Can Ozempic help you sleep better? Comparing Long-Term Adverse Outcomes in Obstructive Sleep Apnea managed With CPAP Alone Vs CPAP Plus GLP-1 Agonists: A Real-World TriNetX Study

Abstract Purpose Obstructive sleep apnea (OSA) is associated with elevated cardiometabolic risk, and continuous positive airway pressure (CPAP) remains the standard therapy. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated cardiovascular benefits, but their combined impact with CPAP in patients with OSA is not well characterized. In view of this, a retrospective cohort study was conducted using the TriNetX Network to compare risks of myocardial infarction (MI), stroke and mortality in CPAP treated OSA patients who did and did not receive GLP-1’s. To evaluate whether adding GLP-1 receptor agonists to CPAP therapy reduces cardiovascular events and mortality compared with CPAP alone in adults with OSA. Methods Using the TriNetX Network, adults (≥ 18 years) with OSA treated with CPAP were identified. After exclusion criteria and propensity score matching, patients who received a GLP-1RA within one year of CPAP initiation formed the exposure cohort; controls were similar CPAP users who never received a GLP-1RA (CPAP+GLP1 vs CPAP only). 6,777 patients remained in each cohort. Outcomes up to 10 years including MI, stroke, and all-cause mortality, were analyzed using risk ratios and Kaplan–Meier survival estimates. Results Compared with CPAP-only controls, the exposure cohort experienced significantly reduced risks of MI (0.5% vs 1.0%), stroke (0.4% vs 1.0%), and all-cause mortality (4.0% vs 13.9%). Conclusion In patients with OSA treated with CPAP, adjunctive GLP-1RA therapy is associated with markedly lower cardiovascular events and substantially improved survival. These findings highlight a potential synergistic cardioprotective effect of combining GLP-1RAs with CPAP in this high-risk population.