In Africa most death during sleep is termed spiritual cases or witchcraft attack but looking at the scientific view one would see that, most of this cases are internal physical conditions.

In some cases, death occurs due to some sort of external factor, either directly from the environment or another outside agent. For example, Carbon monoxide poisoning from generator, electric shock from metal coated earpiece, and a poor heating source may contribute. Homicide can also occur during sleep, and murders may occur more often at night.

Medications that are taken to treat medical disorders, including pain and insomnia, may increase the risk of death. This may be more likely if these drugs are taken to excess, such as in an overdose, or with alcohol. Sedatives and opioid may alter or suppress breathing.

Painful conditions like cancer, for example, may require levels of morphine that accelerate the process of dying by slowing respiration.

Let us assume natural, internal causes are the cause of death and focus on the most likely culprits.

Focusing on Failure of the Heart and Lungs

Evolving respiratory failure may gradually impact the function of the heart and other systems. Acute decline of cardiac function, such as with a massive heart attack, quickly impacts blood flow to the brain and may, in turn, lead to rapid respiratory failure. The lungs may also quickly fill up with fluid as part of pulmonary edema in heart failure.

When evaluating the causes of death in one’s sleep, it can be helpful to explore the causes that impact these two interrelated systems.

Cardiac Arrest

There is considerable evidence that cardiac function may be stressed during sleep. Rapid eye movement (REM) sleep, in particular, may redline the system with increasing risk towards morning. There also seems to be a circadian pattern of cardiac dysfunction, with problems often occurring late in the night and near the time of waking.

Heart attacks occur when a blood vessel (or coronary artery) supplying the muscle tissue becomes obstructed and the tissue supplied is damaged or dies.

These myocardial infarctions may lead to death.