Glucagon-like peptide-1 receptor agonists for the treatment of obstructive sleep apnea: a meta-analysis

Obstructive sleep apnea (OSA) is characterized by disordered breathing during sleep and is associated with major cardiovascular complications. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) as an important treatment for obesity and diabetes mellitus show promising therapeutic prospects in OSA. We conducted a meta-analysis to evaluate the effect of GLP-1RA intervention in OSA individuals.

We searched the PubMed and Web of Science databases (published until July 1, 2024). The included studies evaluated the GLP-1RA in OSA individuals and the efficacy outcomes measured by the apnea-hypopnea index (AHI).

Six studies with a total of 1067 participants enrolled. GLP-1RA significantly decreased AHI with an estimated treatment difference of -9.48 events per hour (95% confidence interval [CI] =  -12.56 to - 6.40, I2 = 92%). The change in weight was -10.99 kg and body mass index (BMI) was -1.60 kg/m2. The mean difference in systolic blood pressure was -4.81 mmHg and in diastolic blood pressure was -0.32 mmHg. Tirzepatide significantly reduced AHI more than liraglutide with an estimated treatment difference of -21.86 events per hour (95% CI = -25.93 to -17.79) vs -5.10 events per hour (95% CI = -6.95 to -3.26). Obese individuals experienced a more significant decrease in AHI with an estimated treatment difference of -12.93 events per hour vs -4.31 events per hour. The application of continuous positive airway pressure and the duration of follow-up did not affect the therapeutic effect.

GLP-1RA could significantly reduce the severity of OSA, and also lead to weight loss and lower blood pressure. Further high-quality randomized controlled trials (RCTs) are needed to explore different GLP-1RA treatments and durations in OSA and identify participant subgroups that may benefit the most.

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