How many hours a day is mask ventilation required?

Studies to date on the effectiveness of mask ventilation in ALS have shown that ventilation therapy has a positive effect when the mask is used for at least eight hours per day (24 hours). Ideally, the mask should be worn throughout the entire night’s sleep. Experience has shown that adhering to this ventilation duration is not always practical, resulting in a shorter ventilation duration. Even if the ventilation duration falls below eight hours per 24-hour period, a positive effect of the treatment can still be expected. There is likely a “dose-response” relationship: even a lower “dose” of ventilation has a therapeutic effect, although it is less pronounced compared to longer ventilation.

Another factor to consider when determining the duration of ventilation is the patient’s subjective experience of breathing difficulty. If respiratory distress (dyspnea) is present, mask use should be extended. To alleviate respiratory distress, mask ventilation can also be used during the day. There is no upper limit for mask ventilation.

In principle, mask ventilation could be used continuously if necessary to alleviate respiratory distress. However, for many patients, prolonged use of mask ventilation is associated with discomforts that prevent its long-term use.