Behavioral Change Techniques to Enhance Adherence to Oral Appliance Therapy in Patients with Obstructive Sleep Apnea: A Qualitative Study
H. Tallamraju, T. Newton, A. JohalObjective:
To identify behavior strategies that affect adherence to oral appliance therapy (OAT) in patients with obstructive sleep apnea (OSA).
Methods:
One-to-one interviews were conducted to explore the barriers and facilitators influencing adherence. The Behaviour Change Taxonomy model, Behaviour Change Wheel (BCW), and Capability, Opportunity, and Motivation–Behaviour (COM-B) model were used to identify and categorize key behavior strategies.
Results:
The abovementioned models identified 8 key behavior strategies influencing patient adherence. Strategies facilitating adherence included recognizing OAT benefits (improved sleep, reduced fatigue), establishing routines, using prompts, receiving social support, and employing self-monitoring tools like mobile apps. Barriers included routine disruptions and distractions, while the lack of social encouragement had a neutral effect. Comparing pre- and posttreatment experiences reinforced adherence, as did counseling on the consequences of nonuse.
Conclusion:
Clinically, strategies such as reinforcing benefits, encouraging habit formation, and promoting self-monitoring should be used to enhance adherence. Identifying individual facilitators and barriers can help tailor interventions for optimal treatment outcomes.
Knowledge Transfer Statement:
The results of this study can be used by clinicians when deciding how best to support adherence to oral appliance therapy in adults with obstructive sleep apnea. By identifying key barriers and facilitators related to routine formation, perceived treatment benefits, self-monitoring, and social support, these findings can inform patient-centered counseling and follow-up strategies. This may lead to more tailored clinical approaches and improved long-term treatment outcomes.