Evaluating the potential of metabolic drugs in obstructive sleep apnea and obesity: a narrative review

To assess the effectiveness of sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptipte-1 (GLP-1) receptor agonists and dual gastric inhibitory polypeptide/glucagon-like peptipte-1 (GIP/GLP-1) receptor agonists in the treatment of obstructive sleep apnea. A comprehensive literature search was performed across multiple medical databases, including Embase, Medline, and Cochrane to look for English articles on interventions with SGLT2 inhibitors, GLP-1 and dual GIP/GLP-1 receptor agonists in people living with sleep apnea and overweight or obesity. Emerging evidence indicates that SGLT2 inhibitors, GLP-1 and dual GIP/GLP-1 receptor agonists are beneficial for treating obesity in combination with sleep apnea. While these medications have shown promise in weight reduction, with GLP-1 receptor agonists slightly outperforming SGLT2 inhibitors, their effect on sleep apnea extends beyond mere weight loss. Preliminary studies suggest a beneficial role in obstructive sleep apnea management with reductions in the Apnea-Hypopnea Index (AHI) and potential improvements in other sleep-related outcomes. There is a need for more therapeutic options to treat sleep apnea as adherence with current treatment options remains a struggle for many patients. According to preliminary research, SGLT2 inhibitors, GLP-1 and dual GIP/GLP-1 receptor agonists are promising candidates as they do show beneficial effects on AHI and weight. Nevertheless, large-scale clinical trials are needed to assess their clinical potential and risk balance in more detail.