What We Know About the Acapella Vibratory PEP Mucous Clearance Device

Acapella(R) Choice

Smiths Medical

Henleys Medical Supplies in the United Kingdom has posted a thorough documentary on YouTube of the Acapella Choice, made by Smiths Medical. Henleys is the sole distributor in the United Kingdom for Smiths Medical's Acapella Choice PEP Mucus Clearance Device. The device can be purchased online as well.

How the Acapella Device Works

The Acapella is intended to open your airways and mobilize secretions. It's a hand-held device that uses positive expiratory pressure, known as PEP, and vibratory flutter to activate excess mucus so that it doesn't continue to build up and cause harm. Vibratory therapy gently loosens and disengages trapped mucus. Positive expiratory pressure (PEP) therapy creates a force that splits your airways open during exhalation and pushes air behind the mucus, pushing it through the small airways and into the larger airways.Once in the large airways, the secretions can be more easily coughed up.

Conditions That Cause Excess Secretions

Certain conditions cause excess secretions to gather in the airways and prevent important gasses from entering and exiting the lungs, including:

Patients with these conditions have difficulty getting secretions to move out of their airways. If left unchecked, this can lead to further serious conditions like an infection in the lungs, lung inflammation, and airway obstruction.

How to Use the Acapella Choice Device

To use the Acapella, you place the hand-held device in your mouth and inhale, thus allowing air to enter. When you breathe out, the valve closes, creating PEP. The vibrations caused by the device's internal "valve" activate when you breathe through it.

With a doctor's prescription, the Acapella unit can be attached to an asthmatic's bronchodilator device. The combination of these two devices may optimize delivery and accelerate the effects of the medication.


Benefits of using the Acapella device include:

  • You administer your own therapy, not needing a second person to help
  • Therapy can be performed anywhere, thus reducing hospital or clinic visits
  • It can be used at any time or in any position, for further convenience
  • The device is adjustable to each patient's needs
  • It's inexpensive
  • It's easy to operate and doesn't require electricity to use
  • It has a shorter treatment time than percussion therapies

Four Models

There are four models of the Acapella to choose from, including:

  • Acapella DH: Used in acute care settings for patients with near-normal expiratory capacity who are able to expire for 3 to 4 seconds.
  • Acapella DM: Used in acute care settings by adults and children with below-normal expiratory capacity who cannot exhale for 3 to 4 seconds.
  • Acapella Choice: Used in any setting, hospital, or home. It can be disassembled for cleaning and disinfecting and incorporates a numbered adjustable frequency dial.
  • Acapella Duet: Used in any setting, and can be disassembled for cleaning and disinfecting. Features a dedicated port for attaching a small volume nebulizer.

Since the Choice and Duet models are the two that can be used anywhere, these are the two that may be prescribed by a physician to take with you to home, work, and school.

Regarding the expiratory resistance frequency adjustment dial, this feature allows you to adjust the vibrations and resistance. This ensures maximal therapeutic results are achieved. The setting should be determined by your physician because it will affect the results you experience.

How to Use Acapella

Follow these steps to use the Acapella Choice device:

  • Wash your hands
  • Adjust the dial to the recommended setting
  • Place the mouthpiece in your mouth
  • Take a deep breath
  • Hold your breath for 2 to 3 seconds
  • Exhale actively, but not forcefully, through the device
  • Exhalation should last 3 to 4 seconds
  • Inhale through the mouthpiece
  • Repeat for 10 to 20 breaths as recommended by your healthcare provider
  • Perform 3 huff coughs (A huff cough is a short, quick, forced exhalation)
  • Repeat 10 to 20 breaths and 2 more huff coughs
Was this page helpful?

Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Franks LJ, Walsh JR, Hall K, Jacuinde G, Yerkovich S, Morris NR. Comparing the Performance Characteristics of Different Positive Expiratory Pressure Devices. Respir Care. 2019;64(4):434-444. doi:10.4187/respcare.06410