Pulmonary Hygiene for Respiratory Disease

Why you might want to consider trying this approach

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Deep breathing, lung exercises, and tapping on the chest are a few of the techniques that fall under what's known as pulmonary hygiene. These strategies are used in people with chronic conditions like chronic obstructive pulmonary disease (COPD), cystic fibrosis, and bronchiectasis to help remove mucus build-up from blocking the lungs.

There is inconclusive evidence about the benefits of pulmonary hygiene, but many people feel an improvement in symptoms with this treatment. Pulmonary hygiene may be particularly useful when such illnesses are complicated by infections, such as pneumonia, which increase mucous secretions.

You may have portions of your treatment performed by a physical therapist or a respiratory therapist. You can also learn how to perform some pulmonary hygiene methods at home, though you may need assistance from family members or other caregivers in some cases.

Also Known As

Pulmonary hygiene is also sometimes called bronchopulmonary hygiene or pulmonary toilet.

Pulmonary Hygiene Methods

There are several facets of pulmonary hygiene. They all entail the use of physical manipulation techniques to help you cough up sticky mucus. You and your therapist may use any combination of techniques during a pulmonary hygiene session.

Controlled Coughing

Controlled coughing is one of the most effective means of airway clearance in lung disease. Your therapist or nurse can show you the proper way to sit and how to cough to make it productive.

Deep Breathing

Deep breathing is as simple as it sounds: You breathe in deeply and then attempt to cough up mucus and secretions. A physical therapist should be able to instruct you in the most effective breathing techniques for your condition.

Incentive Spirometry

An incentive spirometer is a medical device that you can use to exercise your lungs. As you blow into the device, it measures how much air you are breathing out. This measurement can be used as a benchmark for you to exercise your lungs.

Chest Percussion

If you will have chest percussion, your therapist will tap on your chest repeatedly or do so with a mechanical device. The resulting vibration may help break up thick mucus that is trapped in your lungs so that you can expel it more easily.

Chest Vest

Chest vests, also called high-frequency chest wall oscillation (HFCWO) devices, are worn to help loosen mucus and clear the airway. The vest vibrates and is either plugged in or run on a battery. Coughing is done throughout the session and afterward to expel mucus.

Postural Drainage

This method uses your body's position (with assistance from gravity) to help drain the mucus out of your lungs. Your physical therapist or respiratory therapist will tell you exactly how to position yourself for this procedure. Postural drainage is often performed along with chest percussion, which breaks up mucus in the lungs.


While this type of therapy has been used for many years, experts have not been able to definitively verify its long-term benefits. Pulmonary hygiene is believed to help prevent atelectasis, a harmful effect of lung disease in which the alveoli (tiny air sacs in your lungs) collapse, making it difficult to breathe.

If you've been hospitalized with COPD, it's possible that pulmonary hygiene can help lessen your need for a mechanical respirator, and it may also reduce the length of your hospital stay. However, it doesn't appear to reduce the number of COPD exacerbations, nor does it reduce the number of COPD-related hospitalizations.

Pulmonary hygiene is only one of several ways of preventing atelectasis. Other physical methods and prescription medications can help as well.

You can also use pulmonary hygiene techniques along with other methods of clearing your lungs.

Alternatives to Pulmonary Hygiene

Pulmonary hygiene techniques are considered safe, and many people who have lung disease feel a sense of improvement with this therapeutic approach. Yet, you may feel that pulmonary hygiene is inadequate for managing your symptoms, or you might find it inconvenient or physically uncomfortable.

In addition to or instead of pulmonary hygiene, there are other methods that can be used to decrease or thin your respiratory mucus. Speak to your healthcare provider about:

  • Expectorants: Expectorants are medications that are used to thin and loosen airway mucus. These medications may actually make you cough more. In this case, that's a good thing, as these drugs are intended to make your cough more productive.
  • Mucolytics: Mucolytic medications are used to thin thick lung secretions. These medications may reduce the frequency of respiratory exacerbations.

A Word From Verywell

It can be difficult to predict whether this approach will be right for you unless you try it. Overall, the most effective management of respiratory disease includes a wide range of approaches—ranging from medications to lifestyle changes.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Jelic S, Cunningham JA, Factor P. Clinical review: airway hygiene in the intensive care unit. Crit Care. 2008;12(2):209. doi:10.1186/cc6830

  2. Kumara P, Yimam W, B A, Getachew Y, A S. Practice on pulmonary hygiene and associated factors among health professionals working in two government hospitals at Amhara, EthiopiaInternational Journal of Medical and Health Research. 2017;3(10):40-43.

  3. Leemans G, Belmans D, Van Holsbeke C, et al. The effectiveness of a mobile high-frequency chest wall oscillation (HFCWO) device for airway clearancePediatr Pulmonol. 2020;55(8):1984-1992. doi:10.1002/ppul.24784

  4. Aaron SD. Mucolytics for COPD: negotiating a slippery slope towards proof of efficacy. Eur Respir J. 2017;50(4). doi:10.1183/13993003.01465-2017

Additional Reading

By Deborah Leader, RN
 Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD.