Breathing

What Causes Breathing Difficulties in MS?

The most common cause of breathing (respiratory) problems in MS is a loss of muscle strength and endurance. Just as a person with MS can get weakness in the arms and legs, weakness can happen in muscles of the chest and abdomen that are involved in breathing. This weakness can happen early in MS and worsen over time.

If you are very disabled, are not standing or walking much, or have other medical needs, you may find that managing your breathing becomes an important part of your care. Any of these things can result in you taking shallower, more frequent breaths, having a reduced lung capacity, or a sense in which you can't take a big breath.

People with breathing problems in MS may also notice their cough isn't as strong, their voice is quieter or weaker, and they find it hard to talk for long.

If you have any sudden onset of breathing difficulties, or shortness of breath, you should see a GP urgently or contact 111/999 for assessment and advice.

How Can Breathing Problems be Managed?

Exercise Your Respiratory Muscles

Regular exercise of the arms and upper body can help to strengthen the chest muscles. Trying to stay as active as you can may also help to strengthen your breathing muscles. If you are not very active, you tend to breath less deeply and therefore, less effectively.

Breathing exercises can be done at any time of the day. Singing and whistling are very good for taking deep breaths and strengthening your muscles. If this is not for you, take a long slow breath in, trying to fill your lungs with air, and then blow out to the count of 20-30. There are many different types of breathing exercises, so it is important to find what works for you and what you enjoy.

Exercise Resources

Breathing exercises | MS Trust

Breathing Exercise Tips for MS - YouTube

Breathing Exercises (uhd.nhs.uk)

Joining a choir can be an uplifting experience · LiveWell Dorset

Relaxation and Mindfulness

Relaxation and mindfulness can be helpful with your breathing, if you find yourself becoming anxious or short of breath.

For more information, please refer to relaxation and mindfulness sections.

Further Support With Breathing Problems

If you are finding that you are coughing on food and/or drinks, you may be at risk of aspiration pneumonia. This is where food/drinks are inhaled into the lungs which can lead to a chest infection or pneumonia, if left untreated. If this is the case, a referral to a speech and language therapist would be recommended for assessment to look at how you are swallowing. You can also try to ensure you take care to chew your food fully, reduce any distractions, such as having a conversation when eating and drinking, and ensure you are in a good sitting position.

If you feel you have a weak cough, a peak cough flow device may be advised for you to monitor your cough strength. Depending on these results, a home exercise programme may be advised, or you may be referred to Southampton Respiratory Centre for further assessment.

Instructions how to use a peak cough flow test - How to perform a peak cough flow test at home - patient information (uhs.nhs.uk). If you have any problems performing a peak cough flow test, please get in touch with the MS helpline for further advice.

This information has been adapted from Breathing problems | MS Trust and and National Multiple Sclerosis Society (US) information.