Glucagon-Like Peptide-1 Receptor Agonist Utilization Among Sleep Surgery Clinic Patients.

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are approved to treat obstructive sleep apnea (OSA), yet their use in an OSA population has not been characterized. This study evaluates GLP-1 RA use in patients presenting to a sleep surgery clinic. Retrospective. Tertiary care institution. Patients with OSA who presented to our sleep surgery clinic between October 2023 and March 2025 with available sleep studies were included (n = 384). Demographic data, body mass index (BMI), apnea-hypopnea index (AHI), OSA history, GLP-1 RA prescription data, and usage details were collected through chart review. Eligibility for GLP-1 RA was defined by FDA drug labeling criteria, with diabetes, obesity, or BMI ≥ 27 kg/m² with a weight-related comorbidity. The cohort had mean age 53.3 ± 14.8 years, BMI 29.4 ± 5.7 kg/m², and AHI 28.7 ± 24.2 events/h. Most patients (52.1%) had tried CPAP. Among the full cohort (n = 384), 249 patients (64.8%) met FDA-approved drug labeling criteria for GLP-1 RA use, and there were 70 (28.1%) current GLP-1 RA users among eligible patients. Semaglutide (54.8%) and tirzepatide (27.4%) were the most prescribed. The most common reasons for discontinuing or changing GLP-1 RA types were insurance-related issues and adverse effects. Among eligible patients, having Medicaid was associated with lower likelihood of using GLP-1 RAs (adjusted odds ratio 0.25, P = .04) while BMI ≥30 kg/m² (adjusted odds ratio 3.45, P < .001) was associated with higher likelihood. Among sleep surgery clinic patients, a large proportion were eligible for GLP-1 RA use, and utilization was high compared to that of the general population.