I do not and have not used a vest. My docs (pulmonologist & primary) said I am not a candidate due to arthritis and my small size. I find even a vibrating massage chair at the nail salon to be painful.
Sue

I do saline first then smart vest. You can do them at the same time but I find that overwhelming!

I use the vest and nebulize at the same time. I’m usually finished with the saline before the vest time (20 minutes) is finished. It’s nice to be able to do them at the same time unless you are too sensitive to use both together.

I do both at the same time twice a day. If I'm in a flare, I use them three times a day. The neb is usually finished before the vest. After the vest, I use an Acapella to help with the coughing. Hope this is helpful.