MS and Breathing Problems

Medically Reviewed by Jennifer Robinson, MD on April 19, 2022
4 min read

When you’re living with multiple sclerosis (MS), there’s a chance you might have trouble breathing. It’s not as common as other MS symptoms, like numbness, tingling, blurry vision, and trouble walking. But it can still happen.

If you start to have trouble breathing, your doctor and other specialists have lots of ways to help. Once they find out the exact cause of your breathing problem, they can recommend treatments that allow you to breathe better and improve your quality of life.

MS can impact the muscles that affect your breathing. So breathing problems with MS usually happen when those muscles lose strength and endurance. There can be other causes, though, and some of them need treatment right away.

If you suddenly have trouble getting air, or if you’re having problems breathing right now, call your doctor or 911 immediately.

You may have shortness of breath or feel like you can’t take a deep breath.

You might have trouble talking, too. Breathing problems can make it harder and more tiring for you to hold a conversation or speak loudly enough for others to hear you.

Other possible clues of breathing problems with MS are:

The most common cause is weakness in muscles of the chest and belly that help you breathe.

Muscle weakness is common with MS. It can happen in any part of your body, including the muscles involved in breathing. It can also start early in the course of MS and gradually get worse over time.

If the muscles involved in breathing become weak, you’ll need to work harder to breathe in and out. And the more effort it takes, the more it could tire you out, especially if you already have MS fatigue (a symptom that may affect up to 80% of people with multiple sclerosis).

Other things can cause MS-related breathing problems, too. Certain prescription drugs that some people take to ease their symptoms -- like tranquilizers, muscle relaxants, or opioid painkillers -- can cause you to breathe slower and less effectively. Your doctor may want to watch you closely if you’ve had trouble breathing or swallowing and you take any of these meds.

Another cause of MS-related breathing problems is a dangerous condition called aspiration pneumonia. It can happen if you’re not able to clear things like mucus from your nose and throat, or if you accidentally inhale food, liquids, or other particles into your lungs.

A common multiple sclerosis symptom known as the MS hug (which feels like a tight band is wrapped around your torso) can also bring on breathing trouble by causing pain and tightness in your chest.

One much less-common cause of trouble breathing is a problem with the autonomic nervous system. That’s the part of your nervous system that automatically controls things like your breathing and heartbeat. MS doesn’t usually affect your autonomic nervous system.

Talk to your doctor right away. They may send you to a specialist who’s trained to treat breathing problems. Depending on your needs, your treatment plan, and the exact cause of your breathing troubles, your doctors might prescribe a breathing aid like:

  • A nebulizer: A small machine that turns liquid medicine into a mist, which you inhale deep into your lungs through a mouthpiece or mask
  • An inhaler: A handheld device that lets you breathe medication into your lungs in the form of a mist or spray
  • CPAP: A machine that treats sleep apnea by helping you breathe through a mask or nosepiece while you sleep

Build up your breath. Ask your doctor to refer you to a respiratory therapist. They’re a certified medical professional who can come up with a plan to help your lungs work better.

Your plan may include breathing exercises that strengthen the muscles involved in breathing. Along with helping you breathe better, some of these techniques may lower your stress, too. A few examples are:

  • Square breathing: Inhale for 2 counts through your nose. Hold it for 2 counts. Then exhale through your mouth for 2 counts. Do it a few times to relax and lower your heart rate.
  • 4-7-8: Breathe in through your nose for 4 counts. Hold it for 7 counts. Then slowly breathe out for 8 counts. Closing your eyes while you do this may help you relax.
  • Inhale-release, exhale-engage: Place your hands on your stomach. Inhale into your belly and feel it expand. As you exhale, tighten your stomach and engage your abs.

Treat any swallowing issues. If your breathing problems come from trouble swallowing, ask your doctor to refer you to a speech-language pathologist. This communication expert can also help you if your breathing issues affect your ability to talk.

A speech-language pathologist can teach your exercises and do other forms of therapy that help you swallow or speak more easily, which may improve your breathing. They might also recommend changes in your diet, as well as changes in your posture, to help you swallow better while you eat. If you’ve had aspiration pneumonia, they may suggest you use an assistive device called a feeding tube to lower your chances of getting that condition again.

Quit smoking. If you light up, ask your doctor to help you quit. Smoking makes you more likely to get breathing problems -- and it can cause your MS to get worse more quickly. Kicking the habit is one of the best things you can do for your overall health.