▁of ▁age . ▁As ▁of ▁ 2 0 1 9 , ▁appro val s ▁in ▁the ▁EU ▁and ▁Japan ▁are ▁pending ▁while ▁an ▁intr at he cal ▁form ulation ▁for ▁older ▁people ▁is ▁in ▁development . ▁ ▁Bre ath ing ▁ ▁The ▁resp ir atory ▁system ▁is ▁the ▁most ▁common ▁system ▁to ▁be ▁affected ▁and ▁the ▁comp lications ▁are ▁the ▁leading ▁cause ▁of ▁death ▁in ▁S MA ▁types ▁ 0 / 1 ▁and ▁ 2 . ▁S MA ▁type ▁ 3 ▁can ▁have ▁similar ▁resp ir atory ▁problems , ▁but ▁it ▁is ▁more ▁rare . ▁The ▁comp lications ▁that ▁arise ▁due ▁to ▁weak ened ▁inter cost al ▁mus cles ▁because ▁of ▁the ▁lack ▁of ▁stim ulation ▁from ▁the ▁n erve . ▁The ▁dia ph rag m ▁is ▁less ▁affected ▁than ▁the ▁inter cost al ▁mus cles . ▁Once ▁weak ened , ▁the ▁mus cles ▁never ▁fully ▁recover ▁the ▁same ▁functional ▁capacity ▁to ▁help ▁in ▁breath ing ▁and ▁c ough ing ▁as ▁well ▁as ▁other ▁functions . ▁Therefore , ▁breath ing ▁is ▁more ▁difficult ▁and ▁pose ▁a ▁risk ▁of ▁not ▁getting ▁enough ▁o xygen / sh allow ▁breath ing ▁and ▁ins u fficient ▁clear ance ▁of ▁air way ▁secret ions . ▁These ▁issues ▁more ▁commonly ▁occurs ▁while ▁as leep , ▁when ▁mus cles ▁are ▁more ▁relax ed . ▁Sw allow ing ▁mus cles ▁in ▁the ▁ph ary nx ▁can ▁be ▁affected , ▁leading ▁to ▁asp iration ▁couple d ▁with ▁a ▁poor ▁c ough ing ▁mechanism ▁increases ▁the ▁lik elihood ▁of ▁in fection / p