I had been using the Vest for years, and my pulmonologist thought I should switch to the Volara because I have osteoporosis. I used the Volara for about 9 months, but I was really uncomfortable with the cleaning protocol and wasn't ever convinced the device was getting clean enough. I decided to stop using it. This was before I was diagnosed with M Abcessus. After consulting with my osteopath, I went back to the vest and a regular nebulizer. I never noticed any difference between the two in terms of airway clearance.