Not every respiratory symptom related to MG, curtails an emergency situation or is immediately life threatening. In fact, most of the times it is not. Yet, involvement of the respiratory muscles in this illness can have a significant impact on the quality of life, and significantly affect functional ability. Therefore it is important to recognize those symptoms as early as possible in order to institute proper support and possibly prevent life threatening complications.


What are the symptoms and signs that suggest respiratory muscle involvement in myasthenia?

Shortness of breath on physical exertion-eg-climbing steps, walking
Shortness of breath when talking.
Heavy breathing following a meal.
Chest pain or chest tightness..
Feeling dizzy after exertion
Feeling "tired"
Multiple awakening during the night, and non-refreshing sleep.
Waking up with a feeling of suffocation. Sometimes as if you have had a nightmare.
Morning headaches.
Unexplained fatigue.

Most of those symptoms are not specific, and may be unrelated to MG, but their occurrence or worsening; warrant a proper respiratory evaluation by a respiratory specialist with a good understanding of neuromuscular disease.

Some of the symptoms are easier to recognize as related to breathing problems, others are less obvious and are the result of CO2 retention. It is important to be aware of the fact that many of them may mimic depression or anxiety, and can be easily over looked and attributed to that.

A very easy test to perform on your own, if you experience any of those symptoms, or have concerns of respiratory muscle weakness, is to take a deep breath (as much as you possibly can) and then try counting, with taking in air again.

A normal and healthy person should be able to count to around 50, being unable to count more then 10 is usually an indication for respiratory support. Anything in between will suggest some degree of respiratory muscle weakness.

What can you do to feel better, until you have proper evaluation?

Rest as much as possible, and try to avoid significant physical or emotional exertion.
Stress can significantly increase the heart rate, and the oxygen demand and make things worse.

Find a sleeping position that is most comfortable and you don't experience as much shortness of breath. Sleeping in a semi-supine position may be helpful.