Can someone die from alcohol poisoning while they are asleep?

Unfortunately, yes. One of the biggest dangers of alcohol poisoning is that a person can lose consciousness and continue to be at risk even while appearing to sleep. Blood alcohol levels may still be rising, breathing can slow or stop, and a person can choke on their own vomit without waking up. This is why it is critical to never leave someone alone to “sleep it off” if you suspect they have had too much to drink. Stay with them, keep them on their side, and call for help if you are concerned.