Unconsciousness is a state where a person is unresponsive and unaware of their surroundings, differing from sleep as they cannot be easily awakened. A common question is whether people breathe when unconscious. Generally, an unconscious person does continue to breathe, though patterns and effectiveness can vary significantly.
The Automatic Nature of Breathing
Breathing is primarily an involuntary process, controlled by the brainstem. This lower part of the brain regulates fundamental bodily functions, including heart rate, blood pressure, and respiration. Unlike voluntary actions, breathing’s basic mechanisms are hardwired into this primitive brain region. Since the brainstem operates autonomously, breathing often continues even when higher brain functions, responsible for consciousness, are impaired. However, while the brainstem maintains the basic rhythm, muscles supporting breathing, particularly in the upper airway, can relax considerably. This relaxation can lead to partial or complete airway obstruction, even if the brainstem is still sending signals to breathe.
Breathing Patterns During Unconsciousness
An unconscious person’s breathing patterns offer important clues about their condition. “Normal” unconscious breathing is typically regular, steady, and quiet, similar to deep sleep, with rhythmic chest and abdomen movement.
However, patterns can vary. Shallow breathing shows minimal chest movement, indicating insufficient air exchange. Slow breathing means fewer breaths per minute than usual. Noisy breathing, like snoring, gurgling, or wheezing, often suggests a partial airway obstruction, perhaps from the tongue falling back or fluids. More concerning patterns include Cheyne-Stokes respiration, where breathing gradually increases in depth and rate, then decreases, followed by a period of apnea, before repeating. Agonal breathing, sounding like gasping, snorting, or labored breaths, indicates a severe lack of oxygen and is a sign of impending respiratory arrest.
When Unconscious Breathing Becomes a Concern
Unconscious breathing can become a serious concern despite its automatic nature. Airway obstruction is a primary risk, occurring if the tongue relaxes and blocks the throat, or if vomit or fluids are present. These physical blockages directly impede oxygen intake.
Another concern is a depressed respiratory drive, where the brainstem’s signals to breathe become weak or irregular. This can result from drug overdose (especially opioids or sedatives, which suppress the central nervous system), severe head injuries, strokes, or diabetic emergencies. In these cases, even with a clear airway, insufficient breaths can lead to a dangerous lack of oxygen.
Immediate Steps to Take
If you encounter an unconscious person, immediately assess their breathing. Check for chest rise and fall, listen for breath sounds, and feel for air movement on their cheek. This “look, listen, feel” assessment should take no more than 10 seconds.
If the person is breathing but unresponsive, carefully place them in the recovery position. This involves rolling them onto their side, with their head tilted back and an arm supporting their head. This position helps keep the airway open and allows fluids to drain, preventing aspiration.
Immediately call emergency services (e.g., 911 or equivalent local numbers), providing your location and the person’s condition. If the person is not breathing normally or at all, emergency services will likely instruct you on how to begin basic life support, such as chest compressions, until professional help arrives.