Other breathing support options

Many people living with ALS do not choose to use a trach and IMV. For example, in the United States, only 5 percent of people living with ALS get a trach.

You can choose to use non-invasive ventilation (NIV) instead of using a trach and IMV. NIV devices are portable, and you can use them 24 hours a day. However, as respiratory muscle weakness progresses, NIV may not provide enough support to help you breathe. You’ll also become more likely to develop pneumonia or other serious health problems as it becomes harder for you to swallow. Plus, some people living with ALS simply prefer not to use NIV.

You also have the choice not to use any medical devices to help you breathe. Without breathing support, it will become harder for you to breathe over time, increasing your risk for pneumonia and other serious, life-threatening complications. Know that you can always talk to your ALS care team. Your care team is here to help make sure you are as comfortable as possible.

If you prefer to use NIV only — or not to use breathing support at all — talk to your ALS care team about your decision. They can help you manage your ALS symptoms and improve your quality of life. A palliative care or hospice team can also provide support.