Abstract Background Sleep-disordered breathing (SDB) describes a range of conditions characterized by abnormal breathing patterns during sleep. Despite advancements in treating SDB, particularly obstructive sleep apnea (OSA), challenges like adherence issues highlight the need for more convenient and effective therapeutic options. SGLT2 inhibitors have recently attracted attention as increasing evidence suggests their potential broader benefits relevant to sleep apnea. Purpose This study aimed to evaluate the impact of SGLT2 inhibitors on patients with SDB by analyzing results from clinical trials. Methods A systematic electronic search was conducted across Embase, PubMed, Scopus, Web of Science, and ClinicalTrials.gov databases. The search included studies published up to October 31, 2024. Eligible studies included clinical trials involving any patient population that compared SGLT2 inhibitors with a control group. Study quality was assessed using the Cochrane Risk of Bias tools (ROB2 and ROBINS-1). Data synthesis was accomplished using narrative summaries, forest plots, and random-effects meta-analysis. Results Nine clinical trials comprising 15,529 patients met the eligibility criteria. A meta-analysis of two RCTs showed that SGLT2 inhibitors significantly reduced OSA incidence by 53% (RR: 0.53, 95% CI: 0.35, 0.80, p = 0.003). The intervention group demonstrated significant improvements in Apnea-Hypopnea Index (AHI) (SMD: 0.86, 95% CI: 0.52, 1.21, p 0.001) and Epworth Sleepiness Scale (ESS) scores (SMD: 0.45, 95% CI: 0.12, 0.78, p = 0.008). Two RCTs assessing minimum SpO₂ levels showed a trend toward improvement, though results were not statistically significant (SMD: 0.13, 95% CI: -0.20, 0.46, p = 0.444). An analysis of three RCTs indicated that SGLT2 inhibitors significantly reduced BMI compared to the placebo group (SMD: 0.30, 95% CI: 0.04, 0.55, p = 0.023). Conclusion Our results demonstrated that patients treated with SGLT2 inhibitors experienced a significant decrease in both the occurrence and severity of OSA, as measured by AHI and ESS, compared to those in the placebo group. Although oxygen levels showed no significant changes, the improvements in OSA-related metrics suggest that SGLT2 inhibitors could be promising as a potential therapeutic strategy for OSA prevention and management.
Ebrahimi et al. (Sat,) studied this question.