0619 Depression and Treatment Use in Patients with Obstructive Sleep Apnea on Glucagon-Like Peptide 1 Receptor Agonists

Abstract Introduction Depression and obesity are both prevalent among patients with obstructive sleep apnea (OSA). Treating OSA has been shown to improve depressive symptoms. Routine treatment for OSA often includes positive airway pressure (PAP) therapy combined with weight management strategies, including glucagon-like peptide 1 receptor agonists (GLP-1s), which have been approved to treat type 2 diabetes (T2D) and obesity. Little is known about the relationship between GLP-1 use and OSA and depression treatment patterns, or how these may be affected by depression status and gender. Methods Administrative insurance claims from 2014-2023 for adult patients with OSA who filled a GLP-1 prescription with ≥1 year of enrollment before and after the first recorded GLP-1 fill (index date) were analyzed. Depression was defined based on ICD-10 diagnosis codes within the year prior to index. Antidepressant use and OSA treatment in the year pre- and post-index were described. Results Of 151,529 patients included (mean age 54.3 years; 48.9% female), 26.3% had depression prior to index. Those with depression were more often women (66.2% vs 42.8%). Prevalence of Medicaid insurance (40.9%) and class III obesity (65.7%) was highest among women with depression, compared to men or those without depression. T2D was common (85.7% overall), with higher prevalence among men. Prior to index, approximately 53% of women and 56% of men had evidence of PAP therapy; this decreased slightly to approximately 48% and 51%, respectively, in the year after index, regardless of depression status. Among patients with depression, prevalence of ≥1 antidepressant prescription was consistent pre- and post-index, but higher among women than men in both periods (pre: 86.0% vs 81.0%; post: 86.0% vs. 80.4%). In the year after index, approximately 41% of women and 39% of men discontinued GLP-1s, regardless of depression status. Conclusion Among patients with OSA starting GLP-1 therapy, prevalence of PAP-related claims were similar in patients with and without depression and by gender. Antidepressant use remained consistent among men and women with depression. Future research should evaluate the impact of GLP-1 use on treatment patterns by indication (T2D or obesity/overweight). Support (if any) ResMed