0984 Do Glucagon-Like Peptide-1 Agonists Improve Sleep? Evidence from a Nationally Representative Sample of Adults in the United States

Abstract Introduction Glucagon-like peptide-1 agonists (GLP-1) are widely prescribed for obesity and type-2 diabetes. These medications may also influence sleep through metabolic and neuroendocrine pathways. Small clinical trials in the United States (US) have reported improved self-reported sleep quality with GLP-1 use. However, population-level links between GLP-1 therapy and sleep health across body mass index (BMI) categories remain unclear. Methods We analyzed data from the 2024 National Health Interview Survey, a representative sample of US adults aged ≥18 years, to examine associations between self-reported GLP-1 use among adults with prediabetes/diabetes and multiple sleep health indicators across BMI categories. Outcomes included: self-reported sleep duration (categorized as very short [≤4hrs], short [5-6hrs], healthy [7-9hrs if 18-64 years; 7-8hrs if ≥65 years], and long [≥10hrs if 18-64 years; ≥9hrs if ≥65 years]); trouble falling asleep; trouble staying asleep; and sleep restfulness (four responses: never; some days; most days; every day in the past 30 days). Weighted regression models with interaction terms for GLP-1×BMI (healthy weight, overweight, obesity classes 1-3) and covariates (age, sex, race/ethnicity, marital status, education, employment, place of birth, and poverty) were estimated. Results Of 7,322 participants, 16% used GLP-1 medications. Among these users, 3% had very short sleep duration, 29% had short sleep duration, 60% had healthy sleep duration, and 8% had long sleep duration. Trouble falling asleep was reported by 38% (some days), 13% (most days), and 9% (every day). Trouble staying asleep was reported by 34% (some days), 15% (most days), and 13% (every day). An interaction between GLP-1 use and BMI was observed among very short sleepers (F1,604=6.82, p< 0.01), indicating that the probability of very short sleep duration was less frequent among GLP-1 users with increasing BMI, but not among non-users. Another interaction was found between GLP-1 use and BMI for those who woke up rested “some days” (F1,609=4.55, p< 0.05). No interactions were seen for other outcomes. Conclusion GLP-1 therapy may reduce the risk of very short sleep duration among individuals with higher BMI. These results show a need for tailored sleep interventions among GLP-1 users, especially those with higher BMI. Support (if any) P20GM139743 (PI: Carskadon)