OBJECTIVES: Obstructive sleep apnea (OSA) affects almost 1 billion people globally, and its increasing prevalence is related to rising obesity rates, ranging from 14% to 55%. The impact of newly approved anti-obesity medications (AOM) on the risk of OSA among US patients with obesity was assessed in this study.

METHODS: Utilizing Kythera data, a retrospective cohort study was conducted from November 2022 to June 2024. Patients with obesity and AOM use were identified based on diagnosis claims and prescription claim(s) for Zepbound or Wegovy (identification period, 11/1/2023-12/31/2023) and had 6 months of follow-up to measure OSA risk. Patients with AOM use and OSA diagnosis before the identification period were excluded. The risk of OSA among patients with obesity was determined using Cox regression. Multivariable analysis was used to control for comorbidities and sociodemographic factors.

RESULTS: We identified 20,384 patients with obesity and AOM use (Wegovy: 17,859; Zepbound: 2,525) and 85,018 patients with obesity in the non-AOM cohort. The AOM cohort had a higher percentage with a Chronic Disease Score ≥2 than the non-AOM cohort (52.25% vs 8.44%; std. diff.=1.3176). However, the incidence of OSA was lower in the AOM cohort (3.12%) than the non-AOM cohort (12.56%) (std. diff.=0.3075). Furthermore, the risk-adjusted likelihood of OSA was 40% lower in the AOM cohort than in the non-AOM cohort (hazard ratio [HR]=0.60, p<0.0001). The incidence of OSA was slightly lower among Zepbound users (2.65%) than Wegovy users (3.18%) (p=0.0303). However, the risk-adjusted likelihood of OSA showed no difference between Zepbound and Wegovy users (p=0.1664).

CONCLUSIONS: This study reveals a significant association between AOM use and a lowered risk of OSA, even after meticulous adjustment for demographic and clinical variables. This finding underscores the potential of AOMs as a valuable component in mitigating the risk of OSA in relevant patient populations.