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

Abstract

Study Objectives 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-1RA) as an important treatment for obesity and diabetes mellitus show promising therapeutic prospect in OSA. We conducted a meta-analysis to evaluate the effect of GLP-1RA intervention in OSA individuals. Methods 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 apnea-hypopnea index (AHI). Results 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% CI, −12.56 to −6.40, I2=92%). The change in weight was -10.99kg and BMI was –1.60kg/m2. The mean difference in SBP was -4.81mmHg and in DBP 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 CPAP and the duration of follow-up did not affect the therapeutic effect. Conclusion GLP-1RA could significantly reduce the severity of OSA, and also lead to weight loss and lower blood pressure. Further high-quality RCTs are needed to explore different GLP-1RA treatments and durations in OSA, and identify patient subgroups that may benefit the most.