Patient and Parent Support Supporting Therapies Breathing Support Duchenne affects muscles, including the muscles needed for breathing. People with Duchenne will eventually have trouble breathing (hypoventilation) as their lung muscles get weaker as they get older. People with Duchenne who are still walking should have a breathing test every year to measure forced vital capacity (FVC) and monitor lung function. Also, they it is important they receive flu vaccinations and all recommended childhood vaccinations. Chest infections should be treated aggressively and early with antibiotics and physiotherapy. If anaesthesia is needed it should not be inhaled and succinylcholine should never be given. Care needs to be taken also with administering oxygen. Once a person with Duchenne is in a wheelchair, breathing tests should be increased in frequency and undertaken before surgery and when unwell. As a teenager, it may be necessary to start using a BiPAP or CPAP machine (ventilator) to assist with breathing at night. Symptoms of nocturnal hyopoventilation include: fatigue, nightmares, headaches, poor concentration during the day, anxiety, disorientation, loss of appetite, softened voice and unproductive cough. Coughing may become difficult, limiting the ability to expel mucus from the lungs, which can lead to infection. Assistance with coughing may also be needed and cough assist machines are available for home use. As an older teenager or adult, an external ventilator may be needed to assist with breathing during the daytime.