you can inhale and exhale through it or you can just exhale through it. You wait a second after inhaling to exhale. Personally I only exhale through it because it is plastic. But you really can do it either way. I would experiment to see what actually works. I have to do about 16 exhales through it before expelling mucus. And i have to repeat that cycle many times till I feel all the mucus is cleared. Some of those rounds are done lying on my back and sides as well as sitting up. Everyone is different so see what works! I do all this after nebulizing all the saline but again see what works. I tried the Acapella and find the Aerobika more effective.

I started out similarly watching videoes online trying to figure things out. After asking my doctor. I received one-on-one help from a respiratory therapist (zoom meeting as my Dr is a long ways off) Asking for one or even more visits with respiratory therapist certainly helped me out.

I just had pt ed the pt Ed. She told me to breath in a bit deeper than normal, but exhale longer and with a bit more power than usual. She had me do both thru Aerobika, but it's the exhale that's important.
The instructions on p 3-4 in instruction booklet mirror what she told me.
Good luck.

I just had pt ed the pt Ed. She told me to breath in a bit deeper than normal, but exhale longer and with a bit more power than usual. She had me do both thru Aerobika, but it's the exhale that's important. The point about the plastic is good and I'll prob just start exhaling thru it, too.
The instructions on p 3-4 in instruction booklet mirror what she told me.
Good luck!