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There are many things you can try to do help this situation get better. As many have already stated, medications, suction machine, cough assist, and NIV (non-invasive ventilator). Let’s talk about why this is happening. Most important thing to realize here is that ALS does not affect the lungs. The lungs are not a muscle. What is affected is a weakening diaphragm which is the muscle we use to breath. Weaking diaphragm and weaking intercoastal muscles cause a patient to breath shallow, Shallow breathing causes atelectasis in the lungs and the buildup of secretions, which could lead to pneumonia and respiratory failure.
Theoretically, if lungs aren’t truly affected, then if we keep the lungs clear, expanded and healthy then we should not have this buildup of mucus and secretions. This why some people have already stated that symptoms went away with the use of NIV. NIV pops the lungs open and keeps them free of atelectasis (small sacs in the airway that collapse). Good lung expansion is what’s needed to keep the lungs healthy and clear of mucus. This can be obtained via use of NIV and cough assist machine. All of us out there who DO NOT have ALS are not walking around full of mucus every day. Because we have good diaphragm strength, and we take good deep breaths. I currently have about 600 patients that I treat aggressively with these machines. I almost rarely run into any of these situations with mucus, pneumonia and respiratory failure.
Notice I said rarely. Some patients have this equipment and do not use it as recommended. Some wait until they have mucus to begin to use the equipment. If you use it daily, you will not have this issue to begin with. Now, there are situations where you can still catch flu, covid or other infections just like anyone else and this can cause buildup of mucus/secretions.
I hope this helps. I can talk all day long about these topics.