Aerobika How Much Pressure

@picartist Tbere seems to be a lot of misinformation about PEP devices like Aerobika. The lever controls the frequency of the oscillation, not the amount of force required to operate the device.
According to my first pulmonologist's nurse, who was of more help than anyone else except my speech therapist, the oscillation is designed for different purposes. First, deep breathing patterns, with a hold and full exhale, gets the air deep in the lings, below the mucus. Then lower frequency (slower) oscillations open the larger airways, switch to higher frequency (faster) ones move the mucus from smaller airways so you can huff cough it out. Repeat the pattern a few times.
Forceful coughing and breathing are stressful to the airways, larynx, throat and maybe even lungs. This can actually make you feel worse, and/or increase the amount of mucus.

@sueinmn Let me see if I understand -- that during aerobika use it's helpful to change the oscillation settings from low and then to high?

@scoop That is what I was taught, but a lot of the time I can't tell any difference. Most of the time, moving is all I need to get the mucus out.

@sueinmn Sue, when everything seems under control during daytime and yet bad night coughing comes in at random during the night with very little or no mucus coming up, is caused by improper lung clearance during the day? I've read quite a few of your posts and I know you have had this problem too as does most people here. Last night, for example, I had about three episodes that kept me awake about two or three hours. I have tried cough syrup and it does not seem to stop them as well as honey and water. Until my last Aerobika session I was doing what my lung therapist told me and that was to inhale, hold my breath, then blow out as hard as I can. I bought a manometer and learned I was blowing extremely hard (emphasis added) and wondering if I have damaged something that will take time to calm down. Question is, what techniques have you used to calm down in the middle of the night and get back to sleep, if you can?

@picartist Sometimes when we have Bronchiectasis, we blame all our issues on this without considering other causes.
Here are the things that worked for me -
Elevating the head of my bed helped and using a sleep apnea device (a mouthpiece from a specialized dentist, not a CPAP.)
Using my allergy medications before bed rather than in the morning.
Using a HEPA air filter in the bedroom, to supplement the whole-house unit and the one in the living space.
We also did a quick scan of our room and realized we were no longer following the allergy precautions we learned years ago (described below.)

When our daughter was young, she NEVER slept through the night until we saw an allergist - we determined her nighttime issues were allergic in nature, and followed lengthy process to remove as many allergen-harboring materials from her room as possible. Here are a few - carpet, down comforters, stuffed animals, throw pillows, bedskirts, curtains... Instead we had a mattress encased in an allergy cover, washable comforter & pillows, easily wipeable window shades, and hardwood flooring. Everything was washed/dusted frequently with scent-free products, the 3 stuffed animals she was allowed were run through the dryer weekly to shake off dust, the bed was covered with a spread during the day and removed at night.

Combined, these have reduced my night time coughing to once or twice a week. If I do begin coughing, I immediately get up and drink sips of water and do deep, slow breathing until the spasms pass.

I was fortunate enough to visit National Jewish Health in August 2025 for one week of exams and education. The respiratory therapist introduced me to the manometer and explained that I should only blow out so that the gauge registers in the green zone only. I should not blow any harder than that. I was amazed at how hard I had been blowing on this thing before and how damaging it could be to the structures in my throat. I previously had been placed mistakenly on oxygen by local pulmonologist due to sob. However, I was diagnosed with vocal cord dysfunction & was removed from oxygen therapy and have had to learn diaphragmatic breathing with rescue techniques. I am much improved my energy & exercise tolerance. I have also learned there is no need to strain myself to clear my lungs - using aerobika with manometer correctly manages my lung clearance nicely.

@robot I just found out the same thing and love the Manometer. I found two of them online and putting them in my Aerobikas. My lung therapist was of the school to inhale and blow out as hard as I can and ended up with bad side muscle pains and hated doing it. I find now I get just as much if not more mucus up doing it mildly.