An apparatus comprising: a blower having an intake, an exhaust, and a controllable speed; a direction valve having an intake port operationally connected to said blower intake, an exhaust port operationally connected to said blower exhaust, an atmosphere port open to the atmosphere, and a common port; a hose connector adapted to receive a hose with a patient mask; and a controller controlling operation of said apparatus; said apparatus having an insufflation mode wherein said controller sets said direction valve such that said exhaust port is operationally connected to said common port and said intake port is operationally connected to said atmosphere port, thereby providing positive pressure at said hose connector for an insufflation; said apparatus having an exsufflation mode wherein said controller sets said direction valve such that said intake port is operationally connected to said common port and said exhaust port is operationally connected to said atmosphere port, thereby providing negative pressure at said hose connector for an exsufflation; and said apparatus having a rest mode wherein said controller sets said direction valve such that said exhaust port is operationally connected to said common port and said intake port is operationally connected to said atmosphere port, thereby providing positive pressure at said hose connector; characterized in that the apparatus further comprises an oscillator having a connector port and a valve port operationally connected to said valve common port, said oscillator being a butterfly valve including a chamber between said connector port and said valve port and a rotatable disc within said chamber, said disc being rotatable about 360°, the hose connector operationally connected to said oscillator connector port and said apparatus having a flutter mode wherein said controller rotates said oscillator disc at a settable frequency during exsufflation. a blower having an intake, an exhaust, and a controllable speed; a direction valve having an intake port operationally connected to said blower intake, an exhaust port operationally connected to said blower exhaust, an atmosphere port open to the atmosphere, and a common port; a hose connector adapted to receive a hose with a patient mask; and a controller controlling operation of said apparatus; said apparatus having an insufflation mode wherein said controller sets said direction valve such that said exhaust port is operationally connected to said common port and said intake port is operationally connected to said atmosphere port, thereby providing positive pressure at said hose connector for an insufflation; said apparatus having an exsufflation mode wherein said controller sets said direction valve such that said intake port is operationally connected to said common port and said exhaust port is operationally connected to said atmosphere port, thereby providing negative pressure at said hose connector for an exsufflation; and said apparatus having a rest mode wherein said controller sets said direction valve such that said exhaust port is operationally connected to said common port and said intake port is operationally connected to said atmosphere port, thereby providing positive pressure at said hose connector; characterized in that the apparatus further comprises an oscillator having a connector port and a valve port operationally connected to said valve common port, said oscillator being a butterfly valve including a chamber between said connector port and said valve port and a rotatable disc within said chamber, said disc being rotatable about 360°, the hose connector operationally connected to said oscillator connector port and said apparatus having a flutter mode wherein said controller rotates said oscillator disc at a settable frequency during exsufflation.