A system (10) and method of insufflating-exsufflating a subject (12) that enables monitoring and/or control over an enhanced set of breathing parameters during insufflation-exsuffiation. The system and/or method may include automatic triggering and/or notification to a caregiver of insufflation-exsuffiation. The insufflation-exsuffiation of the subject may be preceded by a secretion loosing routine that loosens secretions in the airway of the subject without moving the loosened secretions up the airway.