GLP-1 receptor agonists for obstructive sleep apnea: a meta-analysis of randomized controlled trials
- Design
- Meta-analysis · 1069 participants · Intermediate outcome
- Match to healthy normal-weight adults aged 55–75
- Different populationINDIRECT: the review is scoped to adults with moderate-to-severe obstructive sleep apnoea, a condition the target group does not have, and is framed around weight reduction in overweight and obese patients; participant BMI, age and diabetes status are not reported.
- Could weight loss explain it?
- LikelyLikely: pooled body weight fell by 9.68 kg alongside the AHI reduction, sleep apnoea is an outcome weight loss is known to improve, and the abstract reports no analysis separating the two.
- Study tier
- Study tier 2MODERATE: a meta-analysis pooling 6 randomized trials (1,069 participants) on an intermediate outcome, limited by substantial heterogeneity (I2 = 87% for AHI) and the small number of trials.
- Assessment
- Version 3 · Two reviewers differed; settled by a recorded ruling · 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.
This meta-analysis pooled 6 randomized trials (1,069 adults with moderate-to-severe obstructive sleep apnoea) of liraglutide or tirzepatide against control. The drugs lowered the apnoea-hypopnoea index by 9.99 events per hour and body weight by 9.68 kg, and lowered blood pressure, but oxygen desaturation index and minimum oxygen saturation did not differ. Adverse events were not increased, and the results varied widely between trials.
01Findings
What the study reported
- Drugs
- Liraglutide, Tirzepatide
- Comparator
- control
- Primary outcome
- apnea-hypopnea index (AHI); body weight, ODI, minimum oxygen saturation, blood pressure and adverse events also assessed
- Effect
- Versus control, AHI fell by 9.99 events/hour and body weight by 9.68 kg; SBP fell by 4.77 mmHg and DBP by 1.41 mmHg; no significant difference in ODI or minimum oxygen saturation; adverse events not increased
- 95% confidence interval
- 95% CI, - 16.47 to - 3.50 (AHI)
- P value
- p < 0.01 (AHI)
- Follow-up
- Not stated
- Adverse events
- GLP-1 receptor agonist-based therapies did not increase the risk of adverse events
- Limitations
- The authors note substantial heterogeneity that limits interpretation of the pooled effect size; only six trials of two drugs were pooled, and the findings do not establish the drugs as substitutes for CPAP.
Who was studied
- Obesity status
- not reported in abstract
- Diabetes status
- not reported in abstract
- Cvd status
- not reported in abstract
- Ckd status
- not reported in abstract
- Baseline condition
- moderate-to-severe obstructive sleep apnea
- Sample size
- 1069
- Inclusion exclusion
- RCTs of GLP-1 receptor agonist-based therapies versus control in adults with moderate-to-severe OSA
Study quality details
- Study design
- Meta-analysis
- Sample size
- 1069
- Randomization
- yes
- Blinding
- not stated
- Comparator
- control
- Follow up duration
- not stated
- Outcome type
- intermediate
- Replication
- not assessed
- Consistency with other evidence
- not assessed
- Population applicability
- INDIRECT
- Statistical precision
- CI reported: 95% CI, - 16.47 to - 3.50 (AHI)
- Risk of bias
- not assessed
- Funding conflicts
- unclear
- Peer review status
- yes
02Funding
Funding and conflicts
- Funding
- not reported in abstract
- Industry funded
- Unclear
- Manufacturer
- not stated in source
- Sponsor role
- not reported in abstract
- Author conflicts
- The authors declare no financial or non-financial conflicts of interest.
- Independent replication
- unknown
Funding is shown on every study and never used to score it.
04Source
The source, as retrieved
Abstract
[PURPOSE] Weight reduction is recommended in all overweight and obese patients with obstructive sleep apnea (OSA). Glucagon-like peptide-1 (GLP-1) receptor agonists-based therapies have demonstrated clinical benefits in reducing weight and could potentially improve OSA outcomes. We aim to analyze the efficacy and safety of GLP-1 receptor agonists-based therapies in patients with moderate-to-severe OSA. [METHODS] We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) that compared GLP-1 receptor agonists-based therapies versus control in adults with moderate-to-severe OSA. We systematically searched electronic databases and registries up to February 10, 2025. Outcomes assessed included apnea-hypopnea index (AHI), body weight, oxygen desaturation index (ODI), minimum oxygen saturation, systolic blood pressure (SBP), diastolic blood pressure (DBP), and adverse events. [RESULTS] A total of 6 RCTs involving 1,069 participants were included, four evaluating liraglutide and two tirzepatide. Compared with control, GLP-1 receptor agonist-based therapies reduced AHI by - 9.99 events/hour (95% CI, - 16.47 to - 3.50; p < 0.01; I2 = 87%) and body weight by - 9.68 kg (95% CI, - 15.84 to - 3.51; p < 0.01; I2 = 98%). These therapies also reduced SBP by -4.77 mmHg (95% CI, -7.04 to -2.51; p < 0.01), and DBP by -1.41 mmHg (95% CI, -2.71 to -0.11; p = 0.03). No significant differences were observed in ODI or minimum oxygen saturation. GLP-1 receptor agonists-based therapies did not increase the risk of adverse events. [CONCLUSION] GLP-1 receptor agonist-based therapies reduced AHI and body weight in the populations studied. Substantial heterogeneity limits interpretation of the pooled effect magnitude. These findings support their potential role within comprehensive OSA management but do not establish them as substitutes for CPAP. [REGISTRY] International Prospective Register of Systematic Reviews; No.: CRD42024564018; URL: https://www.crd.york.ac.uk/prospero/ .