The impact of GLP-1 agonists on sleep disorders: spotlight on sleep apnea.

INTRODUCTION: For the first time in history, a medication - tirzepatide, has been approved by the United States Food and Drug Administration (FDA) for the treatment of obstructive sleep apnea (OSA). This approval adds to the current array of therapeutic options and raises many issues regarding the future of treatment for OSA; in particular, the role of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in the chronic management of patients with OSA. AREAS COVERED: This review aims to summarize the impact of GLP-1 RAs for the treatment of OSA in the context of the recent FDA approval of tirzepatide following the SURMOUNT-OSA trial. EXPERT OPINION: The FDA approval of tirzepatide for OSA represents a major shift from symptom-based management with continuous positive airway pressure (CPAP) toward a weight-centered, disease-modifying strategy. Questions remain about whether benefits from GLP-1 RAs are purely weight-mediated, or whether they involve direct respiratory effects as well. Moving forward, pharmacotherapy could transform OSA management into a more individualized framework which views the condition as a chronic metabolic disease rather than solely a mechanical airway disorder.