Understanding and Managing ALS (Amyotrophic Lateral Sclerosis)

10. Complications and long-term effects

As respiratory function continues to decline, people with ALS will require advanced care and respiratory support. When respiratory decline first starts to occur, someone with ALS may use non-invasive positive pressure ventilation, a machine that uses a mask that fits over the nose and mouth to apply pressure to fill the lungs with air. Some people only need this type of ventilation at night initially but will need to use it during the day once symptoms start to progress. Someone with this condition may also use a cough assist machine, which helps facilitate coughing by delivering a deep breath of air to the lungs followed by negative pressure to simulate a cough.

A tracheostomy may be necessary for some people to support late-stage breathing difficulties. This is a procedure that creates an opening in the windpipe. A small plastic tube is inserted so that air can bypass the nose and mouth and pass directly into the windpipe and lungs. A ventilator can be attached to the trach to assist further. For people who have trouble eating, chewing, or swallowing, a feeding tube may be inserted into the stomach to ensure adequate nutrition.