In their recently published paper Simondset al 1 importantly emphasised the desirability of using non-invasive intermittent positive pressure ventilation (IPPV) rather than tracheostomy for optimising quality of life in patients with hypercapnic Duchenne muscular dystrophy, and suggested that the use of nocturnal nasal IPPV can help to prolong survival. They also noted that five of the 23 patients treated in this manner died from respiratory failure two years after beginning nocturnal nasal IPPV, and that most subsequent “admissions were for treatment of chest infections”. In reality, nocturnal nasal IPPV is only likely to prolong the lives of …