Short answer
Unconsciousness, such as a coma, does not cancel the duty: in the Hanafi school you make up every day missed, even a whole month, except the first day if you had intended to fast. Insanity is different: if it lasts the entire month, nothing is owed, but if you recover on any day of Ramadan, you make up the whole month. Advanced dementia removes the duty.
Ighma (loss of consciousness) is a kind of illness, so all days are made up, except the day on which it began, which is counted as fasted if intended. Junun (insanity) covering the whole of Ramadan removes the obligation; recovering in any part of it makes the whole month owed.
Other madhhabs
- Shafi'i
- Days lost to insanity are never made up, even if the person recovers within the month; a day of total unconsciousness from dawn to sunset is made up.
Explanation
The Prophet ﷺ said the pen is lifted from three, including the afflicted until he recovers. The scholars distinguish between losing consciousness, which is like a severe illness, and losing one's reason, which lifts the obligation itself.
Unconsciousness, coma, general anaesthetic:
- If you intended to fast and then fell unconscious, that first day counts as fasted, provided nothing was fed to you.
- Every day after that is made up when you recover, even if it was the whole month.
- If you were fed through a tube on that first day, it must be made up too.
Insanity and serious mental illness that removes reason:
- If it lasted the whole of Ramadan, no fasts are owed for that Ramadan.
- If you recovered for any day of Ramadan, you make up the days you missed in that month.
- Conditions that do not remove reason, such as depression or anxiety, do not lift the duty, though they may be an illness that excuses fasting with qada. See fasting when sick.
Dementia. An elderly person with advanced dementia, who no longer understands, is not obliged to fast, and nothing is owed for those days. Earlier fasts they could have made up and did not are a separate matter. See what is fidya.
These situations are often painful and complicated, so please ask a qualified mufti about your case, and see mental health in Islam.
Ask a mufti about your own case. This answer explains the general ruling. When the details of your situation matter, as they do here, ask a qualified mufti and give them the full facts. Where to ask a scholar.
The evidence
Quran, Surah Al-Baqara 2:184
أَيَّامًۭا مَّعْدُودَٰتٍۢ ۚ فَمَن كَانَ مِنكُم مَّرِيضًا أَوْ عَلَىٰ سَفَرٍۢ فَعِدَّةٌۭ مِّنْ أَيَّامٍ أُخَرَ ۚ وَعَلَى ٱلَّذِينَ يُطِيقُونَهُۥ فِدْيَةٌۭ طَعَامُ مِسْكِينٍۢ ۖ فَمَن تَطَوَّعَ خَيْرًۭا فَهُوَ خَيْرٌۭ لَّهُۥ ۚ وَأَن تَصُومُوا۟ خَيْرٌۭ لَّكُمْ ۖ إِن كُنتُمْ تَعْلَمُونَ ﴿١٨٤﴾
[Fasting for] a limited number of days. So whoever among you is ill or on a journey [during them] - then an equal number of days [are to be made up]. And upon those who are able [to fast, but with hardship] - a ransom [as substitute] of feeding a poor person [each day]. And whoever volunteers excess - it is better for him. But to fast is best for you, if you only knew.
Unconsciousness is treated like illness, so the days are made up.
Sunan Abi Dawud 4398
Graded sahih... رفع القلم عن ثلاثة عن النائم حتى يستيقظ وعن المبتلى حتى يبرأ ...
"The pen is lifted from three: the sleeper until he wakes, and the afflicted until he recovers."
One who has lost his reason is not under obligation.
Where the ruling is recorded
- al-Hidaya, Kitab al-Sawm, chapter on what requires qada. One unconscious for all of Ramadan makes it up, except the day it began; one insane for all of it does not, but if he recovers in part he makes up all.
- al-Majmu' (Nawawi), Kitab al-Siyam, section on the insane and the unconscious. The Shafi'i rulings on insanity and unconsciousness.
Checked by our team. For a more accurate answer to your own situation, consult a scholar. Quran translation by Sahih International. Hadith Arabic from the standard editions of the six books and the Muwatta, with gradings as recorded there; the English is our own rendering. Spotted a mistake? Tell us.