Hello n4seth, You said "silent aspiration", did you mean "silent reflux" ? It is my understanding silent aspiration happens during the act of eating either solid or liquid foods, and can certainly be an underlying cause of MAC/Bronchiectasis. Silent reflux aka laryngopharyngeal reflux or LPR, can happen while upright but tends to cause greater symptoms if refluxing while lying down/sleeping. You are already not eating before bed and using wedges, you might also add other lifestyle changes such as weight loss if needed, a healthier diet with less fat, acidic foods and alcohol. Reflux (acidic or non-acidic) that gets in your airways is a known pre-disposing factor for MAC/Bronchiectasis also. Another point that is not well known is drugs such as Prilosec do a good job in reducing acidity in your reflux but does nothing for non-acidic reflux (such as Pepsin, bile acids etc), it actually does not deduce the total amount of reflux that could cause problems in your lungs. Please read this excellent video from National Jewish Health that explains all of this in detail. https://www.youtube.com/watch?v=BZwM3fsTIIY&feature=youtu.be