Using Huff Cough with Airway Clearance

Woman feeling her throat muscles as she begins huff coughing after airway clearance therapy.

Huff cough” is a popular coughing exercise that works to remove phlegm from the airways. This technique is typically performed in combination with airway clearance therapy to help loosen the mucus, so it becomes easier to cough out. In fact, all forms of airway clearance rely on good coughs to prevent mucus buildup [1].

However, if a patient is living with a chronic lung condition, coughing may start to become less effective at clearing mucus independently. 

Bronchiectasis, for example, causes a patient’s airways to become abnormally widened. Therefore, it becomes harder for the lungs to mobilize and break up mucus. Though a patient may still experience a persistent cough, which is a common symptom of this condition, the cough may become uncontrolled [2], thus lacking the ability to properly loosen mucus and clear it from the airways. 

The result is mucus buildup which leads to respiratory infection. 

Why Is Huff Coughing Different?

Huff cough differs from regular coughing since it incorporates deep breathing with slow, controlled movements of air in and out of the lungs. The technique works to help strengthen coughs [3] and prevent patients from feeling any discomfort or fatigue. 

How to Huff

Huff cough can be performed either during or after airway clearance therapy. 

Your patients will sit up straight in a chair, with their chin tilted slightly upward. Next, patients will inhale a slow, deep breath of air through the nose, filling the lungs with about 3 quarters worth of air [4].

After holding the breath for 3 seconds, patients will begin to pull their abdomen inward and exhale the air slowly but forcefully in 3 equal breaths. 

Have your patients think of breathing on a pair of reading glasses to create fog. Often, people will naturally make a “huff” sound from the back of their throat [5]. This is the type of breath they’ll want to achieve.

Graphic icons to show steps of huff coughing at home.

Following the 3 equal breaths, your patient can begin the process over again. They will inhale deeply through the nose, hold for 3, and out through the mouth in 3 equal huffs. This technique should be repeated at least 2-3 times and performed in tandem with their daily airway clearance therapy [6].

SmartVest user putting respiratory vest on before starting therapy.

Using Huff Cough with SmartVest

Similarly to how airway clearance therapy relies on effective coughing exercises to move phlegm up and out of the airways, techniques like huff cough depend on airway clearance devices that actively work to thin and loosen mucus, so phlegm becomes easier to move and cough up.

That’s where SmartVest makes all the difference.

Providing patients with complete 360° coverage, our high frequency chest wall oscillation (HFCWO) therapy device delivers repeated pulses of air that gently squeeze and release the upper chest wall. By creating a natural oscillation of air, SmartVest helps loosen, thin, and propel mucus upward into the large airways, where it can be coughed out more easily.

In addition to providing patients with complete chest wall coverage to break up mucus, SmartVest is designed to release 91% of its air between compressions, creating more BREATHING ROOM™ and comfort for patients [7]. And once a SmartVest is prescribed, one of our Registered Respiratory Therapists will schedule an in-person training session with your patients to ensure they feel comfortable using SmartVest at home, independently. 

By pairing huff cough with The SmartVest Airway Clearance System, your patients will have a proactive defense against the onset of respiratory infections that could cause a worsening of symptoms that require hospitalization [8]. 

Learn more about how SmartVest can support your patients and allow them to take a proactive role in their airway clearance therapy. To start prescribing SmartVest now, we offer easy access to GoScripts to send your prescriptions electronically, in addition to reimbursement support to ensure your patients can start experiencing the benefits of airway clearance right away!Request a Patient Packet


[1] American Thoracic Society. “Treating Bronchiectasis.” Retrieved from

[2] American Lung Association. “Understanding Mucus in Your Lungs.” Retrieved from

[3] American Thoracic Society. “Treating Bronchiectasis.” Retrieved from

[4] Cystic Fibrosis Foundation. “Coughing and Huffing.” Retrieved from

[5] American Thoracic Society. “Treating Bronchiectasis.” Retrieved from

[6] American Thoracic Society. “Treating Bronchiectasis.” Retrieved from

[7] Pokorney J. Comparison of Oscillatory Trough Pressure Generated by High Frequency Chest Wall Oscillation (HFCWO) Systems: A White Paper.

[8] Powner, J, et al. Employment of Algorithms of Care Including Chest Physiotherapy Results in Reduced Hospitalizations and Stability of Lung Function in Bronchiectasis. BMC Pulmonary Medicine, BioMed Central. 25 Apr. 2019.