Postoperative Oropharyngeal Muscle Training Compliance in Obstructive Sleep Apnea: Growth Mixture Model

Purpose: To explore developmental trajectories of oropharyngeal muscle training adherence and their influencing factors in postoperative adult patients with obstructive sleep apnea (OSA). Patients and Methods: This study was a prospective longitudinal observational study. Using convenience sampling, adult OSA patients who were hospitalized and underwent surgery at the First Affiliated Hospital of University of Science and Technology of China from October 2023 to January 2025 were selected as the study subjects. A total of 215 patients were enrolled, with 11 lost to follow-up during the postoperative periods of 4 weeks, 8 weeks, and 12 weeks, resulting in a final analysis sample size of 204 cases. Using the General Information Questionnaire, Oropharyngeal Muscle Training Adherence Questionnaire, Self-Management Questionnaire for Adult Obstructive Sleep Apnea Patients, General Self-Efficacy Scale, and Epworth Sleepiness Scale, patients’ oropharyngeal muscle training adherence levels were assessed at 1 week, 4 weeks, 8 weeks, and 12 weeks after adult OSA surgery. A latent variable growth mixture model was applied to identify adherence development trajectories, and multivariate logistic regression analysis was used to examine the influencing factors of different trajectory categories. Results: Three oropharyngeal muscle training adherence development trajectories were identified in adult OSA patients post-surgery: the Low-start Sustained Increase Group, the Moderate Gradual Decline Group, and the Moderate Rapid Decline Group. Multivariate logistic regression analysis identified self-management scores and GSES as significant independent predictors of trajectory group membership, with ESS also showing predictive value for certain trajectory comparisons (p < 0.05). Conclusion: There is significant heterogeneity in postoperative oropharyngeal muscle training (OMT) adherence trajectories among adult OSA patients. Identifying these distinct patterns enables the stratification of patients for tailored interventions. Healthcare providers should prioritize individuals showing declining adherence for early, targeted support. Keywords: obstructive sleep apnea, oropharyngeal muscle training, adherence patterns, growth mixture modeling, daytime sleepiness