Prospective changes in sleep quality and depressive symptom burden following initiation of GLP-1-based therapies in patients with obesity: a real-world study.

PURPOSE: This study aimed to evaluate short-term changes in depressive symptom burden and sleep quality and factors associated with clinical response in patients with obesity initiating GLP-1-based therapies. METHODS: In this prospective observational study, patients with obesity initiating semaglutide or tirzepatide were enrolled. Depressive symptom burden and sleep quality were assessed at baseline and month 3 using the Patient Health Questionnaire-9 (PHQ-9) and Pittsburgh Sleep Quality Index (PSQI), respectively. Clinically significant depressive symptom burden was defined as PHQ-9 ≥ 10 and poor sleep quality as PSQI > 5; clinical response was defined as reductions of ≥ 5 PHQ-9 points and ≥ 3 PSQI points. Multivariable logistic regression models evaluated factors associated with each response. RESULTS: A total of 78 patients were included (tirzepatide n = 52; semaglutide n = 26). Median PHQ-9 decreased from 10.0 (7.0-14.0) to 6.0 (4.0-8.0), and the prevalence of PHQ-9 ≥ 10 declined from 55.1% to 11.5% (both p < 0.001). Median PSQI decreased from 6.0 (5.0-8.75) to 3.0 (2.0-4.0), and the prevalence of PSQI > 5 declined from 55.1% to 16.7% (both p < 0.001). In multivariable models, higher baseline PHQ-9 and younger age were associated with depressive symptom response, whereas higher baseline PSQI and greater improvement in depressive symptoms were associated with sleep response. Percentage weight loss and treatment type were not significantly associated with either response. CONCLUSION: In this prospective real-world cohort of patients with obesity, initiation of GLP-1-based therapy was followed by clinically meaningful short-term improvements in depressive symptom burden and sleep quality.