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9 Mucus Clearing Techniques for COPD Patients

Jun 2, 2018 2:21:06 AM / by Cory Luckner


As a patient diagnosed with chronic obstructive pulmonary disease (COPD), you are faced with a variety of symptoms.

These range from shortness of breath, fatigue, loss of appetite, wheezing, chronic cough, chest tightness, and excessive mucus (phlegm) production to name a few.

You may not experience all of them but for a large portion of patients, they are faced with an excessive amount of airway blocking mucus production.

Excess and thick mucus (sputum, secretions, phlegm) in your lungs can lead to increased levels of shortness of breath (breathlessness) and higher chances of developing a disease worsening lung infection such as pneumonia.

However, airway secretions can be worsened by certain types of food or drinks, development of a cold or the flu, exposure to extreme weather conditions, COPD exacerbations (flare ups), or even certain types of medications that are used to treat COPD and its related symptoms.

But that doesn't mean you have to put up with worsening lung congestion due to excess mucus production.

When experiencing thick airway secretions, use these 9 mucus clearing techniques to improve the severity of your COPD related breathlessness.

How to Clear COPD Related Mucus Secretions for Improved Breathing

Deep (Controlled) Coughing Technique

Rather than clearing your throat or using a hacking cough, deep coughing requires less energy and is much more effective in clearing mucus from your lungs and throat.

The deep coughing technique uses the power of your stomach muscles to expel air and thus removing thick and sticky mucus.

Deep coughing is a must know airway clearance technique for patients with COPD as apart of their breathing treatment.

  • Step 1: Sit down in a chair or on the edge of your bed with your feet firmly planted on the ground; lean forward slightly.

  • Step 2: Cross your arms across your abdomen, then use diaphragmatic breathing to take a slow deep breath through your nose and hold it for 2-3 seconds.

  • Step 3: Press your arms up against your stomach and use the strength of your stomach (abdomen) muscles to push out the air, then deep cough 2-3 times.

  • Step 4: Make sure to exhale using pursed lips.

  • Step 5: Repeat until mucus is cleared from your airways. 


Huff Coughing Technique

Instead of a single cough, the huff coughing technique contains several "mini" and low pressure coughs.

Huff coughing can be used instead of deep coughing if you are having troubles clearing your airways of thick mucus. Follow the steps below to properly perform the huff coughing technique:

  • Step 1: Push out the stale air from your lungs by slowing your breathing and gently prolong exhalation over 3 to 4 breaths.

  • Step 2: Inhale slowly and take a slightly deeper breath than normal.

  • Step 3: Open up your airway and use your stomach muscles to cause a series of 3 rapid exhalations. While doing so, make a "hu, hu, hu" sound. Control your breathing using your diaphragm.

  • Step 4: Repeat the huff coughing technique by taking a smaller breath.

  • Step 5: Again, repeat the huff coughing technique for a third time with a smaller partial breath.

  • Step 6: Take a full breath of air deep into your lungs using controlled diaphragmatic breathing; Use a deep cough when you feel mucus breaking apart and moving up your airways.

Chest Physiotherapy (CPT) Techniques

This mucus clearing technique is most effective with the help of a caregiver or respiratory therapist.

Chest physiotherapy, also known as chest physical therapy (CPT), involves gently and firmly clapping on your chest and/or back with the percussion technique using a cupped hand (see image below), which will loosen up thick mucus secretions in your air passages.

Allowing you to more easily expel or cough up the mucus. Chest physical therapy can be done with a cupped hand (percussion), shaking, or vibration techniques.

chest-pysiotherapy-hand-position.jpg   Vibration-Technique-Chest-Physiotherapy.png

How to Perform Manual Chest Percussions:

  • Screen_Shot_2016-03-01_at_12.49.22_PM.pngStep 1: Position yourself halfway between sitting up and laying flat on a chair or bed. Place a pillow behind your back for support and comfort. (See Image)
  • Step 2: Your caregiver or therapist should percuss (clap) between your nipple and collarbone on the left side of your chest. Do this for 2 to 3 minutes.

  • Step 3: Repeat step 2, except on the right side of your chest.

How to Perform Manual Back Percussions:

  • Step 1: Lean forward slightly on a chair or bed so you are halfway between sitting up and laying flat. Place a pillow in front of your chest and wrap your arms around it. (See image below)

  • Step 2: Have your caregiver/therapist percuss (clap) gently directly over your left shoulder blade with a cupped hand. Doing so for 2 to 3 minutes.

  • Step 3: Switch to the right side and repeat step 2 for 2 to 3 minutes.


Postural Drainage

postural-drainage-positions.jpgThe postural drainage technique is often paired with chest physiotherapy and harnesses the power of gravity to assist in removing phlegm from your lungs and airways.

Even better is the fact that this mucus clearing technique can be done yourself, by a caregiver, friend or family member.

There are at least 10 different postural drainage positions, all of which are specifically designed to promote the drainage of mucus from different parts of your lungs.

While in each of the varying postural drainage positions, either a family member or a caregiver should use their hand to form a cup and clap gently and rhythmically on your back or chest (depending on the position).

When done right, you should hear a hollow sound when your caregiver claps, however, if you hear a slapping sound their hand is not cupped enough.

Expectorants (Mucus Medicine)

You have probably seen or even used these types of medications before. If not, expectorants are a type of cough medicine that are specifically intended to help loosen the mucus in your lungs.

Allowing you to cough up secretions from your lungs with greater ease and effectiveness. Expectorants are available over the counter or by prescription.

Expectorants Include:

  • Mucinex
  • Guaifenesin (Generic Form of Mucinex)
  • Robitussin

Are you currently using over-the-counter or prescribed mucus medicines but not getting the results you desire? Try these 5 natural expectorants and learn how to remove mucus from your lungs naturally.

Airway Clearance Devices

Positive Expiratory Pressure (PEP) Therapy

Developed as an alternative to chest physiotherapy (CPT), positive expiratory pressure (PEP) therapy requires you to inhale normally and then exhale slowly into a mouthpiece or face mask against slight resistance.

By doing this the PEP device allows additional air to flow into the smaller air passages. Creating pressure that builds up behind thick and sticky mucus secretions, forcing them towards larger air passages so they can be more easily expelled.

PEP Devices Include:

  • Astra PEP Mask
  • AeroPEP
  • Pari PEP

How to Use a Positive Expiratory Pressure Device

  • Step 1: Place the mouthpiece in your mouth and seal your lips around it.

  • Step 2: Use your diaphragm to take a deep breath.

  • Step 3: Using moderate force, exhale slowly through the valve for as long as possible. The increased pressure in the airways from the device will give you a coughing feeling.

  • Step 4: Once you have a feeling to cough, inhale with a deep breath and hold it for 1-3 seconds, then cough to break up and loosen the mucus. 

High Frequency Chest Wall Oscillation (HFCWO)

Continuing on the topic of airway clearing devices, HFCWO is performed with an inflatable vest that providesThe-Vest-Airway-Clearance-System_.jpg gentle oscillation against the chest wall by applying positive pressure air pulses. Resulting in increased airflow, improved mucus clearing ability, and a greater cough clearing ability.

HFCWO Devices Include:

Flutter Mucus Clearance System

The Flutter mucus clearing device uses a combination of PEP therapy with high-frequency oscillations. By featuring a controlled vibration system, the Flutter mucus clearing device is able to gently osscilate both the small and large airways during exhalation. Causing mucus to be thinned, boosting airflow, and enhancing your ability to expel mucus and clear your lungs. 

flutter-mucus-clearing-device.png*Flutter Valve Mucus Clearing Device

Similar Mucus Clearing Devices Include: 

Whether you opt to use the Flutter valve, Acapella device, or the Cornet as your flutter valve device for breathing treatment. All 3 are portable, hand-held, and easy to use mucus clearance devices that are extremely effective in dislodging thick mucus secretions so you can more easily cough up airway blocking mucus.

Lung Flute Acoustic Impedance Device


The Lung Flute device is like a PEP device in the instance of having you vigorously exhale through a mouthpiece into a reed, causing a vibration that generates low frequency sound waves.

The acoustic vibrations produced by the movement of the reed inside the Lung Flute travel down into your lower airways to help loosen and stimulate mucus clearance. Additionally, the Lung Flute will help reduce the amount of air trapped in your airways, keep airways open, and even enhance the delivery your bronchodilator medication. The Lung Flute will enhance the quality and effectiveness of your overall breathing treatment.

How to Use the Lung Flute 


  • Step 1: Grab a chair and find a relaxed position, be sure to sit up straight so your back is not touching the back of the chair.

  • Step 2: Tilt your head in a slightly downward position, allowing your windpipe and throat to be wide open. This will allow the low frequency sound waves that are produced from you exhaling into the Lung Flute to easily travel deep into your lungs.

  • Step 3: Hold the Lung Flute in a slightly downward position, while sealing your lips around the mouthpiece.

  • Step 4: Begin inhaling, slightly deeper than normal.

  • Step 5: Blow into the Lung Flute, just as if you were blowing out a candle. When using correctly you will hear the reed inside the Lung Flute make a fluttering sound.

  • Step 6: Remove the mouthpiece and quickly inhale, then place the Lung Flute back into your mouth and exhale through the mouthpiece.

  • Step 7: Take the mouthpiece out of your mouth and wait 5 seconds, while taking several normal breaths. Repeat steps 2-7 as needed.

As you begin to adapt to using the Lung Flute, you should eventually aim to complete up to 20 sets with 2 blows each (depending on the severity of secretions). Once you are able to complete an adequate number of 2-breath cycles, wait for 5 minutes after your sessions to bring up mucus secretions using the huff coughing technique.

The Importance of Understanding Mucus Color

You should always make it a top priority to regularly examine the color of your sputum (mucus), as the color of your mucus is an important indicator of how your COPD is affecting you. Typically, the color of mucus is either clear or gray. But when diagnosed with COPD, you may have a chronic cough that expels thick yellow mucus.

Contrary to common belief, green or yellow colored mucus doesn't necessarily mean an infection is present.

Instead, many patients with COPD cough up green or yellow mucus due to the mucus sitting in their bronchial tubes for an extended period.

Discolored phlegm can also be caused in patients with COPD due to an exacerbation of symptoms (flare up), or white blood cells from allergens moving into their bronchial tubes.

If you are coughing up blood, which is commonly caused by an infection such as pneumonia, this can also be a sign of more serious health problems such as tuberculosis or cancer. You should get evaluated by your physician or health care professional if you are coughing up bloody mucus.

Additional Mucus Clearing Tips

  • Stay Hydrated: Help reduce the thickness and stickiness of mucus by staying hydrated throughout the day. Ensuring you are well-hydrated will help to liquefy excess mucus and thus making it easier to cough up and expel from your airways. Aim to drink six to eight 8 ounce glasses of water per day, unless instructed otherwise by your physician.

    Additionally, you should stay clear of sugary beverages such as soda or fruit drinks, and caffeinated beverages, as they are known to increase mucus in the lungs and throat. While also being mindful of how dairy products such as milk impact mucus production.

  • Control Your Breathing: By this we mean that you should avoid taking quick, deep breaths after coughing. When breathing like this it may interfere with further mucus clearance.

  • Use a Bronchodilator Inhaler: As you are already well aware, clearing mucus is extremely difficult when your airways are constricted. By using a bronchodilator inhaler before performing one of the above coughing techniques, your airways will become relaxed to make coughing and mucus clearance more effective.


Excess mucus production is a common symptom when diagnosed with chronic obstructive pulmonary disease (COPD). Which often leads to increased levels of shortness of breath and leaving you more susceptible to the development of symptom worsening infections like pneumonia.

But now that you are equipped with 9 mucus clearing techniques that will improve your COPD related breathlessness, you can minimize your chances of developing a lung infection and improve the overall quality of your life with COPD. Give all 9 mucus clearing techniques a try to find the most effective option for you.

Which single technique or combination of mucus clearing techniques do you use to clear thick and sticky phlegm from your COPD ridden lungs? Let us know by leaving a comment below.

Click the button below to download your very own Mucus Clearing Techniques Checklist that you can refer to when experiencing increased mucus production that worsens the severity of your shortness of breath with COPD. 


Cory Luckner

Written by Cory Luckner

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