timing of doing nebulizer and ACT protocols before mucus relief starts

@doberdoo There is truly nothing "typical" about the &%$#@* disease - every one of us is defferent and needs to find what works for us. I had a problem with this after my infection got under control - only my coughing started around 2am - how annoying.
Than I heard Dr Pamela McShane say exercise was a great airway clearance tool. It was during Covid, when all the gyms were closed, so I started doing a brisk walk after my saline neb - it worked - after about 15 minutes, the coughing would start and the junk was coming up. I carried tissues and paper towels to catch it all. When I got home, if my lungs still felt "juicy" I would do some more clearance with the Aerobika. Since then, I also found 30 minutes of yoga has the same effect for me.
Have you tried anything like this? And maybe if a morning walk doesn't do it, try one after dinner too?

I too have had VERY similar issues and I nebulize levalbuterol followed by 7% saline also. I started doing some of my ACT intermittently while doing the 7%. I also found that drinking a sip of water before each Areobika session helped thin and loosen the mucus. My mucus seems to be in layers though I know this sounds strange, but I’ll get through a portion that I expell quite a bit, then right back to hard to expell, and it’s back & forth like that for me. My a.m and p.m sessions take about an hour each time. I was told by a respiratory therapist and a Mayo Dr. that if the worst of your Bronchiectasis is in the lower lobes of your lungs, it MAY act like that. My mucus though usually starts coming up on its own after ACT in about 2-3 hrs. Not 5-6 as you describe.

@doberdo So sorry to hear what does happen for you and the frustration that comes with it.
Yes it is so important to do our therapy at least two times a day to help clear the lungs.
Referring back to what we will always here and is so true, we are all different. For me I do a bit of aerobic exercise, walking, postural drainage every time I do the other therapy measures we know to do. If you do not have a vibrating vest are you able to do percussion clapping on your lungs, front and back. For me I am finally, after months, truly seeing what I want and need to see come up.
It is good that you bring up and clear, it's just not the most convenient timing.
For me I noticed that recently I am now getting more pure mucus and mucus plugs up in the morning after nearly a year of doing all I do for my BE/MAI, the therapy. I also am doing better about getting it all up and out in the late afternoon. I think it truly has to do with all the therapy techniques plus getting enough moisture and making it "juicy" into our lungs which the neb is suppose to help with, plus lots of healthy liquids. You may be doing all this and why you have to clear as you do.
Do you clear all into a clear cup to see what it is that you are bringing up. One can distinguish better what one is bringing up by clearing it into a cup such as a clear solo cup. That helps me with encouragement when I know what I am bringing up and out. I use a bottle brush for cleaning the solo cup with dish detergent, to be conservative in light of all we know.
You are highly concerned, rightly so, about the sleep aspect. I also have that problem of needing to clear my throat before and through the night, awaking to do so. It has caused me to stay in bed longer than I would like to because it sure limits what one can do during our awaking hours but sleep is so important. If you are still working sleeping longer in the mornings is hard to do.
Hoping you see a change that isn't as frustrating for you. The good thing is you are bringing up sputum.
Barbara

I wonder if this might help, a change of position, *but of course check with your doctors first, Is it possible you could try a different position like laying down earlier in the day after your nebs? My worst area is my right lower lobe, so, Dr. Pamela McShane (very well known for NTM) instructed me to do the following: Lie in bed with head somewhat up due to my GERD, on my left side almost on my stomach. Reach right arm over my head, then do the "Active cycle of breathing". It is in her talks on you tube. active cycle of breathing techniques (ACBT) in gravity-assisted drainage positions. Research you tube for her link on ACBT. Best of luck !