On this page: 

• Key points

• Get your breathing checked regularly

• Change your body position

• Ask about breathing exercises

• Keep your cough strong

• Manage saliva

• Use airflow to make breathing comfortable

• Save your energy for what matters

• Consider non-invasive ventilation (NIV)

• Try to relax if you are having difficulty breathing

• Make eating and drinking easier and safer

• Eat enough and keep your bowels moving

• Protect yourself from chest infections

• Talk about changes early

• Questions to ask your healthcare team

• Related information

Key points

• Ask for your breathing to be checked regularly, even if you have not noticed any changes.

• There are things you can do to make breathing more comfortable, keep your energy and help keep your lungs clear.

• Changing your position and the air flow around you can make breathing more comfortable.

• Breathing and coughing techniques can help you expand your lungs and clear thin and runny or thick and sticky secretions (fluid made by the body, such as saliva and mucus) from your throat and chest.

• Managing saliva and getting advice about eating and drinking can help keep your lungs clear.

• Save your energy for the activities that matter most to you.

• Your healthcare team can help you find strategies and equipment that suit you.

Get your breathing checked regularly

MND weakens the muscles you use to breathe. This can happen at any stage of MND. You might:

• feel short of breath

• feel more tired

• notice your voice is not as loud

• find it harder to breathe when lying flat

• have difficulty sleeping

• have headaches in the morning

• have trouble coughing, sneezing, clearing your nose or throat.

You do not need to wait until you notice these changes to ask for information or support.

Regular breathing checks (assessments) from soon after diagnosis can identify changes early and help you and your healthcare team decide what support may help. A breathing assessment typically involves answering questions and performing breathing tests (“lung function tests”).

Talk to your MND clinic or healthcare team about having your breathing checked regularly.

Change your body position

The way you sit or lie can make breathing easier or harder.

Some people find breathing harder when lying flat. You may find it easier when you are:

• sitting upright

• supported by pillows

• standing

• leaning slightly forward.

These positions can help you breathe because they give your main muscle underneath your lungs (the diaphragm) more room to move.

Equipment such as an electric recliner chair, adjustable bed or wheelchair can help you find a comfortable position without using too much energy.

Ask your physiotherapist or occupational therapist about positions and equipment that may help you.

Ask about breathing exercises

Some breathing exercises may help you take deeper breaths and expand your lungs more fully.

There are exercises that address specific aspects of breathing which may help keep your breathing better for longer. Ask your physiotherapist, specialist respiratory nurse or respiratory physician which breathing exercises might be appropriate for you to try.

Keep your cough strong

Coughing helps keep saliva (spit), food and fluid out of your lungs. An effective cough also clears mucus from the back of your throat and from your lungs.

As the muscles used for breathing become weaker, your cough can also become weaker. This can make it harder to clear your lungs and may increase the chance of chest infections.

A physiotherapist can show you ways to make your cough more effective. Ask about:

• breath stacking

• strategies to clear saliva

• whether additional equipment may help you.

You should not wait until your cough becomes weak to ask for advice.

Manage saliva

MND can make saliva harder to manage. Saliva may be thin and watery, or thick and sticky, and can change over time and during the day. For example, as the weather or room temperature changes.

Changes to swallowing, breathing, positioning, eating and medicines can all affect how easily you can clear saliva.

A speech pathologist, physiotherapist, pharmacist or doctor can help. They may suggest changes to your position, mouth care, medicines, or equipment to make saliva easier to manage.

Use air flow to make breathing more comfortable

Moving air across your face can help reduce the feeling of being short of breath (breathlessness).

You could try:

• opening a window

• using a handheld or room fan

• keeping the room at a comfortable temperature.

If dry air is uncomfortable, ask your healthcare team whether a humidifier may help.

Save your energy for what matters

Everyday activities can take more effort as MND progresses. There is no advantage in pushing yourself until you are very tired.

Save your energy for the activities that are important to you.

You might:

• pace yourself and rest before you become too tired

• break activities into smaller steps

• find easier ways to do everyday tasks

• use technology or equipment to help you

• use mobility equipment, like a wheelchair when going out

• plan rest periods or naps during the day

• ask other people for help.

A physiotherapist or occupational therapist can help you find ways to save your energy and recommend equipment.

Consider non-invasive ventilation (NIV) to support your breathing

Non-invasive ventilation (NIV) is a treatment that can support your weakened breathing muscles. It can help you to:

• sleep better

• feel less breathless

• save your energy

• feel better during the day

• live longer.

Talk with your healthcare team about whether NIV is right for you. Use our resources to learn about NIV and to help prepare for your appointment.

Try to relax if you have difficulty breathing

Feeling like you can’t breathe can cause anxiety or worry. This can change the way you breathe and make you feel worse.

Controlled breathing and relaxation techniques may help you feel calmer and make breathing more comfortable. Sometimes medications can be used.

A calm and confident approach from a family member or carer can also help.

Ask your physiotherapist, palliative care team, specialist respiratory nurse or respiratory physician to show you techniques that are suitable for you.

Make eating and drinking easier and safer

If your swallowing or cough become weaker, food or drink may sometimes go down the wrong pipe into your lungs instead of your stomach. A weak cough can make it harder to clear.

A speech pathologist can assess your swallowing and recommend foods and drinks that are easier and safer for you to manage.

A dietitian can help you get enough food and drink and help reduce the effort when eating. If you are finding meals hard or tiring you may consider a feeding tube.

A physiotherapist can also show you and your carer how an assisted cough may help clear food, drink or saliva that goes towards your lungs instead of your stomach.

Eat enough and keep your bowels moving

Getting enough food and fluid helps maintain your energy, weight and helps your muscles work, including the muscles you use for breathing and coughing.

Tell your healthcare team if eating is becoming tiring, takes a long time or you are losing weight.

It is also important to manage constipation (difficulty emptying your bowels). Straining to empty your bowels takes effort and uses your diaphragm, the main breathing muscle. A bloated stomach can also make it harder to breathe.

Enough fluid and appropriate nutrition (food) can help. Talk to your dietitian, pharmacist or GP if constipation is a problem.

Protect yourself from chest infections

Coughs, colds and chest infections can make breathing more difficult.

Where possible, avoid close contact with people who are sick and keep up to date with recommended vaccinations.

Ask your GP or respiratory physician which vaccinations are recommended for you.

Talk about changes early

Tell your healthcare team if you notice changes in your:

• sleep

• energy

• ability to lie flat

• cough

• ability to clear saliva

• eating or drinking

• weight

• breathing.

Getting advice early gives you more time to understand your options and decide what works best for you.

Talk to your GP, neurologist, MND clinic or your healthcare team.

Questions to ask your healthcare team

You should not wait until breathing becomes difficult. Talk to your healthcare team about a breathing assessment and how they will monitor your breathing.

Use the following tools to prepare for your healthcare appointment:

• NIV question builder (for creating your own question list)

• Printable NIV question guide - long

• Printable NIV question guide - short

• One page NIV information sheet

Related information:

• Breathing and ventilation treatment with MND

• Breathing and MND: about breathing assessments

• Physiotherapists: a vital part of your care team