What is a positive expiratory pressure (PEP) device?

A positive expiratory pressure (PEP) device helps to loosen and remove mucus buildup in your lungs. It's a type of therapy that helps you clear your airways. There are different kinds of PEP devices.

When you exhale into the device, it creates resistance, or pressure, against your breath. This helps open the airways and loosen the mucus in your lungs so that it can move. This allows you to cough the mucus out. In some devices, the resistance against your breath creates a flutter or vibration in your airways that helps loosen the mucus.

Why is this device used?

This device is used to help clear mucus from your lungs. It may be used if you have certain conditions that affect the lungs, such as cystic fibrosis, bronchiectasis, or COPD. These conditions can cause mucus to build up in the lungs. This can lead to an infection or other problems.

Clearing mucus from your lungs may:

• Help prevent infections.
• Open your airways, which can help you breathe more easily.
• Lead to an improved quality of life.

How do you use it?

Your doctor, nurse, or respiratory therapist can show you how to use this device. They can tell you how often and how long to use it. They can also show you how to change the resistance setting for your device.

Be sure to follow the instructions that came with your device.

1. Sit comfortably.

   Make sure you have a tissue or spit cup nearby.

2. Position the mask or mouthpiece.

   If you're using a mask, put it over your mouth and nose. Be sure it fits tightly.

   If you're using a mouthpiece on the device, place your lips around it tightly.

3. Inhale.

   Take a breath that's larger than normal, but don't totally fill your lungs with air. It might help to pretend you're sucking a thick milkshake through a straw.

4. Hold your breath for 2 to 3 seconds.
5. Exhale.

   Breath out through the device more strongly than a normal breath, but not too strong. Keep your cheeks flat.

   • Your doctor or therapist can tell you how to exhale correctly, including how long and hard you should blow. This may be for about 5 to 10 seconds. You may blow about as hard as you would to blow out a candle.
   • If you're using a device that vibrates, you should feel a slight flutter or vibration as you exhale.
6. Repeat the deep breaths and blowing out.

   Do this for as many times as your doctor says. This may be 10 to 20 times.

7. Do "huff coughs".

   This is a forced breath—like a cough—that helps to move mucus up and out of your lungs. Your doctor can show you how to do this cough.

   • Take in a deep breath and hold it for 2 to 3 seconds.
   • Then breathe out through an open mouth with force (huff). It's much like breathing out to fog up a mirror.
   • If any mucus comes up, spit it out into a tissue or cup and throw it away.
8. Repeat these steps as often as your doctor says.

It's important to keep your device clean. To clean your device, follow the instructions that came with it. Clean it after each use.