[1] Accumulation of fluids such as saliva and bronchial secretions in the throat and upper airways is the cause.
[2] Those who are dying may lose their ability to swallow and may have increased production of bronchial secretions, resulting in such an accumulation.
[3] Usually, two or three days earlier, symptoms of approaching death can be observed, such as saliva accumulating in the throat, difficulty taking even a spoonful of water, shortness of breath, and rapid chest movement.
[4] This symptom most commonly appears sometime during the last 24 hours of the person's life, although some live somewhat longer.
[5] The dying person is usually unaware of the noisy breathing and is not disturbed by it, but some healthcare providers attempt to minimize the sound for the emotional comfort of family members and caregivers.