DOI: https://doi.org/10.36347/sasjm.2026.v12i06.005

Pages: 599-604

Obstructive sleep apnoea (OSA) is a common condition associated with significant cardiometabolic morbidity. Continuous positive airway pressure (CPAP) remains the gold-standard therapy, providing immediate and reliable suppression of apnoea–hypopnoea events through mechanical airway stabilization. Adherence challenges and residual cardiovascular risk have prompted exploration of adjunctive and alternative therapies. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), originally developed for type 2 diabetes and obesity, have recently demonstrated promise in OSA management, particularly among obese patients. This literature review synthesizes evidence from randomized controlled trials, meta-analyses, and narrative reviews comparing CPAP and GLP-1 agonists. CPAP consistently reduces apnoea–hypopnoea index (AHI), improves oxygen saturation, and alleviates daytime sleepiness, though long-term cardiovascular outcomes remain debated. GLP-1 agonists, including liraglutide and tirzepatide, achieve substantial weight loss and modest reductions in AHI, with additional benefits in improving glycaemic control and reducing systemic inflammation. Current data comparing CPAP to GLP1-agonists is limited by the absence of head-to-head randomized trials and heterogeneity in study populations. Furthermore, GLP-1 agonist trials have tended to be weight-centric, which contrasts with airway-centric CPAP, complicating direct comparison. Current data suggest GLP-1 agonists should be considered adjuncts to CPAP, enhancing long-term disease modification and cardiometabolic risk reduction, rather than substitutes. In CPAP-intolerant patients, GLP-1 agonists may serve as alternatives, though they do not replicate CPAP’s immediate efficacy in airway stabilization. Future research should prioritize combined and personalized therapeutic strategies, integrating CPAP’s mechanical benefits with GLP-1–mediated metabolic improvements. Such approaches may optimize both symptom control and long-term