Amyotrophic lateral sclerosis, more commonly referred to as ALS or Lou Gehrig's disease, causes progressive weakening of the muscles, usually beginning in the extremities. As the disease advances, the muscles involved in breathing begin to suffer as well. Respiratory failure ranks as the most common cause of death in ALS patients and typically occurs within three to five years after the onset.
Affected Muscles
Your diaphragm and intercostals -- muscles between the ribs -- help you breathe. As you breathe in and out, the muscles contract and relax to move air in and out of your lungs. ALS damages these muscles so they can no longer perform these functions as effectively. While you normally breathe without even thinking about it, it becomes a conscious, difficult act that will take up more of your energy.
Associated Problems
Reduced respiratory capacity causes a number of problems. You might wake up with a headache or a sense of confusion or have trouble sleeping through the night. The increased energy required to breathe can leave you feeling fatigued. Lying down can become an uncomfortable position, making you feel short of breath. Inability to cough strongly can lead to a buildup of secretions in the lungs.
Controlling Infections and Secretions
Respiratory infections can worsen breathing problems. Always treat these infections promptly and take precautions to reduce the risk of getting sick. The ALS Association recommends a yearly flu shot and a pneumonia shot every four years.
Your inability to effectively clear secretions from your lungs and back of your throat can cause breathing difficulties in two ways: Secretions obstruct airflow and also set the stage for respiratory infections. Talk to your doctor or respiratory therapist about medical devices used to clear secretions. Your respiratory therapist can also show you and your caregiver techniques used to clear the lungs.
Self-Care
While self-care cannot adequately address the complications of this disease, several self-care measures can help mitigate breathing difficulties. Talk to your respiratory therapist about breathing exercises you can do on your own. The ALS Association recommends taking five to 10 deep breaths several times a day to expand the lungs. Elevating your head at night can also help. You can accomplish this by adding extra pillows or placing blocks under the headboard.
Assisted Ventilation
The ALS Division of the Muscular Dystrophy Association explains that many experts on ALS regard assisted ventilation as the most important factor in increasing life expectancy. Non-invasive ventilation does not require any sort of surgical procedure, while the invasive tracheostomy requires the creation of a hole in your windpipe. If the muscles of your throat and mouth have significantly weakened, you might require invasive ventilation.
Medication Considerations
Many medications can depress respiratory function, worsening your breathing problems, the ALS Association explains. Medications linked to decreased breathing function include those used to treat muscle stiffness, insomnia, anxiety, pain and depression.
