@bayarea58 I think most of the research on hypertonic saline was done in cystic fibrosis patients. It seems for them the recommendation is 2x daily if they can tolerate it and one time/day if they can’t.

I’m new to hypertonic saline since last month. I only have bronchiectasis without recent positive culture. My pulmonologist from Penn’s Bronchiectasis Ctr (I trust a lot) suggested I start hypertonic saline a few times per week to see if it helps me have a better winter. I have young grandkids and caught every bug they had last year.

My impression from this and other forums is that if people have a lot of mucus, they do airway clearance 2x/day. Mayo suggested airway clearance with albuterol, aerobika and postural drainage 2x/day and walking 30” to me when I was initially diagnosed (March 2023) with bronchiectasis and thought to have MAC. Note-hypertonic saline wasn’t mentioned. When those cultures were negative and I wasn’t producing sputum, the Mayo doc approved cutting the regime to daily.
When I finally got in to current pulmonologist in August, 2023, he agreed daily was OK and as I said, just last month suggested adding the hypertonic saline. I had stopped postural drainage due to reflux. If I start producing mucus. I’d increase to 2x/day because the studies I’ve found so far (brief searches) were on 2x/day , but done on CF patients.