How does ALS affect breathing?

Breathing is a function of lungs as well as the muscles that move the chest and lungs. The breathing muscles include the diaphragm (the major muscle that separates the chest from the abdomen, used for inhaling) and the muscles between the ribs. Amyotrophic Lateral Sclerosis (ALS) often involves breathing muscles, resulting in ineffective breathing or respiratory failure.

What pulmonary problems can I get with ALS?

  • Shortness of breath when walking or during rest
  • Inability to lie flat in bed
  • Poor strength of cough
  • Inability to clear secretions from the throat and lungs
  • Increased salivary secretions
  • Recurrent chest infections and pneumonia
  • Respiratory failure (high blood carbon dioxide level)

How can pulmonary therapy help breathing?

The pulmonary care team (including doctors and respiratory therapists) can work with you to:

  • Monitor the strength of your respiratory muscles to diagnose early evidence of weakness
  • Provide breathing assistive devices, such as:
  • Suction machine to clear mouth and throat secretions
  • Non-invasive ventilation
  • In-Exsufflator
  • Flu vaccine and pneumovax (pneumonia vaccine)

What are some concerns regarding non-invasive ventilation?

  • Mask is uncomfortable, puts pressure on the nose and face and makes you feel claustrophobic
  • Causes dry nose
  • Causes red eyes
  • Machine is too noisy
  • Air can leak from the mask
  • Poor coordination of breathing

What are some recommendations to improve breathing?


  • Do not lie down immediately after eating.
  • Avoid eating large meals which can prevent diaphragm from expanding fully.
  • Maintaining good nutritional status is essential to ensure optimal functional capability of breathing muscles.


Elevate your head with pillows from 15 to 30 degrees to help keep abdominal organs from the diaphragm.

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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