Effectiveness of GLP-1 receptor agonists to prevent obstructive sleep apnea in patients with type 2 diabetes: active comparator, new user cohort study
- Design
- Retrospective cohort · Unknown outcome
- Match to healthy normal-weight adults aged 55–75
- Different population[Auto] Participants had type 2 diabetes and obesity/overweight (BMI ≥30 required).
- Could weight loss explain it?
- Possibly[Auto] Participants had obesity and/or type 2 diabetes and the abstract does not separate direct drug effects from weight loss or glycaemic improvement.
- Study tier
- Study tier 3[Auto] Observational design; confounding by indication and healthy-user effects cannot be excluded (auto-provisional).
- Assessment
- Version 1 · automatic, not yet reviewed by a person · Sep 20, 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.
[Auto, unreviewed; quoted from abstract conclusions] In routine clinical care, GLP-1RAs were not associated with a decreased incidence of OSA in patients with T2D and no history of OSA, when compared with DPP-4i.
01Findings
What the study reported
- Drugs
- Class unspecified
- Comparator
- DPP-4i use was 1
- Primary outcome
- Not extracted
- Effect
- Not extracted
- 95% confidence interval
- Not extracted
- Follow-up
- 3 years of follow-up
- Adverse events
- Not extracted
- Limitations
- Auto-classified from abstract only; effect estimates, adverse events and limitations not extracted. Requires manual review.
Who was studied
- Bmi min
- 30
- Obesity status
- obesity/overweight present (all or most)
- Diabetes status
- type 2 diabetes present (all or most)
- Baseline condition
- obstructive sleep apnea
Study quality details
- Study design
- Retrospective cohort
- Sample size
- not extracted
- Randomization
- no
- Blinding
- not stated
- Comparator
- active comparator
- Follow up duration
- 3 years of follow-up
- Outcome type
- unknown
- Replication
- not assessed (auto)
- Consistency with other evidence
- not assessed (auto)
- Population applicability
- INDIRECT
- Statistical precision
- CI reported: 95% confidence intervals (CIs
- Risk of bias
- not assessed (auto)
- Funding conflicts
- unclear
- Peer review status
- yes
02Funding
Funding and conflicts
- Funding
- not reported in abstract
- Industry funded
- Unclear
- Manufacturer
- None identified
- Sponsor role
- not reported in abstract
- Author conflicts
- not available in metadata
- Independent replication
- unknown
Funding is shown on every study and never used to score it.
04Source
The source, as retrieved
Abstract
[RATIONALE] Obstructive sleep apnea (OSA) is highly prevalent in type 2 diabetes (T2D), sharing metabolic risk factors, notably obesity, and increased cardiovascular outcomes. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been shown to reduce OSA severity in clinical trials but their role in preventing incident OSA in T2D remains unclear. [OBJECTIVE] To assess whether GLP-1RA use is associated with a reduced risk of incident OSA compared with dipeptidyl peptidase-4 inhibitors (DPP-4i), a weight-neutral comparator, in patients with T2D. [METHODS] We conducted a population-based cohort study using the UK CPRD (2007-2023) database with an active-comparator, new-user design. Adults with T2D and BMI ≥30 kg/m² initiating a GLP-1RA or DPP-4i were included, excluding individuals with prior sleep apnea. Propensity scores with fine-stratification weighting were used within BMI strata. The primary outcome was incident clinical diagnosis of OSA. Cox proportional hazards models estimated hazard ratios (HRs) with 95% confidence intervals (CIs) using an as-treated approach, with up to 3 years of follow-up. [RESULTS] The cohort included 47,315 GLP-1RAs and 159,066 DPP-4i initiators with baseline characteristics well balanced after weighting. During follow-up, 612 and 1,197 incident OSA cases occurred among GLP-1RAs and DPP-4i users, yielding incidence rates of 5.8 and 5.4 per 1000 person-years, respectively. The HR of incident OSA with GLP-1RA use compared with DPP-4i use was 1.07 (95% CI 0.93-1.23). Results were consistent across BMI strata, sex, drug type, and multiple sensitivity analyses. [CONCLUSIONS] In routine clinical care, GLP-1RAs were not associated with a decreased incidence of OSA in patients with T2D and no history of OSA, when compared with DPP-4i.