As Duchenne muscular dystrophy (DMD) progresses, maintaining healthy lungs becomes a major challenge. Coughing is the body’s natural reflex to clear mucus and keep the airways open, but DMD can weaken the muscles that power a productive cough.
That’s where a cough assist device comes in. You may have heard this term used in clinics or support groups, but if you have any questions about how it works and why it’s used, here’s a breakdown.
Why people with DMD struggle to cough effectively
Coughing is much more than an annoying nuisance when you have a cold or flu. It’s an important defense mechanism that clears out mucus and phlegm, which, if not expelled, can impair breathing and get into your lungs where bacteria can collect and cause infections like pneumonia.
Learn more about DMD treatment and care
Over time, people with DMD lose the ability to cough effectively, as the muscles responsible for this action — namely the diaphragm and the muscles between the ribs — gradually deteriorate. This results in a weakened cough.
How a cough assist device works
A cough assist device is a machine that mimics a strong cough through air pressure. It works by pushing air into the lungs and then rapidly suctioning to pull air and mucus out.
Several companies make cough assist devices, so it’s important to follow the instructions of the one that’s recommended for your child. Most devices are non-invasive and use a control unit and a face mask or mouthpiece, though there are also machines with a tracheostomy adapter. Cough assist devices are portable and can be used at home.
Typically, these machines have three main functions: in breath, out breath and pause. The timing of the pause between breaths can usually be adjusted in the device’s settings. Your doctor will tell you how many sets of full in-and-out breaths should be completed at a time.
When is it time to start using a cough assist device?
Most children with DMD don’t need to use a cough assist device right away, but many will benefit from them with time.
Signs it may be time to consider a cough assist device include:
- Weaker cough
- Trouble clearing mucus
- More frequent respiratory infections
Your doctor will use pulmonary functioning tests to assess lung strength and determine the right time to introduce the device.
Making it part of your routine
How often you use a cough assist device will vary based on individual needs. Some families find that incorporating it into their daily routine helps avoid hospital visits and improves overall comfort. Others may reserve its use for colds, flu or periods of increased congestion.
Talk to your care team about creating a plan that’s right for your family.
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