Korean sleep medicine experts have formally incorporated glucagon-like peptide-1 receptor agonists into clinical guidelines for managing obesity in obstructive sleep apnea patients, marking a significant shift toward pharmacological weight management in sleep disorders. The multidisciplinary panel developed eight evidence-based statements emphasizing that weight loss improves apnea-hypopnea index, symptom severity, and cardiometabolic markers while potentially reducing reliance on continuous positive airway pressure therapy.
This represents a pragmatic acknowledgment that lifestyle interventions alone often prove insufficient for the substantial weight loss needed to meaningfully impact sleep-disordered breathing. The integration of GLP-1 agonists like semaglutide and tirzepatide into sleep medicine protocols reflects their demonstrated efficacy for sustained weight reduction, often exceeding 15-20% of body weight. However, the guidelines maintain a hierarchical approach, positioning medications as second-line therapy after structured lifestyle interventions fail. The recommendation for bariatric surgery in severe, treatment-resistant cases aligns with mounting evidence that substantial weight loss can essentially cure mild-to-moderate OSA in many patients. This guideline may accelerate adoption of comprehensive weight management approaches in sleep medicine, though cost considerations and long-term safety data for these newer agents remain important clinical considerations.