Ep. 291 Integrating GLP-1s in Obesity & OSA Management with…

About this episode

Which patients with obstructive sleep apnea are candidates for a GLP-1, and how do you start, escalate, and monitor one safely? On this episode of BackTable ENT & Allergy, host Dr. Gopi Shah is joined by obesity medicine specialist Dr. Shanail Berry and sleep specialist Dr. John Carter to discuss the practical questions that arise when adding GLP-1 and GLP/GIP therapies in OSA management. They discuss drug mechanisms and formulations, patient selection, screening and referral, management of side effects and contraindications, adherence strategies, perioperative considerations, and nutritional issues. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:18 - The Overlap Between Obesity and Sleep Apnea 04:02 - GLP-1 Medications: Basics and History 05:52 - Dual and Triple Agonists in Development 08:56 - Clinic Evaluation and Team-Based Referrals 14:18 - Navigating Insurance Coverage 17:28 - Key GLP-1 Trials in OSA 18:25 - Results from SURMOUNT-OSA 26:31 - Integrating CPAP and GLP-1 Therapy 37:35 - Moving Beyond AHI: New Assessment Metrics 40:40 - Safety, Perioperative Risks, and Sarcopenia 50:16 - Wrap-Up --- More about this episode The discussion also addresses the challenges of long-term GLP-1 therapy, including insurance barriers, prior authorizations, dose escalation, and common side effects. The doctors review when to reassess OSA after starting treatment, the growing importance of hypoxic burden beyond AHI, and strategies to prevent sarcopenia during weight loss. Throughout, they emphasize a multidisciplinary approach and the evolving landscape of OSA care in the era of GLP-1 therapies. --- Resources SCALE Study https://pubmed.ncbi.nlm.nih.gov/26132939/ SURMOUNT-OSA Trial https://pubmed.ncbi.nlm.nih.gov/38547961/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app