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What Is a Flutter Valve, and Does It Help COPD?

COPD Basics

August 29, 2023

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Illustration by Brittany England

Illustration by Brittany England

by Stephanie Orford

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Medically Reviewed by:

Adithya Cattamanchi, M.D.

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•••••

by Stephanie Orford

•••••

Medically Reviewed by:

Adithya Cattamanchi, M.D.

•••••

•••••

Using a flutter valve may help you breathe more easily with COPD, particularly if you tend to produce a lot of sputum.

If you live with chronic obstructive pulmonary disease (COPD), your doctor may prescribe you a flutter valve.

A flutter valve, also called a flutter, is a simple plastic device you can keep at home to use whenever you feel short of breath.

A flutter valve is a type of positive expiratory pressure (PEP) device that oscillates. Therefore, it’s called an oscillating positive expiratory pressure (OPEP) device.

People have used flutter valves and other OPEP devices since the 1970s for COPD and other conditions, including bronchiectasis and cystic fibrosis.

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What is positive expiratory pressure therapy?

Your doctor may recommend PEP therapy if you live with COPD. PEP involves breathing in freely and breathing out against resistance, which makes it harder to exhale.

When you exhale into a PEP device, the pressure in your airways will increase. The increased pressure can help keep your airways open, making them less likely to collapse — similar to how pursed lip breathing works.

According to a 2015 research review, the goal of PEP is to reduce the work of breathing and improve gas exchange so that your body can absorb more oxygen from the air you inhale.

You can use a PEP device several times a day or whenever you have trouble breathing.

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What is a flutter valve?

A flutter valve is a pipe-shaped plastic OPEP device with a ball inside. When you exhale into a flutter valve, the ball oscillates quickly, creating vibrations that reverberate in your airways. These vibrations may help clear out mucus from your airways.

Flutter valves are small enough to carry when you’re out and about during the day, so you can use them whenever you have trouble breathing.

What does a flutter valve do for your lungs?

A flutter valve applies positive expiratory pressure to your lungs. It provides resistance for you to exhale against and increases pressure in your airways, holding them open as you exhale. This can be helpful if you experience airway collapse while exhaling.

When you feel short of breath, you can exhale into a flutter valve several times.

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What’s the difference between a flutter valve and an Acapella device?

Flutter valves and Acapella devices are both handheld OPEP devices you can use at home. They can increase pressure in your airways and create vibrations to help loosen mucus.

The difference is in their shape and design. A flutter valve is shaped like a pipe and requires gravity to work. You need to keep a flutter valve level for it to work properly.

An Acapella device is shaped like a cone and doesn’t depend on gravity, so you can use it while lying down or in another position.

How do you use a flutter valve?

Here’s how to use a flutter valve or another OPEP device:

  1. Sit or stand up with your back straight.
  2. Take a deep breath in and hold it for a moment.
  3. Put your OPEP device up to your mouth and use your lips to create a seal around the mouthpiece. The base should be parallel to the ground.
  4. Breathe out through your mouth, pushing with your abdominal muscles. Try to let out most of the air in your lungs, but don’t strain until you can’t breathe out any longer.
  5. Repeat 10 times.
  6. Cough outside the device to expel any mucus you’ve loosened.
  7. If you can’t bring up any mucus, use the flutter valve again.
  8. Use your flutter valve 2–4 separate times per day, or whenever you feel like coughing but can’t.

As you get used to using a flutter valve, you’ll get a feel for the force you need to apply to get your lungs vibrating at the best frequency to loosen mucus.

You’ll also need to clean it regularly. You can take it apart and clean the components in one of three ways: by boiling them, microwaving them in a steam bag, or soaking them in isopropyl alcohol or hydrogen peroxide.

Follow the cleaning instructions for your particular model.

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Do flutter valves work?

Flutter valves and other OPEP devices may help improve breathing in people with COPD, but results are mixed and more research is needed.

A small 2022 study of 50 people living with COPD compared the results of two treatments: drug therapy with OPEP therapy and drug therapy alone.

Researchers found that after 3 months, the group assigned to use a flutter valve daily showed improved lung function measurements, increased exercise capacity, and reduced symptoms compared with the control group.

In a small randomized controlled trial in 2023, researchers assigned 103 participants with COPD and regular sputum production to use an Acapella device regularly for 3 months. Compared with the control group, participants who used the Acapella device experienced improved cough symptoms and quality of life.

Where to get a flutter valve

You can find a flutter valve or another OPEP device at a pharmacy, but you’ll need a prescription from your doctor.

Well-known brands of OPEP devices include:

  • Flutter
  • Acapella
  • AerobikA
  • RC-Cornet
  • Lung Flute
  • Quake
  • PocketPEP
  • Vibralung
  • ShurClear
  • vPEP
  • Vibra-PEP
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Takeaway

Flutter valves are portable and often simple to use at home. They can help keep your airways open during exhalation while vibrating your airways to help increase mucus clearance.

If you live with COPD, your doctor may prescribe you a flutter valve or another type of OPEP device.

Once you have a prescription, you can get an OPEP device at a pharmacy.

Medically reviewed on August 29, 2023

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