Safety and efficacy of glucagon-like peptide-1 receptor agonists in patients with obstructive sleep apnea: a systematic review and meta-analysis of randomized controlled trials
- Design
- Meta-analysis · 828 participants · Mixed outcome
- Match to healthy normal-weight adults aged 55–75
- Population unclear[Auto] Synthesis; population mix not determinable from abstract. Review the included-study populations.
- Could weight loss explain it?
- Unknown[Auto] Not addressed in abstract.
- Study tier
- Study tier 2[Auto] Systematic review/meta-analysis of randomized trials (auto-provisional; heterogeneity and included-study quality not assessed).
- Assessment
- Version 4 · Checked against the source by AI · Oct 19, 2026
Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.
Pooling three randomized trials in 828 adults with moderate-to-severe sleep apnea (two of tirzepatide, one of liraglutide), the drugs improved the Apnea/Hypopnea Index, weight and systolic blood pressure; diastolic blood pressure did not differ significantly. No significant serious adverse events were seen, but gastrointestinal side effects were more common. The evidence is limited to two published studies of three trials using different drugs, so firm conclusions cannot yet be drawn.
What the study reported
- Drugs
- Tirzepatide, Liraglutide
- Primary outcome
- Not extracted
- Effect
- Not extracted
- 95% confidence interval
- Not extracted
- Follow-up
- Not stated
- Adverse events
- No significant serious adverse events observed; gastrointestinal adverse events more frequent with GLP-1 agonists/tirzepatide.
- Limitations
- Not extracted
Who was studied
- Obesity status
- obesity in all included trials (full text)
- Diabetes status
- excluded (eligibility required non-diabetic patients; full text)
- Baseline condition
- obstructive sleep apnea
- Sample size
- 828
Study quality details
- Study design
- Meta-analysis
- Sample size
- 828
- Randomization
- n/a
- Blinding
- not stated
- Comparator
- not stated
- Follow up duration
- not stated
- Outcome type
- mixed
- Replication
- not assessed (auto)
- Consistency with other evidence
- not assessed (auto)
- Population applicability
- UNKNOWN
- Statistical precision
- CI reported: 95% CI [-27
- Risk of bias
- not assessed (auto)
- Peer review status
- yes
How far the review's own results can be trusted
This record is a systematic review, so it is appraised with AMSTAR 2, which rates how far the review's own pooled results can be trusted. It does not grade the trials inside the review; those are appraised one by one.
On this scale High is the best rating. The levels run High, Moderate, Low, Critically low: Critically low confidence in the review is the worst rating a review can receive, and means it should not be relied on for an accurate summary. That is the opposite direction to the risk-of-bias scale used for single trials, where High is the worst.
Critically low confidence in the review · AMSTAR 2 · AI: two passes agreed
Why: 2 critical items fail: comprehensive literature search; list of excluded studies, with reasons.
What it is used for here: Used only to find trials. A review at this level does not supply a pooled result to any outcome in this collection; the trials it lists are appraised on their own.
| Item | Answer |
|---|---|
| 1 Research question and inclusion criteria include the PICO components | Yes |
| 2 · critical Review methods set out in a protocol before the review began | Partial Yes |
| 3 Choice of included study designs explained | No |
| 4 · critical Comprehensive literature search | No — a critical flaw |
| 5 Study selection done by two reviewers independently | Yes |
| 6 Data extraction done by two reviewers independently | Yes |
| 7 · critical List of excluded studies, with reasons | No — a critical flaw |
| 8 Included studies described in adequate detail | Yes |
| 9 · critical Satisfactory technique for assessing risk of bias in the included studies | Yes |
| 10 Funding of the included studies reported | No |
| 11 · critical Appropriate methods for combining results | Yes |
| 12 Effect of risk of bias on the pooled results assessed | Yes |
| 13 · critical Risk of bias taken into account when interpreting the results | Yes |
| 14 Differences between study results explained and discussed | Yes |
| 15 · critical Publication bias investigated and its likely impact discussed | Yes |
| 16 Review authors' conflicts of interest and funding reported | Yes |
Two reviewers assessed the review independently against a written guide (AMSTAR 2 guide, version 1.1), from the full text and retrieved supplements, 2026-10-05.
Funding and conflicts
- Funding
- No funding (full text)
- Industry funded
- No
- Manufacturer
- None identified
- Sponsor role
- not reported in abstract
- Author conflicts
- No potential conflict of interest was reported by the author(s).
- Independent replication
- unknown
Funding is shown on every study and never used to score it.
The source, as retrieved
Abstract
[BACKGROUND] Obstructive sleep apnea (OSA) is a common condition affecting around one billion people worldwide. Emerging evidence from recent studies suggests that Glucagon-like peptide 1 receptor (GLP-1) agonists may reduce OSA severity. Hence, this meta-analysis aims to evaluate the efficacy and safety of GLP-1 agonists in patients with OSA. [METHODS] Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched four electronic databases (PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science) to identify eligible studies reported up to 24 June 2024. Using Review Manager software, we reported outcomes as risk ratios (RRs) or mean difference (MD) and confidence intervals (CIs). The protocol for this review has been registered and published in PROSPERO with the ID (CRD42024562853). [RESULTS] The meta-analysis included three randomized controlled trials with 828 patients. Pooled analysis of patients administered GLP-1 agonists or tirzepatide showed improvement in Apnea/Hypopnea Index (MD -16.57 events per hour, 95% CI [-27.41, -5.73], p = 0.003), weight reduction (MD -12.71%, 95% CI [-21.38, -4.03], p = 0.004), and systolic blood pressure (MD -4.93 mmHg,95% CI [-7.67, -2.19], p = 0.0004). Tirzepatide showed a reduction in high-sensitivity C-reactive protein (MD -0.89 mg/dl, 95% CI [-1.25, -0.54], p < 0.0001) and sleep apnea-specific hypoxic burden (MD -66.21%/min, 95% CI [-81.75, -50.67], p < 0.0001). Despite the heterogeneity observed in the AHI and weight, it was resolved, and the results were consistent. GLP-1 agonists/tirzepatide showed comparable outcomes concerning diastolic blood pressure (MD -1.34 mmHg, 95% CI [-2.80, 0.12], p = 0.07). No significant serious adverse events were observed for GLP-1 agonists/tirzepatide, but it was associated with a higher incidence of gastrointestinal adverse events. [CONCLUSION] GLP-1 agonists, including tirzepatide, improved Apnea/Hypopnea Index, weight, and systolic blood pressure in adults with moderate-to-severe OSA. However, the evidence remains limited to two published studies comprising three randomized controlled trials using different pharmacological agents. Consequently, further research is needed before firm conclusions can be drawn.