An adjustable tracheostoma valve includes a housing having a first openingthat is adapted to open to a tracheostoma and a second opening that opens toambient. The housing includes a lower housing portion defining the firstopening andan upper housing portion movably attached to the lower housing portion anddefiningthe second opening. A closure member is disposed in the housing and adapted toclose the second opening. A flexible membrane includes a first regionconnected tothe closure member and a plurality of spiral shaped legs extending from thefirst regionand connected to the housing. The upper and lower housings are axiallyadjustablerelative to one another to adjust an amount of air flow through the valve thatwouldcause closure of the closure member. A heat and moisture exchanger is disposedinthe housing between the first opening and the second opening.