0611 Gamification of Digital Oropharyngeal Exercises Improves Therapy Adherence in OSA Patients

Abstract Introduction OSA is caused by the interaction of impaired upper airway anatomy and dysfunctional upper airway muscle response to airway narrowing during sleep. Oropharyngeal exercises focused on training upper airway muscles are effective in reducing OSA severity and symptoms. However, similar to other physical therapy programs, oropharyngeal exercises require patients to complete multiple therapy sessions which affects patient compliance. To address this, we developed a smartphone application to provide oropharyngeal exercise and tested the effect of adding gamification and habit formation techniques on therapy adherence. Methods The experimental app which included oropharyngeal exercise therapy administered using voice-controlled games, a reward system, a reminder system, and supportive video content was compared to the control app that included text-based exercise therapy instructions and limited video content. Participants with mild to moderate OSA were randomly assigned (1:1) to either group. Demographics, sleep apnea variables, therapy progress, self-reported snoring severity questionnaires were collected for both groups. Appropriate descriptive statistics were used to summarize baseline and outcome data. Results 30 participants (13 male), mean age 60.7 ± 11.1 years were randomized equally to the experimental and control groups. 9 participants (6 in the experimental group and 3 in the control group) were unable to complete the study due to technical challenges with the apps and were excluded from analysis. No statistically significant differences were noted in either group’s baseline demographic and OSA measures. 7/9 (78%) participants in the experimental group vs 7/12 (58%) in the control group met the prespecified compliance thresholds for the 8 weeks therapy period. Self-reported snoring severity mean scores were significantly reduced in the experimental group (from 2.86 to 1.43, p-value 0.04) compared to the control group (from 2.14 to 1.77, p-value 0.21). Conclusion Addition of gamification and therapy monitoring techniques improve compliance to the prescribed oropharyngeal exercises in patients with OSA. Further studies are needed to establish the efficacy of gamified oropharyngeal therapy in the treatment of OSA. Support (if any) Research reported in this abstract was supported by NHLBI of the NIH under award number: R43HL152948-01.