I don't use albuterol or levalbuterol nebs before saline nebs. But I do have a daily long-acting inhaler which I use faithfully morning and evening. My pulmonologist also recommends using it 15 minutes before nebulizing saline/airway clearance if my chest fells tight. I have asthma as well as mild-moderate bronchiectasis.

@kwi raises a good point - for many of us, the problem isn't getting sir in, it is that our damaged airways don't effectively push air out. I have learned over time that I need to consciously exhale fully because my lungs no longer do it naturally - pursed lip breathing helps me do that.

What is your current airway clearance routine?
Sue