BREATHING, it may not be as easy as it used to be People with ALS have healthy lungs, unless a disease of the lungs exists like COPD. However, muscles weaken including the breathing muscles, especially the diaphragm. Breathing in (inhalation) brings air which includes oxygen, into your lungs. Breathing out (exhalation) blows carbon dioxide out with the air. The weaker muscles can mean the carbon dioxide builds up. Symptoms can include: Feeling winded or short of breath with little to no activity Fatigue, more tired than normal Inability to lie flat on your back without feeling the need for more air Waking up with a headache Awakening frequently throughout the night Oxygen is for diseased lungs and does not help this problem. The best option is called non-invasive positive pressure ventilation, sometimes called Bipap. It is similar to the equipment someone with sleep apnea uses; a unit that enhances your smaller breaths with pressure to make them bigger. Using the equipment can alleviate the symptoms and help keep your energy level up. Additional information and answers to any questions will be available in clinic from the respiratory therapist.