This stops you breathing and starves your brain of oxygen.
It affects around 500 people in the UK every year.
According to the document, this was brought on by Paul’s coronary heart disease.
This happens when arteries are narrowed, and less blood and oxygen can reach the heart muscle.
The certificate, obtained by the Express, showed long-time friend and former PA and agent, Joan Marshrons, registered the entertainer’s death six days after he died at home.
She is also secretary for his Buster Productions TV company.
Paul’s husband Andre Portasio paid tribute to Joan after his death, praising her as a “great woman”.
Taking to Instagram on April 2, the former professional ballerina wrote: “Behind every great man there is always a great woman.
“Today is Joan Marshron’s 70th birthday, the woman that for 27 years has been a pillar of trust, commitment, dedication and unconditional love in Paul O’Grady’s life.”
Andre continued: “Please help me cheer the person that made everything happen behind the scenes.”
Leading up to his sudden death, Paul had been throwing himself into work as much as ever, worrying those close to him.
He was known to have suffered a series of health issues in the years before his death, including several heart attacks and a serious Covid infection.
Close friend of 40 years, Christopher Biggins, previously told the Mirror Paul was “like a teenager as far as his health was concerned – he didn’t listen”.
The 74-year-old recalled to The Sun: “About 15 years ago we were staying with Cilla in Spain. Paul had his heart problems already and had been told not to smoke or indulge in alcohol too much.
“She told me to go upstairs and tell him to stop. I felt like the matron from the Carry On films when I went into his bedroom and said: ‘Paul, you’re smoking.’ He looked at me and said: ‘No I’m not’.”
Christopher added: “I know for a fact he was still smoking last week. What a wonderful way to go — peacefully in your sleep.”
This week saw the final series of Paul O’Grady’s For the Love of Dogs air on ITV, with the channel paying tribute to the late presenter.
The first episode aired just weeks after his death and as the credits rolled in silence, ITV viewers were left in tears.
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