Some thoughts after 10 months of nebbing saline

Posted by bronchiectasaurus @bronchiectasaurus, Mar 13 11:43am

This time last year I was well into the 2 months of hellish respiratory illness that led to my bronchiectasis diagnosis May 4. After that managing my lungs became my full-time job. I bought a lot of different nebulizers, eventually finding the expensive-but-definitely-worth-it Pari eRapid in August/September. I went from spending two hours a day on lung care to about 30 minutes. Since then I’ve been nebbing 7% saline once a day with the Pari eRapid, as well as masking indoors and avoiding exposure to communicable illnesses as much as possible.

This regimen (just saline, no other drugs) has worked so well I sometimes forget I have the condition, or how serious it is. Sometimes, on days I don’t go outside or don’t see anyone, I even skip a session. On Monday I was reminded why that is a bad idea.

It was warm, so I took a 100km bike ride. When I got home I was tired and decided to skip nebbing, because I hadn’t been exposed to another human. But I woke up in the middle of the night coughing. I dragged myself out of bed to huff saline then, and my nose started bleeding. (Nosebleeds were a big part of my respiratory illness; any other bronchies get those?) I stuffed my nose with a Nampon (if you get nosebleeds use Nampons, they work better than anything) and continued nebbing, spitting out blood not from my lungs but my sinuses. All this put The Fear in me, and brought me right back to April of last year when I was so sick I thought I’d never bike again. I nebbed a second saline vial for good measure, and coughed up a blob yellower-than-usual sputum. Then I exhaled several times into my Aerobika, which I hadn't used in months. Then I went back to bed.

I woke up breathing clearly and extremely grateful. I think about all those times in my life I fell ill, helplessly, when nebbing saline could have helped me so much. I wish I’d known about it years ago.

That incident reminded me that yes I have bronchiectasis, and yes it’s serious even if it’s currently well-managed. I re-committed to maintaining a strict daily nebbing schedule, not skipping, because things could go downhill fast. I love breathing clearly and understand how lucky I am to have found a regimen that works, and that I got diagnosed with BX before developing MAC/NTM. I caught up on this forum, which also reminds me what can happen if my BX gets worse.

Nebbing saline seems to have brought me other benefits. I can sleep on my back again. Before nebbing, I would usually awaken from that position gasping for breath: sleep apnea, I presume. I trained myself to sleep on my back and stomach, which is fine, but I noticed after several months of nebbing that sometimes I would drift off on my back…and wake up on my back, without gasping. I assume my air passages were always a little inflamed before, and nebbing has reduced that to the point my throat doesn’t close off as frequently.

Over the past 10 months friends have suffered their usual seasonal allergies, but I haven’t. Usually I have many weeks of terrible allergy symptoms, but since nebbing daily I’ve hardly noticed anything. Is the saline washing away allergens that would otherwise settle in my lungs and sinuses?

I have had zero nosebleeds this winter, except for the scary one Monday night. I assume nebbing saline has been reducing or preventing inflammation and clearing out irritants. As a frequent nose-bleeder, this is significant.

Thanks everyone for this forum. Reading bronchiectasis forums is how I learned about various nebulizers and found a way to manage my BX that works (there are no BX specialists where I live). This particular forum is my favorite, full of wisdom and sanity. Sending gratitude and best wishes to you all.

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

Sue, Volunteer Mentor | @sueinmn | Mar 26 9:56pm

In reply to @1fancydancear "Thanks. I have blue and green. Tend toward the green mostly. Maybe I will start taking..." + (show)

@1fancydancear Mucinex in the green box contains dextromethorphan, a cough suppressant as well as guaifenesin. It is definitely not intended for daily or long term use, but can be useful during flare-ups.
Mucinex in the blue box contains ONLY guaifenesin, which is safe for longer term use. (On the advice of my ENT and pulmonology docs, I have used it regularly for over 40 years, without adverse effects, to thin mucus and keep the fluid in my ears from getting thick and blocking my eustachian tubes.)

1fancydancear | @1fancydancear | Mar 27 9:44am

OK, that is very helpful. Blue box it is. Never been able to figure that out.

Thank you.

jnmy | @jnmy | Mar 27 10:07am

@bronchiectasaurus
It’s interesting to read about your experience. I recently found a 2026 journal research article that highlights a study that doesn’t show the direct benefit of nebbing saline for non cystic bronchiectasis.

Yet, your experience and that of others on this forum, suggests a positive correlation to improved lung function and less frequent infection. It seems that many people use hypertonic saline on this site.

Also, some pulmonary specialists do not recommend nebbing for all bronchiectasis patients. Is nebbing more common in the United States?

Article:
BMC Pulmonary Medicine Article
Hypertonic saline in non–cystic fibrosis bronchiectasis (Hyper-BRONCHI): an updated systematic review and meta-analysis

Systematic Review
Open access
Published: 12 February 2026
Volume 26, article number 122, (2026)

scoop | @scoop | Mar 27 10:46am

In reply to @jnmy "@bronchiectasaurus It’s interesting to read about your experience. I recently found a 2026 journal research article..." + (show)

@jnmy I've read these studies and quite frankly they leave me scratching my head. Life without nebbing 7% saline would be uncomfortable. The hypertonic saline makes getting the gunk out so easier for me than without.

jnmy | @jnmy | Mar 27 5:11pm

@scoop. Thanks for the response. I’ve read other journal articles as well.

Nebbing an amount of saline seems to really work for some people with Bronchiectasis. Most people use 3 or 7% from what I’ve read here.

Sue, Volunteer Mentor | @sueinmn | Mar 27 5:31pm

In reply to @jnmy "@bronchiectasaurus It’s interesting to read about your experience. I recently found a 2026 journal research article..." + (show)

@jnmy For curious minds, here is the link:
https://pmc.ncbi.nlm.nih.gov/articles/PMC12997658/
Now, let's address the substance for a minute - it reviewed 3 randomized clinical trials that had control groups and lasted for at least one year - just 356 individuals.

The conclusions were based on that minute sample. The conclusion was that more high-quality studies are needed to confirm their results.

This is just one person's experience, with stable bronchiectasis and managed asthma. Daily or more frequent 7% saline nabs are vital when I have a respiratory illness to keep it from complicating. But when I am healthy, I can manage airway clearance without it through exercise and breathing techniques. Your results may vary.

cwal | @cwal | Mar 28 6:03am

In reply to @1fancydancear "OK, that is very helpful. Blue box it is. Never been able to figure that out...." + (show)

@1fancydancear
It is always wise to read the list of ingredients on labels. There it plainly states what is in a product. If you don't know what something is ask the pharmacist or look it up.

pacathy | @pacathy | Mar 28 7:43am

Thank you for sharing the study!
I’m another convert for hypertonic saline. I have bronchiectasis, but thankfully, NTM cultures have been negative. I started it in Nov 2024 at the suggestion of my pulmonologist to try to reduce number of upper respiratory infections. It sure seemed to work and last Nov, I completed my first year in at least 20 with no bronchitis, sinus or ear infection. I had something going on this past Feb, but didn’t have to see doc. I’m also on a pretty aggressive sinus management plan, but had been on that for one winter before starting saline and was still sick a lot-the reason MD suggested the hypertonic saline.
I noticed the conclusions had low confidence and a recommendation for further studies. Studies have demonstrated its effectiveness in cystic fibrosis patients.

I wonder how Brinsupri will impact the studies that I think are happening now.

desertdwellerjh | @desertdwellerjh | Mar 28 9:18am

My source re 7% saline is my doctor who told me the nebbing attacks the biofilm surrounding organisms and apparently NTM doesn’t “like it” either so if you are taking eg the big three or in my case tobramycin, the med is more likely to kill the organism you’re after. I find it helps me cough up and out mucous, too. It’s not unusual for humidity here in the Southwest to drop to under 10%.

bronchiectasaurus | @bronchiectasaurus | Mar 28 1:44pm

I have "mild bilateral bronchiectasis" and no specialist in my medical system. My doctors would have said nothing about my bronchiectasis had I not pestered them; they were more concerned about the small nodules and granulomas in my lungs, because they DO have specialists to track those, but only as a cancer risk. (If I had a specialist I'd ask if I had "nodular bronchiectasis," since I fit the profile, but no one in my health system is experienced enough to tell me.)

A local friend who is a doctor is mentored by another doctor who has bronchiectasis and nebs saline, and he told me about that as soon as I mentioned what was on my CT scan. If I had relied solely on my own doctors they would have let me get infection after infection until I developed MAC/NTM and then put me on antibiotics.

I don't know if my current health is due to daily nebbing, or fastidious masking, or both. I do know that time I didn't neb after a big bike ride, I woke up coughing like I used to. That's only one data point but more than enough to keep me huffing the salt mist.

I have read many stories from others who didn't treat their mild bronchiectasis until they developed MAC/NTM, and I do not want that to happen to me. I've also watched webinars of bronchiectasis specialists (wishing I had one!) talking about hypertonic saline nebulization and sharing evidence of its efficacy as well as their own experience with patients. Many liken daily nebbing to brushing your teeth, emphasizing maintenance and prevention. So that's what I do! I like breathing.