ALS and Your Lungs
ALS symptoms can vary greatly from person to person. Some people experience breathing symptoms early on, and some don’t have problems until much later. But eventually, weakness in the muscles that control breathing leads to a variety of symptoms.
Breathing symptoms can include:
Shortness of breath, with and without activity
Shortness of breath when lying flat
Fatigue during the day despite a full night sleep
Respiratory problems can include:
A poor cough reflex can lead to pooling of secretions in the lungs and the back of the throat. This can lead to upper airway obstruction or respiratory infections like pneumonia.
Excessive ineffective coughing can lead to fatigue, shortness of breath, and ultimately exhaustion.
Frequent yawning or sighing during the day
Waking up in the morning with a headache or fuzzy-headed feeling (morning confusion)
Awakening frequently during the night (insomnia)
Difficulty lying flat; needing to use more than 2 pillows to sleep at night
How ALS affects your lungs
When you breathe in and out you need to be able to expand and relax the muscles in your chest. When the diaphragm moves down and the muscles of the rib cage contract, air will move into your lungs. Ventilation is the movement of air in and out of your lungs.
When you exert yourself or exercise, the muscles in the body use more oxygen. Therefore, the muscles of ventilation must also work harder to supply more oxygen to the muscles. If your respiratory muscles are weak due to ALS, you may not be able to keep up with the demand. This leads to shortness of breath.
When you are sleeping, your body doesn’t require the same amount of oxygen. The breathing cycle changes, and breathing becomes slower and shallower. This is fine if you have normal lung function. However, when you have ALS, breathing can become shallower. This may lead to frequent awakenings during the night.
When you are lying down the strength of your diaphragm pushes stomach contents away from your lungs. If your diaphragm muscle is weak, you may notice that lying down is no longer comfortable. You may feel restless or short of breath.
Medicines that you take for pain, sleeping, anxiousness, or muscle stiffness may press down on the breathing centers in the brain. It is important to let your healthcare provider know the names of all the medicines you are taking. This includes both prescription and over-the-counter medicines. Also, let your healthcare provider know if you are experiencing problems breathing.
Respiratory infections can affect breathing. The passageway (nose, throat, lungs) that air moves through can become blocked or narrowed anywhere along its path. Nasal congestion can obstruct the upper airway. The tubes that move air in and out of lungs, called bronchi, can become swollen so that air movement is restricted. This can make it even more difficult to breathe.