PEP stands for positive expiratory pressure. PEP valve is a treatment that helps to remove mucus from the lungs. It can also prevent lung collapse or open up areas that have collapsed.

4913-TheraPEP drawing

PEP Valve Treatment Steps

  1. Before starting the treatment, wash your hands with soap and warm water, or use anti-bacterial hand gel, to reduce the risk of infection.

  2. Make sure the dial is set to the correct range ordered by your doctor.

  3. Sit with your elbows resting on the table or sit upright.

  4. Make a tight seal around the mouthpiece with your mouth. If you are using a mask, apply the mask tightly over your nose and mouth.

  5. Take a deep breath in through your nose.

  6. Hold your breath for 2-3 seconds. This allows the air to move through the lungs.

  7. Breathe out into the PEP valve. Keep your cheeks hard and flat while you are breathing out.

  8. During the time that you are breathing out, you will feel resistance. This is positive pressure in your airways.

  9. You should breathe out 3-4 times as long as you breathe in, keeping the blue button between the black lines.

  10. Repeat these steps until you have blown through the PEP valve 20 times.

  11. Remove the mouthpiece and perform a “huff cough”. You do this by taking a deep breath and holding it for 1-3 seconds. Then force the air out of your lungs with your mouth open like you would do if you were trying to fog a mirror.

  12. Keep doing steps 2-10 for a total of _______ minutes as ordered by your doctor.

  13. Your doctor has ordered the therapy ______ times per day at setting level________.

Note: Pace yourself as you breathe out into the PEP valve device. Pause for a few seconds between breaths. If you feel dizzy or get a headache while using the PEP valve, you may be breathing too fast. If you get these symptoms, stop using the PEP valve for a few minutes and breathe as normal. When you begin to use the PEP valve again, take more time between breaths.

Using the PEP Valve with Your Nebulizer

PEP valve also improves how nebulized bronchodilators work. A bronchodilator is a drug that helps to relax the smooth muscles in the lungs to make breathing easier. Your PEP valve can be used at the same time you are doing your nebulizer treatment. Follow the set-up picture below.

4913-Figure 2

Cleaning the PEP Valve

The PEP valve should be cleaned twice weekly or more often if it is dirty. 

  1. Take the PEP valve apart and soak all the pieces except the tubing and “blue indicator column” in warm soapy water for five minutes. 

  2. Rinse all the parts with hot tap water. Then place them in a bowl with enough rubbing alcohol (isopropyl alcohol) to cover the PEP valve. Soak the PEP valve device in alcohol for five minutes.

  3. Remove the PEP valve from the alcohol and rinse with sterile water. Do not use water from the faucet, bottled or distilled water. You can make water sterile by boiling it for 5 minutes and allowing it to cool. Use this water once, then throw it out.

  4. Place all the parts on a paper towel to dry.

Cleaning Your Nebulizer

If you are using the PEP valve with a nebulizer, please clean the nebulizer when you clean your PEP valve. Please refer to the Nebulizer and Aire Compressor for Inhaled Medicines Health Facts for You #6922 for cleaning guidelines.

Return Clinic Visits

Please bring your PEP valve with you to clinic visits.


Please bring your PEP valve to the hospital if you are admitted.


If you have questions or need more supplies, contact your home health equipment provider.