Tirzepatide, sold as Mounjaro and Zepbound, is a medication for type 2 diabetes and weight management. Obstructive sleep apnea (OSA) is a common sleep disorder marked by repeated breathing interruptions. Research shows a connection between tirzepatide and improved OSA, offering a new treatment avenue for this condition.
The Link Between Obesity and Sleep Apnea
The link between excess body weight and obstructive sleep apnea is primarily mechanical. Increased fat deposits in the neck can narrow the upper airway, reducing its size and increasing the likelihood of it collapsing during sleep. The tongue can also accumulate fat, contributing to this obstruction.
Beyond the neck, excess fat in the abdominal area plays a role. This central adiposity can decrease lung volume by putting pressure on the chest wall and diaphragm. This pressure reduces the downward traction that helps keep the upper airway open. This combination establishes why individuals with obesity are at a higher risk for developing OSA.
How Tirzepatide May Improve Sleep Apnea
Tirzepatide is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist. By activating these hormone receptors, the medication helps regulate blood sugar, reduce appetite, and slow stomach emptying. These actions collectively lead to a significant reduction in body weight.
The primary way tirzepatide improves sleep apnea is through this weight loss. Reducing fat tissue, including deposits around the neck and in the tongue, lessens the physical obstruction of the upper airway. This relieves the pressure that causes the airway to collapse during sleep. Researchers are also exploring secondary mechanisms, but weight reduction remains the most understood driver of its benefits for OSA.
Clinical Trial Findings
The most significant evidence for tirzepatide’s effect on sleep apnea comes from the SURMOUNT-OSA clinical trials. These studies measured sleep apnea severity using the Apnea-Hypopnea Index (AHI), which counts the number of times per hour a person’s breathing pauses or becomes very shallow. A higher AHI score indicates more severe sleep apnea. The trials involved two main groups of participants with obesity and moderate-to-severe OSA.
One study focused on individuals not using continuous positive airway pressure (CPAP) therapy. After 52 weeks, those taking tirzepatide saw their AHI score decrease by an average of 27.4 events per hour, compared to a reduction of just 4.8 events for those on a placebo. This was a 55% reduction in AHI for the tirzepatide group versus 5% for the placebo group.
A second study examined patients who were already using and planned to continue CPAP therapy. Patients receiving tirzepatide experienced an average AHI reduction of 30.4 events per hour, while the placebo group saw a reduction of 6.0 events per hour. This was a 62.8% decrease in AHI for the treatment group compared to a 6.4% for the placebo group, alongside an average body weight reduction of 20.1%.
Tirzepatide as a Potential Treatment Option
These clinical findings position tirzepatide as a new therapeutic option for managing obstructive sleep apnea, particularly for individuals with obesity. It presents a valuable alternative for patients who have difficulty with CPAP therapy, the current standard of care. The medication can serve as a complementary treatment to enhance CPAP’s effectiveness or, in some cases, as a standalone therapy.
For some patients, the improvements were so substantial that their OSA was considered resolved. Based on the SURMOUNT-OSA trial data, the U.S. Food and Drug Administration (FDA) approved Zepbound (tirzepatide) for treating moderate-to-severe OSA in adults with obesity. This makes it the first drug specifically approved for this condition.