ALS breathing problems

In the later stages of ALS, breathing problems occur. Gradually, the muscles involved with breathing begin to deteriorate. As these muscles weaken, the act of breathing is no longer automatic. It becomes a conscious act and uses additional energy. As a result, fatigue rises and breathing becomes hard work.

Weakening of the breathing muscles also raises the risk of respiratory infections, such as cold, flu and pneumonia. Accidently taking food and fluids into the lungs – caused by weakened muscles – can also cause pneumonia.

Breathing tips

People in later stages of ALS lose the ability to breathe on their own. Eventually, they must depend on ventilators for breathing assistance.

To reduce shortness of breath and respiratory complications, the following tips may be helpful:

• Positioning – Elevate the head at night. Extra pillows under the head, neck and chest may help.
• Energy conservation – Rest between activities. Reduce unnecessary steps and plan body movement in advance. Sit while doing activities whenever possible. Plan your day around your energy level and ask for help when necessary.
• Breathing exercises – Practice breathing techniques to maintain healthy lung function. Take 5-10 deep breaths (with short rests in between) several times a day. Deep breaths help expand lungs fully.
• Equipment – Devices can help remove secretions from lungs by strengthening coughing ability. Also, noninvasive ventilation can assist with breathing by helping persons with ALS expand their lungs with minimal effort.
• Invasive ventilation – A tracheostomy tube in the neck can be used when the upper airway is obstructed. It is also used in cases of severe respiratory weakness.