GLP-1 receptor agonists (GLP-1RA) are emerging as a potential therapeutic option for patients with obstructive sleep apnea (OSA), according to a recent review that examined growing clinical evidence. With OSA linked to significant cardiometabolic and neurocognitive complications, new treatment strategies beyond traditional positive airway pressure (PAP) therapy are drawing attention.
The review highlights data from randomized controlled trials and meta-analyses that demonstrate reductions in both apnea-hypopnea index (AHI) and body weight among patients treated with GLP-1RA and dual GLP-1 and glucose-dependent insulinotropic peptide (GIP) receptor agonists. These improvements have been observed when the agents are used alone as well as in combination with PAP therapy, suggesting a complementary role for pharmacological and device-based approaches.
Mechanistically, GLP-1RA may benefit patients with OSA through multiple pathways, including reductions in systemic inflammation and adiposity. Hormonal regulation, delayed gastric emptying, and central effects on appetite and sleep-wake regulation are also proposed to contribute to therapeutic efficacy. These effects are particularly relevant given the overlap between OSA, obesity, and cardiometabolic disease.
While these findings underscore the promise of incretin therapies for OSA management, the review emphasizes the need for long-term follow-up to assess durability of benefit and monitor safety. Further comparative studies with PAP therapy are also warranted to establish optimal treatment strategies and better define patient selection criteria.
This evolving evidence base suggests a potential paradigm shift in the management of OSA, where pharmacotherapy could play a central role alongside established device therapies. Clinicians should remain attentive to forthcoming trial data that may guide integration of GLP-1 and dual agonists into standard care.
Reference:
D’Annibale DA et al. Glucagon-like peptide-1 receptor agonists for the treatment of obstructive sleep apnea. Curr Opin Pulm Med. 2025. doi: 10.1097/MCP.0000000000001208
