The rise in GLP-1 medications for weight loss is undeniable. The amount of money Americans spent on GLP-1 medications skyrocketed more than 500% from 2018 to 2023, according to a 2025 study published in JAMA.1 A recent national health tracking poll of 1,350 U.S. adults reported that one in eight people said they are currently taking a GLP-1 medication to either lose weight or treat a chronic condition.2
Obesity is directly correlated with a variety of medical conditions, including obstructive sleep apnea (OSA). This raises an important question for sleep professionals: What impact could GLP-1 medications have on conditions like OSA?
Research shows that patients with obesity have a dramatically higher risk of developing OSA because the airway can be extremely narrow in overweight patients, increasing its collapsibility—and thereby elevating the risk for OSA.3 This can also lead to a reduction in airway stabilization and impairment of neuromuscular reflexes, which alter ventilatory control through metabolic and inflammatory mechanisms. Weight loss could certainly help in this regard, but it’s not the whole solution.
As a practicing dentist for more than 30 years and a diplomate of the American Board of Dental Sleep Medicine (ABDSM), finding effective treatments for patients with OSA has always been a top priority for me. But we must proceed with caution—while GLP-1 medications may be beneficial for some patients suffering with sleep apnea and obesity, they shouldn’t be thought of as a silver bullet that can solve both issues at once.
GLP-1s Could Open the Lines of Communication
We know that millions of Americans currently have OSA, but most of them will never get an official diagnosis and thus won’t receive effective treatment. Estimates suggest OSA will impact nearly 77 million Americans ages 30 to 69 by 2050, according to a 2025 study in The Lancet Respiratory Medicine.4
I believe our focus as providers should be on identifying ways to improve the percentage of people with OSA who are actually being diagnosed and treated. Untreated OSA can lead to excessive daytime sleepiness, cognitive issues, reduced executive function, and overall diminished quality of life. These effects have real-world implications for performance, driving safety, and cognitive efficiency.
From a cardiometabolic perspective, endothelial dysfunction associated with OSA may contribute to hypertension progression, insulin resistance, and low-grade systemic inflammation over time. Disease progression may also be a concern, as OSA exists on a continuum.
Some patients may avoid treatment because they believe it will interfere with their comfort while sleeping. Traditional treatment options like continuous positive airway pressure (CPAP) may not be tolerated well by everyone. In this context, GLP-1s could be a valuable conversation starter. They provide a new opportunity for patients to have an honest discussion about sleep quality with their provider. Maintaining open communication helps ensure therapies are used together to improve patient outcomes.
Losing Weight Isn’t the Whole Solution
It’s important to understand that for most patients, GLP-1 medications are disease-modifying rather than curative. Patients with mild-to-moderate OSA often experience larger proportional improvements than those with severe disease. Sustained weight loss decreases fat deposition in the tongue, soft palate, and parapharyngeal tissues. Residual symptomatic OSA frequently remains even after weight loss, so it is important that patients continue to have effective treatment.
While there is a definitive link between obesity and OSA, weight itself isn’t the only cause. There may be several reasons for this. Some structural and anatomical factors that contribute to OSA remain unchanged with weight loss. Craniofacial morphology, maxillomandibular position, palatal length, tongue size, nasal resistance, and pharyngeal shape do not normalize when a patient loses weight. The things we see daily as dentists—such as retrognathia and high-arched palates, long soft palates, or narrow lateral pharyngeal walls—may continue to obstruct the airway even after weight loss.
GLP-1 medications offer some benefits and can be part of a treatment plan—but they are rarely the entire plan. Rather than being seen as a cure-all, weight-loss medications should be part of a broader long-term treatment plan. Even when a patient’s diagnosis changes from severe OSA to mild OSA, symptom management remains important. In fact, improvements in disease severity make additional treatment options viable. This presents a huge opportunity to help more patients through dental sleep medicine.
For example, the SURMOUNT-OSA study showed that about 50% of patients who were initially dependent on CPAP no longer needed it after one year of treatment with tirzepatide.5 In cases such as these, oral appliance therapy (OAT) could provide an effective, more lifestyle-friendly treatment option when prescribed in collaboration with AADSM Qualified Dentists.
At the end of the day, patients want a treatment plan that is effective and non-intrusive. It is one of the biggest reasons for and benefits of OAT. Patients with OSA who are appropriate candidates for OAT can benefit from this modality because of its convenience, adjustability, comfort, and efficacy.
Specifically, in patients using GLP-1 medications for weight loss, improvements in sleep and cardiometabolic physiology may further enhance overall treatment outcomes. As these patients transition to lower weight categories, adherence to treatment remains critical in reducing residual OSA risk. OAT can provide these patients with a device that is effective, comfortable, and easy to use. Dental sleep medicine will continue to play an important and active role in the management and treatment of OSA, especially as OAT can be used alone or in combination with other therapies to achieve optimal results.
The Increasing Role of Dental Sleep Medicine
The rapid expansion of GLP-1 receptor agonist therapy—particularly agents such as semaglutide and tirzepatide—has reshaped obesity management and introduced a new dimension to OSA care.
With the U.S. Food and Drug Administration’s approval of tirzepatide (Zepbound) for moderate-to-severe OSA in adults with obesity in 2024, dental sleep medicine now intersects directly with pharmacologic therapy. For members of the American Academy of Dental Sleep Medicine (AADSM), this represents a strategic opportunity for structured collaboration—not competition.
AADSM clinicians should proactively engage obesity medicine physicians, endocrinologists, primary care providers, and sleep specialists through formal co-management protocols. Shared data—baseline AHI, BMI, weight trajectory, objective OAT adherence, and follow-up sleep testing—enhances longitudinal outcome tracking and cardiometabolic risk assessment. Importantly, significant weight loss may alter appliance fit and titration requirements, warranting scheduled reassessment.
Residual OSA is common even after substantial weight reduction, reinforcing the ongoing role of dental sleep medicine. By positioning OAT as a complementary structural therapy within a broader metabolic framework, AADSM members can strengthen interdisciplinary credibility and improve comprehensive patient outcomes.
By Kevin Wallace, DMD, DABDSM
Source SleepWorld Magazine March/April 2026
Kevin Wallace, DMD, DABDSM, has been a dentist for more than 30 years. He began specializing in treating patients with OSA in 2010. Dr. Wallace is an at-large board member of the AADSM and chair of the Presidential Committee on Emerging Issues in Dental Sleep Medicine.
References
- Tsipas S, Khan T, Loustalot F, et al. Spending on glucagon-like peptide-1 receptor agonists among US adults. JAMA Netw Open. 2025;8;(4):e252964.
- KFF Health Tracking Poll: Prescription Drug Costs, Views on Trump Administration Actions, and GLP-1 Use. Kaiser Family Foundation. Accessed January 30, 2026. https://www.kff.org/public-opinion/kff-health-tracking-poll-prescription-drug-costs-views-on-trump-administration-actions-and-glp-1-use/.
- Jehan S, Zizi F, Pandi-Perumal SR, et al. Obstructive sleep apnea and obesity: Implications for public health. Sleep Med Disord. 2017;1(4):93-9.
- Boers E, Barrett MA, Benjafield AV, et al. Projecting the 30-year burden of obstructive sleep apnoea in the USA: A prospective modelling study. Lancet Respir Med. 2025;13:1078-86.
- Malhotra A, Grunstein RR, Fietze I, et al. Tirzepatide for the treatment of obstructive sleep apnea and obesity: the SURMOUNT-OSA phase 3 trial. N Engl J Med. 2024;390(23):2218-30.
