If I choose to use NIV, when should I start?

There are benefits to using NIV early — as soon as you start feeling short of breath or having trouble breathing. Starting NIV early can improve your quality of life and help you live longer.

If you start NIV early, you may only need to use the device for a short period of time each day. This can help you get used to the feeling of wearing the mask. If you wait until your symptoms get worse, you may need to use the NIV device for longer periods of time, and it may be harder to get used to it.

Your ALS care team can help you figure out the best time to start NIV. To find out how well you’re breathing, your doctors may do some tests, like:

• A forced vital capacity (FVC) test to check how much air you can breathe out
• A MIP (maximum inspiratory pressure) or SNIP (sniff nasal inspiratory pressure) test to check how well your chest muscles are working
• Blood tests to check your oxygen and carbon dioxide levels

Your ALS care team may also ask you to wear a pulse oximeter while you sleep at night to keep track of your oxygen levels. A pulse oximeter is a small device that clips onto your finger to measure the oxygen in your body.