Skip to main content


Positive Expiratory Pressure (PEP) therapy


Taking deep breaths will fill your lungs with air and help exercise your lungs. Filling your lungs with air is done by breathing in slowly and deeply. We call this inhalation (in heh LAY shun). It helps open the air sacs in your lungs and helps prevent future problems. Blowing out air from your lungs is called exhalation (eks heh LAY shun). It helps to rid the body of a gas called carbon dioxide.

A positive expiratory pressure (PEP) breathing device (such as the Acapella®) uses inhalation and exhalation to keep your lungs healthy. Also, when blowing the air out of your lungs or exhaling, the PEP device provides vibrations you will feel in the airways of your lungs.

Learning to use the PEP device is easy. You should try to do the exercise 10 times each time you use the device. Remember to use your PEP device at least 8 times a day. Of course, if you want to use it more often that is OK. We recommend that you try to use it every hour while awake. The more you do this breathing exercise the healthier your lungs will be.

Using the PEP device should help you:

  • Increase or maintain your inhaled lung volume (amount of air you breathe in on a single breath);
  • Improve how well you rid your lungs of mucus; and
  • Possibly avoid serious lung infection, especially after surgery or a procedure.
PEP device
PEP device

If you have any questions about the PEP device or PEP therapy after reading this information, please talk to the respiratory therapist, doctor, or nurse.

PEP device

Using your PEP device

  1. If this is the first time you will use your PEP device, the respiratory therapist or nurse will decide on what level the dial should be set. With each use, make sure the dial is on this setting.
  2. Sit with elbows resting on a table and relax.
  3. Take in a deep breath and hold it for 3 seconds.
  4. Place the mouthpiece lightly in mouth. Breathe out (exhale) through the PEP device slowly and smoothly. Be sure to keep a tight seal on the mouthpiece when breathing out. You should be able to exhale for 3 seconds while the device vibrates.
  5. Perform 10 breaths with each use. You should use your PEP device 8 times per day, or every hour while awake.

Cleaning your PEP device

Cleaning your PEP device properly is important to decrease the risk of infection. The PEP device should be cleaned every night at bedtime. That way when you wake up in the morning it will be clean and dry and ready for use. Please, do not use bleach to clean the device, and do not put it in the microwave.

Diassembled PEP device
Let air dry
  1. Take apart the PEP device. There are 4 parts to be cleaned: A. the cover, B. the base, C. the mouthpiece, and D. the rocker.
  2. Soak the parts in warm soapy water for 15—20 minutes. When in the hospital, use a plastic basin and handsoap to clean it. When discharged, a dish detergent can be used. The PEP device is also dishwasher safe. It is important to rinse your PEP device thoroughly with warm water.
  3. Be sure to air dry the PEP device on a paper towel. Put the cover back on the base for drying.


To learn more about using the positive expiratory pressure (PEP) device or about taking care of your lungs, talk to your doctor, nurse, or respiratory therapist.


This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-278-5833 (TTY: 1-901-595-1040).

تنبيه: إذا كنت تتحدث باللغة العربية فيمكنك الاستعانة بخدمات المساعدة اللغوية المتوفرة لك مجانا. .يرجى الاتصال بالرقم. 5833-278-866-1  (الهاتف النصي: 1040-595-901-1).