You can use your Aerobika and nebulizer together in one session by attaching the nebulizer directly to the Aerobika’s built-in port, letting you inhale your medication and perform airway clearance at the same time. This combination saves time and may help medication reach deeper into your airways. A typical session takes 20 to 30 minutes.
Why Combining Them Helps
The Aerobika is an oscillating positive expiratory pressure (OPEP) device. When you breathe out through it, a mechanism inside creates rapid pulses of back-pressure in your airways. These pulses do two things: they hold your airways open with gentle pressure, and they create vibrations that loosen mucus stuck to your airway walls. The loosened mucus gradually moves from the smaller airways toward the larger ones, where you can cough it out.
When you add a nebulizer to the setup, the aerosolized medication enters your lungs on each inhale while the Aerobika does its work on each exhale. Because the device is actively opening airways and thinning mucus during the session, the medication can potentially penetrate further than it would with a nebulizer alone. You also cut down on total treatment time since you’re not doing two separate sessions back to back.
How to Connect the Nebulizer
The Aerobika has a dedicated nebulizer port with a standard 22 mm adapter, which fits most small volume nebulizers. Here’s how to set it up:
- Add your prescribed medication or hypertonic saline to the nebulizer cup as you normally would.
- Remove the mouthpiece (or mask) from the nebulizer. You won’t need it because you’ll breathe through the Aerobika’s own mouthpiece instead.
- Attach the nebulizer cup to the nebulizer port on the Aerobika device. It should click or fit snugly into the adapter.
- Connect the nebulizer tubing to your compressed air source or compressor.
- Turn on the compressor, confirm you see a mist forming, and begin your breathing session.
If the nebulizer doesn’t seat firmly in the port, check that you’re using a cup with a 22 mm connection. Most standard small volume nebulizers are compatible, but some newer designs differ.
The Breathing Technique
The breathing pattern is the same whether or not a nebulizer is attached. Place the Aerobika mouthpiece in your mouth and seal your lips around it.
Inhale slowly through the device, taking in a slightly larger breath than normal. Hold that breath for two to three seconds. Then breathe out through the device more strongly than usual, but not so hard that you feel dizzy. Don’t puff your cheeks. You should feel the device vibrate in your hands and hear a fluttering sound. Keep exhaling steadily until the flutter stops.
Repeat this inhale-hold-exhale cycle 10 to 20 times. Resist the urge to cough during these breaths. After those 10 to 20 cycles, remove the mouthpiece from your mouth and do 2 to 3 “huff coughs.” A huff cough is like fogging up a mirror with your mouth open: a sharp, forceful exhale from deep in your chest. This pushes loosened mucus up and out. Spit out whatever comes up, then go back to the breathing cycles. Continue this pattern for 20 to 30 minutes or until your nebulizer runs dry.
Resistance Settings
The Aerobika has an adjustable dial that controls how much resistance you feel when you exhale. If you’re just starting out, set the resistance low and increase it gradually over several sessions as you get comfortable. The right setting is one where you can feel a clear vibration and hear the flutter on every exhale without straining or feeling lightheaded. Your respiratory therapist or physiotherapist can help you find the setting that works best for your lung function.
Cleaning and Disinfecting
The device comes apart into four pieces, and all of them need regular cleaning to prevent bacteria from building up in a warm, moist environment.
Routine Cleaning
After each use, disassemble the four parts and soak them in warm soapy water for 15 minutes, gently agitating them. Rinse with warm distilled water, shake off excess moisture, and let everything air dry completely before reassembling. You can also place the disassembled parts in a basket on the top rack of your dishwasher and run a normal cycle with detergent and rinse aid. Avoid washing them alongside heavily soiled dishes.
Disinfecting
Periodic disinfection goes a step further than soap and water. You have several options:
- Boiling: Place the four parts in distilled water that has reached a rolling boil and let them boil for 10 minutes. Put a small cloth or rack at the bottom of the pot so the plastic doesn’t touch the hot surface directly.
- Steam sterilizer: Use an electronic steam sterilizer designed for baby bottles, running a cycle of about 15 minutes.
- Microwave steam bag: Place the parts in a microwave steam cleaning bag with distilled water and follow the bag’s instructions.
- Isopropyl alcohol: Soak the parts in 70% isopropyl alcohol for 5 minutes, then rinse thoroughly with distilled water.
Whichever method you choose, always let every part cool and air dry completely before putting the device back together. Trapped moisture encourages bacterial growth, which defeats the purpose.
When to Replace the Device
The Aerobika should be replaced every 12 months, or immediately if any part cracks, warps, or no longer fits together properly. Over time, the internal mechanism can wear down and produce weaker oscillations, which reduces effectiveness even if the device looks fine. Your nebulizer cup and tubing have their own replacement schedules, so check with your equipment supplier on those separately.
Who Should Not Use It
OPEP devices are not safe for everyone. You should not use the Aerobika if you have an untreated collapsed lung (pneumothorax), are coughing up blood, have acute heart failure, or have had recent surgery on your face, mouth, skull, or esophagus. Other conditions that rule it out include severe tuberculosis, a ruptured eardrum or middle ear problems, acute sinusitis, active nosebleeds, raised intracranial pressure, and hemodynamic instability. People in the middle of an acute asthma attack or severe COPD flare may not tolerate the added work of breathing the device requires.