A respiration implant system includes a parasternal respiration sensor is configured for intramuscular placement into parasternal muscle of the implanted patient to develop a respiration signal representing respiration activity of the implanted patient. A movement sensor develops a patient movement signal representing movement of the implanted patient. A pacing processor receives the respiration signal from the respiration sensor and the movement signal from the movement sensor to generate a respiration pacing signal synchronized with the respiration activity of the implanted patient. A stimulating electrode delivers the respiration pacing signal from the pacing processor to respiration neural tissue of the implanted patient to promote the breathing effort of the implanted patient.