When the vest is too tight it doesn't inflate right, or when air is leaking- and the leak can come from either the hoses being cracked, the connection between hose and vest being worn out, or the vest itself can be torn. I would have him measure his chest circumference and call customer service back and make sure he has the appropriate size, and if it's been a while, he likely needs a new vest garment and tubes to go along with the compressor he's already getting. For future reference~ We go a new nebulizer compressor every six months now, but she uses it an hour+ daily when healthy and 2+ hours a day when sick. We used to get longer than that out of them. The pari nebs are under warranty for 5yrs, so call your insurance or whoever provides durable medical equipment to have it replaced; once its been a certain number of years the dr will write a script. Keep an ear out for it getting progressively louder and rattly sounding and have it replaced at that point, don't wait for it to die completely or be putting out barely a wisp of air. The nebs require good psi to make small enough droplets to get deep into their lungs. I have no idea how the nebulizer compressor companies expect anyone to get 5 yrs out of the things. I know those with cf put them through a real workout, but still... I guess they count on an asthma patient using them for an albuterol treatment a few times a week or something.
