Maximizing lung function with ALS

Last updated Sept. 24, 2025, by ​​Agata Boxe
✅ Fact-checked by Inês Martins, PhD

 

Amyotrophic lateral sclerosis (ALS) can weaken the muscles that support breathing, leading to respiratory issues and a higher risk of complications such as lung infections and respiratory failure.

Taking a proactive approach to managing lung function with ALS — from daily hygiene to breathing exercises — can go a long way in helping you protect your lung function and maintain your quality of life.

The basics of maintaining lung function

When it comes to ALS and lung health, trying to prevent lung infections is key. You can start by maintaining good hygiene and taking certain daily precautions.

Some everyday tips to protect your lung health include:

  • wash your hands frequently, or use a hand sanitizer if you can’t
  • stay away from crowds during the cold and flu season
  • don’t smoke or vape, and avoid secondhand smoke

The importance of monitoring and early treatment

Regular check-ins with your ALS care team can play a crucial role in identifying potential lung issues early on. These visits allow for the necessary tests to be conducted and enable your healthcare providers to recommend treatments for any lung problems as soon as possible.

Depending on your symptoms and other factors, your doctor may recommend pulmonary function tests, which are used to track the strength of respiratory muscles over time. These tests can help guide treatment decisions and give you and your care team a clearer picture of what your lungs need as things change.

Noninvasive ventilation

If your doctor notices any signs of reduced lung function, they may prescribe noninvasive ventilation (NIV), such as a bilevel positive airway pressure (BiPAP) device.

NIV is commonly used for respiratory support with ALS. It works by supporting the respiratory muscles, especially during sleep, when breathing becomes shallower.

You may not want to delay using NIV until symptoms become severe. Early adoption of NIV is recommended because it may help to slow the decrease in respiratory muscle strength.

Your doctor may recommend that you use NIV either only at night or both during the day and at night.

Cough assistance and airway clearance

As ALS weakens chest muscles, you may find it challenging to cough and clear mucus from the lungs, which raises the risk of infections such as pneumonia.

Your doctor may prescribe medications that help thin mucus or suggest using mechanical insufflation-exsufflation devices, known as “cough assist” machines. These devices mimic a strong cough by pushing air into the lungs and quickly pulling it out, creating a flow that helps move and expel mucus.

Your doctor may also recommend other manual techniques that may help.

Making sure you stay hydrated throughout the day can further ease airway clearance.

Breathing techniques

Certain breathing exercises can aid in maintaining lung capacity with ALS. It is important that you work with a respiratory therapist who can recommend the best techniques for you and teach you how to use them correctly.

Examples of breathing exercises include:

  • Diaphragmatic breathing, which involves inflating the belly instead of the chest during deep, slow breaths. It can help strengthen the diaphragm, a dome-shaped muscle below the lungs that is needed for breathing.
  • Breath stacking, which involves taking a series of small breaths without exhaling and “stacking” them to expand the lungs as much as possible, followed by a controlled exhale.
  • Pursed lip breathing, which entails inhaling slowly through the nose and exhaling through pursed lips, like blowing out a candle, helping keep the airways open for longer.

Lifestyle adjustments

In addition to NIV, cough assistance, and breathing techniques, you can also try to adjust your lifestyle to maximize your lung function.

Some suggestions include:

  • eating smaller meals to avoid putting pressure on the diaphragm, which would make it more difficult to breathe
  • getting out of bed every day, if possible, because sitting and standing up can help the lungs expand
  • trying to stay as active as possible and getting some fresh air
  • maintaining good oral hygiene to prevent bacterial infections that might spread to the chest

Finally, make a plan for respiratory emergencies and share it with your caregivers and family so they know how to help you.

Although living with ALS often involves dealing with respiratory challenges, there are ways to try to maximize your lung capacity for as long as possible. Through regular communication with your care team, lifestyle modifications, and breathing exercises, you can get the support you may need to nurture your respiratory health.

ALS News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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