Orofacial Myofunctional Therapy for Patients with Obstructive Sleep Apnea—A Mixed Methods Study of Facilitators and Barriers to Treatment Adherence

Orofacial myofunctional therapy (OMT) for obstructive sleep apnea (OSA) is a promising, new treatment. We aimed to study patients’ experiences and adherence to OMT. Twelve patients with OSA were included in the study, and they engaged in OMT exercises three times daily for 12 weeks. Participants tracked their sleep and OMT exercise activities in an electronic diary. Exercise techniques were guided by a certified therapist. Patients’ experiences with OMT were assessed through semi-structured individual interviews conducted after a 12-week intervention, and the transcripts were analyzed using thematic analysis. The findings revealed an overarching theme that captured both facilitators of and barriers to OMT, organized into three subthemes: (1) motivation, (2) perceived support, and (3) perceived effects. Motivation was driven by a desire to improve general health and avoid continuous positive airway pressure treatment, and was supported by a sense of mastery and perceived effectiveness. Key facilitators included a trusting patient–therapist relationship, as well as developing routines and a sense of control. Barriers involved managing the comprehensive treatment protocol, insecurities around exercise execution and the potential impact of OMT, sickness burden, and previous negative healthcare experiences. These themes were supported by quantitative findings, which demonstrated high treatment adherence, while sleep data indicated modest individual improvements in subjective sleep quality and efficiency. By recognizing facilitators and barriers and addressing the individual differences among OSA patients, healthcare providers can better tailor their approach to meet diverse patient needs. This personalized approach, supported by emerging sleep improvements, may enhance patient engagement and improve adherence to OMT.