People with ALS often use non-invasive forms of ventilation to assist with breathing difficulties. Non-invasive forms of ventilation usually use a facemask, which covers the nose and mouth, or nasal mask or nasal pillows, which cover only the nose, with positive pressure to assist with ventilation. Many ALS patients begin with non-invasive forms of ventilation. Not all patients with ALS are able to use non-invasive ventilation due to weakness in the throat muscles or due to claustrophobic discomfort.
Some people choose to have a tracheostomy performed.
Tracheostomies are performed on people with impending respiratory failure or difficulty managing secretions. Tracheostomy is most often considered by people with bulbar onset, who retain adequate limb strength. There are pros and cons to each method of ventilation. You and your family will want to discuss this issue before your respiratory status reaches a crisis. The better prepared you, your family and your health care professional, the better your care can be managed.