Help me! I can't breathe!" She is speaking, therefore she is breathing. However, she has the sensation that she cannot breathe. She is terrified that she will die in her sleep.

A second patient, who is also terminally ill, will not allow her bed to be flattened out completely. "I'm afraid I will die if my bed is flat." Some patients breathe more easily when the head of their bed is elevated, however, this particular patient has no difficulty breathing. She readily admits she has developed an association between sleeping while lying flat and death.

This wish for a peaceful, unconscious end to life for some comes from a desire to leave this world without having contemplated their own death. "Take me away before I even register what is happening." For others, this fear of dying while sleeping peacefully is an indication of a lack of preparation or readiness for death.

How do you want to die?

1 comment:

Jennynyc said...

My immediate thought in answer to the question is: not in pain. On the one hand I would like to die suddenly to avoid the loss of health and consequently the diminished independence that often comes with a longer death. On the other hand, I would love to have the time for closure, for me and my friends and family.