Obstructive sleep apnea (OSA) affects approximately 39 million adults in the United States and an estimated 936 million adults worldwide. This condition can severely disrupt sleep and overall health. Recently, Tirzepatide, a medication originally developed for type 2 diabetes and also used for weight loss, has shown promise in treating OSA. Research suggests that this drug could be a breakthrough for many who struggle with sleep apnea due to its ability to reduce weight, a major contributing factor to the condition.

In this article, you will discover how Tirzepatide works against sleep apnea, learn about the latest studies supporting its use, and understand the potential benefits and considerations for those considering this treatment.

Key Takeaways

  • Tirzepatide, initially developed for type 2 diabetes and weight management, shows promise in treating obstructive sleep apnea (OSA) by significantly reducing the Apnea-Hypopnea Index (AHI) in adults with obesity, improving sleep quality and overall health.
  • The drug belongs to the glucagon-like peptide-1 (GLP-1) receptor agonist class. It functions by mimicking a natural hormone that helps regulate blood sugar and appetite, thereby aiding in weight loss—one of the primary contributing factors to sleep apnea.
  • In clinical trials, Tirzepatide demonstrated notable effectiveness in reducing sleep apnea severity in both individuals using Positive Airway Pressure (PAP) therapy and those not using it, with significant weight loss observed across studies.
  • Despite its potential, Tirzepatide is not yet approved specifically for treating sleep apnea. These findings are based on early phase 3 trials, indicating the need for further research to draw definitive conclusions.
  • Tirzepatide addresses the root cause of sleep apnea for many patients by aiding in weight reduction, offering a potentially transformative approach to managing a condition traditionally treated with devices like CPAP machines or lifestyle changes.

What is Tirzepatide?

Tirzepatide is a medication developed by Eli Lilly that is currently used for treating type 2 diabetes and weight management in adults. It goes by the brand names Zepbound and Mounjaro. These drugs are known as glucagon-like peptide-1 (GLP-1) receptor agonists, meaning they mimic the effects of a natural hormone involved in regulating blood sugar and appetite.

What is Sleep Apnea?

woman frustrated in bed with snoring husband

Sleep apnea is a disorder where regular breathing is interrupted or obstructed during sleep. Some key points about sleep apnea:

  • It involves repeated pauses or cessations in breathing during sleep. People with sleep apnea stop breathing repeatedly throughout the night.
  • These breathing pauses can last 10 to 30 seconds, usually followed by a loud snort or gasp when breathing restarts. This cycle of stopping/starting breathing repeatedly disrupts sleep.
  • Sleep apnea is linked to serious health issues affecting the heart, kidneys, and metabolic system if left untreated.
  • The most common type is obstructive sleep apnea, where the upper airway becomes blocked or narrowed during sleep, causing interruptions in breathing.
  • Risk factors include obesity, having a thick neck, being male, and getting older. The condition becomes more prevalent with age.
  • Many people with sleep apnea use a CPAP (continuous positive airway pressure) machine at night to open their airways and allow normal breathing during sleep.

The severity of sleep apnea is measured by the number of events per hour, often referred to as the Apnea-Hypopnea Index (AHI):

  • 30 or more hourly events are considered severe sleep apnea
  • 15 to 29 events per hour is moderate sleep apnea
  • 5 to 14 events per hour is mild sleep apnea
  • Less than 5 events per hour is minimal/normal

The AHI quantifies how frequently a person experiences apnea (complete cessation of airflow) or hypopnea (partial obstruction of airflow) events during sleep. The higher the number of events per hour, the more severe the sleep apnea.

Can Tirzepatide Help with Sleep Apnea?

Box of Mounjaro

Tirzepatide has shown promising results in reducing the severity of sleep apnea in adults with obesity and moderate-to-severe obstructive sleep apnea (OSA), both in individuals using Positive Airway Pressure (PAP) therapy and those not using it. In two phase 3 clinical trials, tirzepatide significantly reduced the Apnea-Hypopnea Index (AHI), which measures the frequency of apneas and hypopneas per hour of sleep.

In the first study involving participants not on PAP therapy, tirzepatide led to a mean AHI reduction from baseline of 27.4 events per hour, corresponding to a 55.0% reduction. The placebo group in this study saw a reduction of 4.8 events per hour or 5.0%. In the second study, which included participants continuing their PAP therapy, tirzepatide achieved a mean AHI reduction from baseline of 30.4 events per hour, equating to a 62.8% reduction, compared to 6.0 events per hour reduction (6.4%) for placebo.

Additionally, significant weight loss was observed in tirzepatide-treated patients across both studies, nearly 20% from baseline, further supporting its efficacy. These results indicate that tirzepatide not only reduces sleep apnea severity but is also effective in patients who are and are not using PAP therapy.

Remember

  • These are early findings from phase 3 trials.
  • Tirzepatide is not yet approved for treating sleep apnea.
  • More research is needed before definitive conclusions can be drawn.

How Does Tirzepatide Work for Sleep Apnea?

Tirzepatide works for sleep apnea by addressing the underlying cause, which is obesity, rather than just treating the symptoms. Here’s how it helps:

Obesity is a major risk factor for obstructive sleep apnea, as excess weight, especially around the neck area, can narrow the airways and make it more difficult to breathe during sleep. When someone is overweight or obese, the extra soft tissue in the throat can collapse and block the airway, leading to the breathing interruptions that characterize sleep apnea.

Tirzepatide is a medication that promotes weight loss by mimicking the effects of certain hormones involved in regulating appetite and metabolism. By helping people lose a significant amount of weight (around 20% in the clinical trials), tirzepatide can reduce the fatty deposits and soft tissue buildup around the upper airway, effectively relieving the obstruction that causes sleep apnea.

With less excess weight and reduced tissue crowding the airway, the throat is less likely to collapse during sleep, allowing for better airflow and fewer breathing disruptions. The weight loss achieved with tirzepatide can potentially alleviate the severity of sleep apnea or even resolve the condition in some cases, depending on the individual’s circumstances.

This approach of targeting the underlying cause (obesity) through weight loss differs from the current standard treatment for sleep apnea, which is continuous positive airway pressure (CPAP) therapy. While CPAP machines are effective in keeping the airways open and improving breathing during sleep, they do not address the root cause of the obstruction. By promoting weight loss, tirzepatide tackles the problem at its source, potentially providing a more sustainable solution for obese individuals with sleep apnea.

What Are the Potential Side Effects?

In the clinical trials for tirzepatide, as detailed in the SURMOUNT-OSA studies, the most commonly reported adverse events were gastrointestinal-related and generally mild to moderate in severity. Specifically, participants frequently experienced diarrhea, nausea, vomiting in Study 1 and diarrhea, nausea, and constipation in Study 2. These findings highlight the side effect profile observed during the trials, which aligns with those previously reported in other SURMOUNT and SURPASS trials involving tirzepatide.

When Will Tirzepatide Be Available for Sleep Apnea?

According to Eli Lilly, the company plans to submit the data on tirzepatide for treating obstructive sleep apnea to the U.S. Food and Drug Administration (FDA) for approval consideration in mid-2024.

As for the potential timeline for FDA approval and availability, it typically takes several months for the agency to review a new drug application or supplemental application for a new indication. The review thoroughly evaluates the clinical trial data, manufacturing information, and proposed labeling.

If the FDA’s review goes smoothly and they find the data supporting tirzepatide’s use for sleep apnea sufficient, approval could come by late 2024 or early 2025. However, it’s important to note that the timeline can vary and may be extended if the FDA has additional questions or requires further information from the company.

Once the FDA approves the sleep apnea indication, Eli Lilly would likely work to make tirzepatide available through pharmacies and healthcare providers relatively quickly, potentially within a few months of the approval date.

It’s worth mentioning that tirzepatide is already approved and available under the brand names Mounjaro for diabetes and Zepbound for obesity/weight management. However, its specific use for treating obstructive sleep apnea would require a separate FDA approval, which the company is pursuing based on the promising clinical trial results.

Of course, these are just estimates based on typical FDA review timelines, and the actual approval and availability dates may differ. For more precise information as the process unfolds, it is advisable to follow updates from Eli Lilly and medical authorities.

Final Thoughts

Who might benefit most from Tirzepatide treatment for sleep apnea?

Adults with moderate-to-severe OSA and obesity may benefit significantly from Tirzepatide treatment.

Can Tirzepatide be used alongside PAP therapy?

Yes, the trials included participants using PAP therapy, and Tirzepatide was also effective in these cases.

Is tirzepatide currently approved to treat sleep apnea?

No, tirzepatide is not currently approved for treating sleep apnea. The study results are promising, but further research is needed before widespread use.

How long do the effects of Tirzepatide last on sleep apnea?

The studies measured effects over a period of 52 weeks, showing sustained benefits throughout this time.

Can Tirzepatide replace PAP therapy?

While Tirzepatide shows promise, it is not currently recommended to replace PAP therapy without professional medical advice.

What medications can make sleep apnea worse?

Several medications can make sleep apnea worse, including barbiturates, benzodiazepines, some beta-blockers, opioids, sildenafil (an erectile dysfunction drug), testosterone, and drugs that cause weight gain.

Can weight loss cure sleep apnea?

No, there is no cure for sleep apnea, but weight loss may help reduce symptoms of obstructive sleep apnea in some people.

What are the disadvantages of Tirzepatide?

Some of the side effects of Tirzepatide include difficulty in breathing or swallowing, fast heartbeat, gaseous stomach pain, heartburn, recurrent fever, skin itching, rash, or redness, stomach fullness, and swelling of the face, throat, or tongue.

Who should not take Tirzepatide?

Tirzepatide should be avoided by people with a personal or family history of medullary thyroid carcinoma, as well as patients with a history of MEN 2 (multiple endocrine neoplasia syndrome type-2).

How long should you take Tirzepatide?

Tirzepatide is injected under the skin once a week (every 7 days). Keep taking it unless your healthcare provider tells you to stop.

Sources

Eli Lilly and Company. (2024, April 17). Tirzepatide Reduced Sleep Apnea Severity by Up to Nearly Two-Thirds in Adults with Obstructive Sleep Apnea (OSA) and Obesity. [Press release]. PR Newswire. https://www.prnewswire.com/news-releases/tirzepatide-reduced-sleep-apnea-severity-by-up-to-nearly-two-thirds-in-adults-with-obstructive-sleep-apnea-osa-and-obesity-302118929.html

Bednarik, J., Chakladar, S., Dunn, J. P., Weaver, T., Grunstein, R., Fietze, I., Redline, S., Azarbarzin, A., Sands, S. A., Schwab, R. J., & Bunck, M. C. (2024, March 26). Tirzepatide for the treatment of obstructive sleep apnea: Rationale, design, and sample baseline characteristics of the SURMOUNT-OSA phase 3 trial. Contemp Clin Trials. Advance online publication.https://pubmed.ncbi.nlm.nih.gov/38547961/