Pharmacotherapy Reshapes Obstructive Sleep Apnea Management Toward Endotype-Driven Care

This narrative review consolidates the mechanistic rationale and current trial evidence for drug therapy in obstructive sleep apnea, with particular relevance to obesity pharmacists managing incretin-based agents now approved for this indication.

tirzepatideGLP-1 receptor agonistsGIPincretinsultiameacetazolamideatomoxetinereboxetineoxybutyninaroxybutyninAD109eszopicloneSGLT-2 inhibitorsobstructive sleep apneaobesitynarrative reviewendotypeCPAPCOMISA Endocrinology / Diabetes / Obesity

Background Information

New drug options show promise for improving sleep apnea treatment beyond CPAP.

Obstructive sleep apnea (OSA) affects many people and current treatments like continuous positive airway pressure (CPAP) have low adherence due to discomfort, prompting the need for new pharmacological options. Promising drug classes for OSA include upper-airway dilator activators, respiratory stabilizers, anti-inflammatory drugs, and metabolic modulators such as glucagon-like peptide-1 receptor agonists. This review highlights the shift towards personalized, drug-based OSA treatments, emphasizing the need for additional studies to evaluate their long-term effectiveness and integration into patient care. Pharmacotherapy is emerging as a promising alternative for obstructive sleep apnea, focusing on phenotype-driven approaches.

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Authors: Zhou R, Yin G, Zhu Y, Sun Y

Citation: Zhou R, Yin G, Zhu Y, et al. Pharmacotherapy for Obstructive Sleep Apnea: From Pathophysiology to Emerging Treatments. Journal of clinical medicine. 2026;15(16). doi:10.3390/jcm15166473

Article Links: PubMed · Journal / DOI

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Executive Summary

Study Design

Patient Population

Primary Outcomes

Secondary Outcomes & Safety Profile

Pharmacist Implications

Clinical Pearls

Limitations

Controversies & Evidence Gaps

Cost & Logistics

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