When respiratory support ALS, the medical interventions used to help people with amyotrophic lateral sclerosis breathe as their muscles weaken. Also known as ALS breathing support, it becomes essential as the disease affects the diaphragm and other muscles involved in breathing. Unlike sudden respiratory failure, this decline happens slowly—often over months or years—which gives time to plan ahead. Many people with ALS don’t realize how vital early planning is until they’re already struggling to catch their breath.
Two main types of respiratory support are used: noninvasive ventilation, a mask-based system that pushes air into the lungs without a tube. Also known as NIV, it’s the most common first step and diaphragm pacing, a surgically implanted device that electrically stimulates the diaphragm to contract. Also known as phrenic nerve stimulation, it’s less common but helps some patients stay off machines longer. These aren’t just for end-of-life care—they’re tools that let people live longer, sleep better, and stay more alert during the day. Studies show that starting NIV early can add months, sometimes years, to life expectancy and improve quality of life significantly.
Not everyone with ALS needs these tools right away. But if you start waking up with headaches, feel tired even after sleeping, or notice your voice getting weaker during the day, those are early signs your lungs aren’t getting enough air. Your doctor can test this with a simple breathing capacity test called FVC. If it drops below 50%, it’s time to talk about options. Some people resist using a mask at night because it feels strange, but most adjust within a week. The real risk isn’t the device—it’s waiting too long to use it.
There are also practical things you can do at home to make breathing easier: sleeping propped up, avoiding sedatives, staying hydrated, and learning cough assist techniques. These aren’t replacements for medical support, but they help delay the need for more invasive measures. The goal isn’t to fight the disease—it’s to keep you comfortable and in control for as long as possible.
The posts below cover real-world experiences and clinical insights on how respiratory support ALS works, what devices are available, how insurance covers them, and what happens when things go wrong. You’ll find stories from patients who started NIV early and kept working, tips on choosing the right machine, and warnings about common mistakes families make when managing breathing support at home. This isn’t theory—it’s what actually helps people live better with ALS.
