I don’t know medically, but when my 93 old Mother was seen at home by her doctor because she was not eating, he examined her and said her organs were failing, but was in no pain.. She went to sleep that evening and never woke up. My sister was sitting with her and didn’t even know she had died as she was so quiet.
“Dying in your sleep” could be any number of things. The only thing that makes it peaceful is that you (at least theoretically) didn’t wake up for your death. You still went through a cataclysmic failure of bodily systems.
As a paramedic, I’ve gone to many early morning “unconscious person” calls where a person died in the night, later determined to have had a heart attack or stroke.
Some times you find the bathroom disturbed (vomit in the sink, etc.) showing that they woke up sick during the night and didn’t call 911, instead choosing to go back to bed. Sometimes it happens too fast to even wake up for, which is more likely in patients who are in worse shape.
As for it being peaceful, I’ve seen more than a few with vomit everywhere, shit everywhere with thrashed sheets and knocked over table lamps. Strokes and heart attacks are painful and confusing, especially if they come on fast or unexpectedly.
Your body has a bunch of systems. Lungs, heart, digestive, etc.
Dying in one’s sleep simply means one of your bodies systems has slowly been getting worse and worse to the point that it stop functioning complety and you die as a result.
I don’t know if there is a “common system” that is the major cause of death when you sleep, but I would guess it would be your heart, because without blood pumping places (especially your brain), you die pretty quickly, and it can be either painless or so sudden that the person doesn’t ever awaken. Or maybe it’s been the digestive and your body simply doesn’t have the necessary nutrients and electrolytes to function.
I’m certain there’s been studies looking into this very thing, but I have not read any of this research, so I may be wrong.
Hopefully someone more familiar with the literature can chime in and give us an ELI5.
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