If you’re wondering how multiple sclerosis affects the respiratory system, you’re not alone. Many with multiple sclerosis face challenges like shortness of breath and a weak cough due to impairment in the nervous system. Without diving too deep too soon, this article outlines the effects of multiple sclerosis on breathing and offers a pathway through the potential respiratory difficulties that can arise with this condition.

Key Takeaways

  • Multiple sclerosis (MS)can disrupt respiratory function through impaired muscle activation in the brain and spinal cord, leading to symptoms such as shortness of breath, decreased lung capacity, and increased risk of respiratory infections.
  • Early detection of respiratory compromise in MS is vital, with symptoms including shallow breathing, fatigue, and sleep disturbances, necessitating strategies like respiratory muscle training to strengthen respiratory function.
  • Preventative measures such as vaccinations, smoking cessation, and proper swallowing techniques are important to reduce respiratory complications in MS patients, alongside personalized management plans for acute and chronic respiratory issues.

The Mechanism Behind MS-Induced Respiratory Dysfunction

Multiple sclerosis can significantly impact respiratory function due to its effect on the central nervous system. The muscle weakness induced by this disease disrupts the control of respiratory muscles, resulting in a variety of breathing difficulties. This dysfunction is primarily due to the presence of demyelinating lesions in the nervous system, which impair the activation of respiratory muscles. Some common breathing difficulties experienced by individuals with multiple sclerosis include:

  • Shortness of breath
  • Difficulty taking deep breaths
  • Weak cough
  • Decreased lung capacity
  • Increased susceptibility to respiratory infections

Individuals with multiple sclerosis need to work closely with their healthcare team to manage and address these respiratory issues.

Impaired Central Muscle Activation

In MS, impaired central muscle activation can result in significant respiratory muscle weakness, a major contributor to the condition’s respiratory complications. For instance, damage to the brainstem region can interfere with the central control of breathing, causing conditions such as obstructive sleep apnea.

The Role of Spinal Cord Damage

Spinal cord damage presents another challenge in the fight against MS-induced respiratory dysfunction. Demyelination and axonal loss in the central nervous system can result in moderate respiratory muscle weakness, impacting pulmonary function and cough effectiveness.

This can potentially lead to complications like pneumonia, affecting overall health and mobility.

Recognising Symptoms of Respiratory Compromise in MS

Early detection of respiratory compromise symptoms in MS can result in a more effective intervention. The initial indicators can include:

  • Posture/Head Placement
  • Shallow breathing
  • Fatigue
  • Speech difficulties
  • Poor sleep

Identifying Weak Respiratory Muscles

Determining the severity of respiratory dysfunction and guiding appropriate treatment in MS patients necessitates the identification of weak respiratory muscles. Indications of severe respiratory muscle weakness can include increased effort during inhalation and exhalation, feelings of fatigue, and possible impact on speech.

Signs of Sleep Disordered Breathing

Photo of a person experiencing excessive daytime sleepiness

Sleep-disordered breathing is a common issue in MS patients, characterised by symptoms such as excessive daytime sleepiness, morning headaches, and mood changes. Nocturnal hypoventilation, for example, can disrupt sleep quality due to the imbalance in the body’s carbon dioxide and oxygen levels, leading to increased daytime sleepiness.

Navigating Acute and Chronic Respiratory Failure

Comprehending the distinctions between acute and chronic respiratory failure in MS is crucial for directing suitable treatment and management strategies. Acute respiratory failure often results from demyelinating lesions in the cervical cord or the medulla, while chronic respiratory failure is more commonly seen in the advanced phases of the disease, associated with weakened respiratory muscles and ineffective cough, leading to aspiration, atelectasis, and pneumonia.

Handling Acute Respiratory Failure Occurring in MS

With prompt treatment like intravenous methylprednisolone and plasmapheresis, acute respiratory failure in MS can be reversible. Manifestations of acute respiratory failure include dyspnea, orthopnea, or confusion, which typically develop over hours or days in individuals with no preexisting respiratory issues.

Managing Chronic Respiratory Issues

Chronic respiratory issues in MS require ongoing management. Strategies include respiratory muscle training and supportive care.

The prevalence of diminished muscle strength and endurance, particularly in the chest and abdomen, are predominant chronic respiratory issues seen in Multiple Sclerosis patients.

Strategies for Strengthening the Respiratory System

Strengthening the respiratory system through targeted exercises and techniques can help improve breathing capacity and reduce multiple sclerosis symptoms. Respiratory Muscle Training (RMT) comprises a set of exercises specifically crafted to enhance the strength and stamina of the respiratory muscles, ultimately contributing to enhanced breathing for individuals with MS.

Benefits of Respiratory Muscle Training

Respiratory muscle training can enhance respiratory muscle strength and endurance in MS patients, resulting in improved overall respiratory function. RMT provides benefits to MS patients by enhancing inspiratory muscle strength, which plays a critical role in respiratory muscle control, enhancing respiratory function and endurance.

Techniques to Enhance Lung Volume and Strength

Techniques such as training in posture and head position, deep breathing exercises and diaphragmatic breathing can help enhance lung volume and strength in MS patients.

Diaphragmatic breathing improves lung volume and strength by strengthening the primary breathing muscles, which results in increased vital lung capacity and improved breathing efficiency.

Preventative Measures to Reduce Respiratory Complications

Photo of a person receiving a vaccination

The risk of respiratory complications in MS patients, such as infections and aspiration, can be mitigated by implementing preventative measures. Vaccinations play a critical role in promoting respiratory health in MS patients.

Additionally, MS patients should try to quit smoking since it can exacerbate respiratory muscle weakness and increase the risk of respiratory infections.

Importance of Vaccinations and Smoking Cessation

Supporting respiratory health in MS patients can be achieved through vaccinations, quitting smoking, and avoiding sedatives. The advised vaccinations for individuals diagnosed with multiple sclerosis comprise of pneumococcal vaccine; Shingrix vaccine for herpes zoster; and other inactivated vaccines such as hepatitis B, HPV, tetanus, influenza, measles, mumps, rubella, variola, BCG, polio, and COVID-19 vaccines.

Tips to Avoid Aspiration

The risk of respiratory infections and aspiration can be reduced by practising proper swallowing techniques and maintaining good oral hygiene. To prevent aspiration, multiple sclerosis patients can utilise various swallowing techniques, including specific exercises to address swallowing difficulties and the water-swallowing test to identify aspiration.

Living with MS: Personal Stories of Respiratory Challenges

Insight, support, and inspiration for others dealing with similar issues can be derived from the personal stories of individuals living with MS and facing respiratory challenges. People with MS commonly experience weakened chest muscles and respiratory difficulties, which can significantly affect their quality of life.

Published accounts shed light on this often-overlooked issue and provide real-life perspectives on the implications of these challenges.


In conclusion, understanding the connection between multiple sclerosis and respiratory dysfunction is crucial for managing the disease effectively. From recognising symptoms and managing acute and chronic respiratory failure to strengthening the respiratory system and implementing preventative measures, every step can have a significant impact on the quality of life of those living with MS.

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